Involuntary childlessness: A neglected problem in poor-resource areas

Abstract

Childlessness is analysed on the individual, the national and the international level. On the individual level five categories of consequences are described: grief and sadness; social isolation and stigma; restricted rights; religious effects and economic aspects. The first category concerns individual feelings and the others are socio-cultural effects in broad-sense. In developing countries childlessness has consequences on individual and socio-cultural level. In the West consequences are mostly restricted to individual feelings. In poor-resource areas there are limited possibilities for modern biomedical treatment. Traditional medicine, with its easy access and cultural acceptation, is a serious 'competitor'. On the national level there are few incentives and possibilities for development of adequate infertility treatment. Though local and national authorities might be sensitive to the problem, allocation of funds is mostly determined by international agencies, which consider other issues more important. On the international level Western perceptions about the urgency of health issues are still dominant. In the Western world there is little interest and understanding in the problem of 'barrenness among plenty' because a focus on population growth reduction and on other problems. Also, the perception of childlessness as an individual problem, makes it difficult to change this attitude. Possibilities for change are discussed. © The Author 2008. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved.