The Agony Of Many Living Without A Child

The Agony Of Many Living Without A Child                       First Lady Rebecca Akufo-Addo and Dr. Rasha Kelej

Mawuli Quainoo began life expecting to give birth to children of her own. Like her mother, she desired to have a family; she, her husband and children. And so when she got married, her wish was that she would bear children for her husband, as is the expectation of her culture.
“Coming from a family that cherishes giving birth, not being able to get pregnant for my husband made me feel less of a woman,” she reveals. 
“It is not easy seeing your siblings having children of their own but you are barren,” she adds.
A few years ago, Mawuli, now in her late thirties, started experiencing frequent blood discharge from her vagina and went to the hospital where she was medically attended to.
“I use to bleed for six months continuously so I went to the doctor and he told me I had fibroid and that I needed to be operated to remove it,” she indicates.
Mawuli had to undergo two more medical procedures at the health facility to address her medical condition. But her life changed after the last operation. 

Her condition improved after the third operation with the frequent blood flow ceasing but Mawuli could not conceive. After several trips to the doctor's office to try and get medical help to conceive, she was advised to look at the option of adopting a child.
“I have tried using all that I know can help me conceive, including herbal treatment, but I cannot conceive but I also want a child,” she adds with desperation on her face.
Infertility
Most people will have the strong desire like Mawuli to conceive a child at some point during their lifetime, but like World Health Organization (WHO) data shows, more than 180 million couples in developing countries, implying one in every four couples suffer from primary or secondary infertility.
Most couples (approximately 85 per cent) will achieve pregnancy within one year of trying, with the greatest likelihood of conception occurring during the earlier months. Only an additional seven per cent of couples will conceive in the second year. 

As a result, infertility has come to be defined as the inability to conceive within 12 months. This diagnosis is, therefore, shared by 15 per cent of couples attempting to conceive.
In Africa, infertility is caused by infections in over 85 per cent women, compared to 33 per cent worldwide.
It can be attributed to some traditional, cultural and religious practices, combined with low resources environment are associated with higher levels of non-genetic and preventable causes of infertility like poor nutrition, untreated sexually transmitted diseases, unsafe abortions and infections.
Data shows that about half of the cause of infertility are or include male factor.
Stigma
Although infertility does not affect only women, they are the target of blame for a childless family transforming from an acute private distress into a harsh public stigma with complex and devastating consequences.
In some cultures, inability to have a child or to become pregnant can result in being greatly isolated disinherited or assaulted. 


For Mawuli, her husband going to have a child with another woman was the hardest part of her childlessness.
“He was advised to look for a child outside the marriage and he has started another family with another lady who has given him a child. I would have stayed with him if he had the problem because we have come a long way but because it is me he has looked for someone else,” Mawuli says.
The hardest part of being unable to get pregnant is the social stigma for childlessness, especially for married infertile women.
The situation has affected her so much that she sometimes hides herself when she sees her friends in town, just so she could avoid the obvious question of when are you getting pregnant?
Mawuli says living without a child of her own is very difficult. “When you send someone's child they refuse to go but there is nothing you can do about it after all she or he is not your child. I think about it a lot because I still cannot understand why such a thing is happening to me.”
'Merck More Than A Mother'
The consequences of infertility are much more dramatic in developing countries, thus, an initiative to address the stigma and empower infertile women through access to information, education and health and by changing mindsets is timely.
'Merck More Than A Mother' initiative of the Merck Foundation, a philanthropic organisation, recently launched its activities in Ghana to support government in defining policies to enhance access to regulated, safe and effective fertility care. 


This powerful initiative also has interventions to break the stigma around infertile women and raise awareness about infertility prevention and management.
Dr. Rasha Kelej, CEO of Merck Foundation & President, Merck More Than A Mother, says the campaign will partnership academia, ministries of health and international fertility societies, and provide medical education and training for healthcare providers and embryologists to build and advance fertility care capacity in Africa and developing countries.
“With 'Merck More Than A Mother', we have initiated a cultural shift to de-stigmatize infertility on all levels: By improving awareness, training the skills of local experts, building advocacy in cooperation with decision makers and by supporting childless women in starting their own small business.
It's all about giving every woman the respect and the help she deserves to live a fulfilling life, with or without a child,” she adds.
Merck Foundation is making history in many African countries where they never had fertility specialists or specialised fertility clinics before 'Merck More Than A Mother' intervention to train the first fertility specialists such as in Sierra Leone, Liberia, The Gambia, Niger, Chad, Guinea, Ethiopia and Uganda.
First Lady of Ghana, Rebecca Akufo-Addo, was made the ambassador of the campaign in Ghana with her charity organisation, The Rebecca Foundation, leading the implementation of activities. 


Already, a special meeting with more than 100 Ghanaian infertile women has been held to identify their needs and challenges and work on a concrete strategy to break the stigma of infertility through art, media as an effective tool to raise awareness about this sensitive topic.
“We must stop the practice where women are blamed for infertility although half the time, infertility is due to the men. We need to encourage men to discuss their infertility and know that fertility is a shared responsibility,” she says.
The Rebecca Foundation has already taken up the case of Mawuli and will be offering her free fertility treatment so she can be the mother she most desires.
“God bless her for taking up my case,” Mawuli responds to the call for help.
“I don't how I will feel if one day I also carry my own baby at my back,” she adds with anticipation.