The pain of barrenness

For years, Nyevu Watsuma longed to hold her own baby in her arms. Not even innumerable visits to witchdoctors and their uncountable prescriptions — roots and barks of trees — could solve her fertility problems.

Now, after five decades, the 60-year-old woman from a small village in Kilifi District has finally resigned herself to her fate of being childless; she has accepted that her dream of having her own child was just a mirage.

But Nyevu is lucky because her husband, Katana Mathu, did not throw her out for her manifest fault of failing to have children. She is aware of this fact, and grateful that she is married to this man.

The Mijikenda, among whom the dead are revered, special importance is attached to children, right next to elders.

Nyevu says it is God’s will that she could not get children. She is grateful that her husband stood by her.

“When we realised that we were not getting children after 30 years, Nyevu asked me to marry another wife because we were growing old,” Katana told DN2 at their home in Kilifi.

“I married Kadzo Waluri and together we have 10 children, five of whom have died. I believe children are important because they carry the family name forward. But I cannot humiliate my wife for not bearing children,” Katana said.

Although among the Mijikenda, marriage and procreation are inseparable, Katana says the pressure to get children became apparent as his peers became fathers and later grandparents.

But he refused to bow to the pressure of ridicule and incessant questions. He said the love between him and his wife helped them weather the pressure during the 40 years they tried to get a child.

“When I was a young man, I heard about this beautiful long-necked girl in an area called Mlima wa Ndege and that no one could pay the dowry her parents were asking for,” recalls Katana.

“I worked hard and after three months, I paid six cows and one bull to her father and married her. It is painful that Nyevu and I cannot get children, but that is God’s will,” says Katana.

Nyevu remembers her travail in her efforts to conceive.

“I ate both raw and cooked herbs, avoided salt, kept away from milk, following the instructions of witchdoctors. Some of the treatments made me bleed. My stomach hurt for hours on end, especially after ingesting some bitter herbs,” she recalls.

Eventually, a doctor at the Kilifi district hospital explained that it was not possible for her to conceive. Nyevu’s elder sister is also barren, but the siblings do not believe it is a curse.

Now that she has reached menopause, Nyevu does not desire children anymore and treats her co-wife’s children like her own.

Human rights activists have pitched spirited campaigns the world over to have childlessness accepted as an appropriate outcome of some women’s adult life.

Their argument that motherhood should not be the only valued position for a woman, that there is more to marriage than just having children has often fallen on barren ground.

Among the Chinese, for one to be considered an adult, one must have a child and having children increases the status of both men and women.

Among the Edo people of Nigeria, like most Africans, children are the perpetuators of the parents’ lineage, inherit property, give them security in their old age and assurance of social recognition, which allows them a befitting burial when they die.

Many explanations have been offered for infertility. Such women are believed to be cursed for their sins or those of their ancestors.

Barrenness is also viewed as the product of an “evil eye” or bewitchment, or explained away as the possession by some force that causes miscarriage and prevents the woman from carrying pregnancy to term.

In more recent times, some people blame infertility on a promiscuous earlier life. In most cases, it is usually the woman who is blamed for the absence of children.

There are many solutions prescribed for barrenness. Where the woman is believed to have offended spirits, she, the community, or her new family are required to make appropriate atonement.

Childlessness among the Igbo of Nigeria is a personal disgrace. It is also seen as a kind of slur on the community, a social fault, and often results in divorce or polygamy. In fact, the Igbo enter marriage on a provisional basis until the woman’s ability to bear children is established.

The man is encouraged to marry another wife, and the childless woman is expected to play a leading role in getting a fertile wife for her husband. This act of “generosity and largeness of heart” usually moves the man and saves her from being thrown out.

“Women who are unable to bear children are often disrespected and will not enjoy the same privileges and status as women with children,” says Dr Lukoye Atwoli, a consultant psychiatrist and lecturer at Moi University’s School of Medicine.

The perception that a family is not complete without children has robbed childless women of a place in society.

“In many communities, marriage is still regarded as being unsuccessful if there are no children to show for it,” says Dr Atwoli.

In most cases, the woman bears the brunt of the “failure” and man is often allowed to either get a second wife or to divorce the first wife and marry another one, he added.

Dr Atwoli noted that barrenness disadvantages couples and they are not regarded as being truly married until they get children.

Dr Gathari Ndirangu, a reproductive health specialist and technical adviser to the division of reproductive health, Kenyatta Hospital, defines infertility as failure to conceive after one year of regular unprotected sexual intercourse in a woman who is not breastfeeding.

According to Dr Ndirangu, infertility is common and affects approximately 10 to 15 per cent of all couples globally.

“In Kenya, the actual rate is not accurately known but is estimated to be between two and 20 per cent of all couples,” Dr Ndirangu noted.
Public health care facilities spend about 30 per cent of their time taking care of infertile women or couples.

Contrary to common belief, infertility is not confined to women.

“For every 10 couples with infertility, female causes account for four of them, male factors for two, and both male and the female factors for three couples,” notes Dr Ndirangu.

Men, says the doctor, are responsible for infertility in up to five out of 10 couples suffering from infertility.

A woman who wants children should consult her gynaecologist if she has not conceived after 12 months of regular unprotected sexual intercourse. Women aged 35 years and above should consult gynaecologists after six months of trying and failing to conceive.

In women, the most common cause of infertility is tubal damage from a previous infection of sexually transmitted disease, especially chlamydia.

Tumours of the pelvis, including uterine fibroids, may block the tubes. Other sexually transmitted microorganisms that cause tubal damage include gonococci, which cause gonorrhoea.

Infertility in men may result from poor sperm production due to abnormalities of the testes and excessive heat from varicocele (enlarged veins in the scrotum).

Occupations that result in excessive heat being transferred to the scrotum also cause barrenness. Particularly vulnerable to this risk are long-distance truck drivers or men who wear tight pants.

Infection in the male reproductive tract such as the epididymis, the testes, or the prostate may cause infertility. Tobacco smoking and hormonal abnormalities may interfere with sperm production, leading to male infertility.

Dr Ndirangu adds that upon diagnosis, the doctor will advise on the appropriate mode of treatment, which may vary from simple advice on how to increase chances of conceiving through use of mediation for the man, the woman, or both, surgical intervention in either partner, or advice on the use of assisted reproductive technology (ART) or even adoption.

“Prevention of infertility involves prevention of STIs, early recognition and treatment of STIs, and avoidance of smoking and excessive alcohol intake,” says Dr Ndirangu.