KNOWLEDGE, PERCEPTION, PSYCHO-SOCIAL EFFECTS AND COPING TECHNIQUES RELATING TO INFERTILITY AMONG WOMEN RECEIVING TREATMENT IN TERTIARY HOSPITALS IN IBADAN, NIGERIA

Abstract

Infertility-related challenges among women constitute a major reproductive health concern in Nigeria. The social stigma associated with infertility often place a psychological burden on infertile women and they in addition, suffer from all forms of discrimination and abuse including ostracisation from the community. Information on the knowledge, perception and coping techniques can inform interventions which can be used in addressing the burden of infertility. The study was therefore, designed to determine the knowledge, perception, psycho-social effects and coping techniques relating to infertility among women receiving treatment at Adeoyo Maternity Teaching Hospital and University College Hospital, Ibadan. The study was a cross-sectional survey which involved 300 consenting women with infertility that were receiving treatment at the gynaecological clinics of the two hospitals between April and June 2013. A semi-structured interviewer-administered questionnaire was used to elicit information relating to socio-demographic characteristics, knowledge, perception, psycho-social effects and coping techniques. A 16-point knowledge scale on infertility was used and the knowledge scores ≤ 5, > 5-10 and>10 were categorized as poor fair and good respectively. Data were analysed using descriptive statistics and Chi-square test at p=0.05 level of significance. Respondents mean age was 35.0±6.9 years and 91.0% were married. Forty-seven percent (47.0%) of the respondents had tertiary education. Seventy-seven percent (77.0%) had ever been pregnant, among whom 35.0% had ever had live births with at least one surviving child. Duration of delay in pregnancy among respondents was 6.6 ± 5.5 years. Respondents with primary infertility were 23.0% and secondary infertility 77.0%. Respondents knowledge score was 7.0 ± 4.1 and those with poor, fair and good knowledge were 25.7%, 46.3% and 28.0% respectively. Only 33.0% of the respondents had ever heard about In-vitro fertilisation. Most (86.3%) perceived that an infertile woman does not command respect in the society and majority (77.3%) perceived that the stigma associated with infertility could be as serious as infertility itself. The experienced psycho-social effects of infertility among respondents included suicidal ideations (91.6%); fear of marriage break-up (89.3%); recurrent thoughts of infertility (82.0%); worry about a future without a child (79.0%) and perceived worthlessness (40.0%). Techniques adopted for coping with infertility included faith in divine intervention (86.3%), preoccupying self with other meaningful activities (61.3%), dedication to job (60.7%). avoidance of discussing pregnancy related matters with people (45.7%), social withdrawal (42.0%), avoiding being with babies (23.7%). use of mood enhancing drugs (15.7%), and child adoption (6.3%). Significantly, more respondents who never had a child were verbally abused by spouses (50.0%) compared with those having at least one child (38.7%). Respondents' knowledge relating to infertility was inadequate. The experienced psycho-social effects and the perceived social stigmatisation associated with the condition constitute public health concerns. Patients education and counselling focusing on improving the knowledge, perception, coping techniques and reducing the psycho-social effects should be intensified among the infertile women.