Quest for Conception: Exploring Treatment Patterns Associated with Infertility in Ghana.

Due to the pronatalist orientation of the Ghanaian society and the social consequences of childlessness, infertile persons adopt several health seeking strategies in their bid to have their own children. This study therefore explored the health seeking behaviour of infertile Ghanaians and the factors that influence this behavior. The study adopted a qualitative research approach. Forty-five semi-structured in-depth interviews were used to collect data. The findings suggest that treatment seeking behaviour of infertile Ghanaians was motivated largely by perceived cause and belief in the efficacy of a treatment form. Two main treatment seeking patterns emerged from the data, hierarchical and concurrent treatment seeking behaviours. Although participants combined spiritual healing with either herbal or orthodox medicine, a combination of orthodox and herbal seemed inappropriate to them. The findings of this study should have implications for healthcare workers in general as the quest for biological parenthood and the treatment seeking behaviours employed by the infertile could be detrimental to the health of these individuals. For instance, the use of unregulated herbalists and itinerant herbal medicine sellers, as well as the over reliance on spiritual healing could have dire implications for health.

Racial and Ethnic Differences in the Utilization of Prayer and Clergy Counseling by Infertile US Women Desiring Pregnancy.

Religion can have a significant influence on the experience of infertility. However, it is unclear how many US women turn to religion when facing infertility. Here, we examine the utilization of prayer and clergy counsel among a nationally representative sample of 1062 infertile US women. Prayer was used by 74.8% of the participants, and clergy counsel was the most common formal support system utilized. Both prayer and clergy counsel were significantly more common among black and Hispanic women. Healthcare providers should acknowledge the spiritual needs of their infertile patients and ally with clergy when possible to provide maximally effective care.

Indigenous Healing Knowledge and Infertility in Indonesia: Learning about Cultural Safety from Sasak Midwives.

In this article I demonstrate what can be learned from the indigenous healing knowledge and practices of traditional Sasak midwives on Lombok island in eastern Indonesia. I focus on the treatment of infertility, contrasting the differential experiences of Sasak women when they consult traditional midwives and biomedical doctors. Women's and midwives' perspectives provide critical insight into how cultural safety is both constituted and compromised in the context of reproductive health care. Core components of cultural safety embedded in the practices of traditional midwives include the treatment of women as embodied subjects rather than objectified bodies, and privileging physical contact as a healing modality. Cultural safety also encompasses respect for women's privacy and bodily dignity, as well as two-way and narrative communication styles. Local understandings of cultural safety have great potential to improve the routine practices of doctors, particularly in relation to doctor-patient communication and protocols for conducting pelvic exams.

'The child that tiire doesn't give you, God won't give you either.' The role of Rotheca myricoides in Somali fertility practices.

The paper introduces the Baanashada Dumarka, a Somali fertility therapy carried out by a spirit medium, known locally as 'Alaqad. Baanashada is aimed at women whose fertility issues are believed to be caused by spirits. The study also explores a component of the Baanashada, namely, the use of tiire (Rotheca myricoides), or the butterfly bush. Although Rotheca myricoides is known to possess a number of medicinal components as confirmed by studies of modern science, so far, there exist no studies on its potential (or lack of) fertility effects. Hence, the alleged fertility benefits of the butterfly bush need examining. In 2008 a British Somali woman died of herbs placed in her cervix by a traditional healer in Somaliland. This piece of information indicated not only the role of herbal medicine in fertility practices, but also the popularity of traditional reproductive medicine beyond border, class or educational background. Yet, current research into Somali women's health focuses mainly on Female Genital Mutilation (FGM), examined often without the context of wider cultural practices. This paper, however, suggests that rituals, beliefs and material culture play a paramount role in women's practices. For example, as explored elsewhere, the wagar, a wooden and sacred object made of the African olive, is critical for fertility practices. The current paper illuminates further the significance of reproduction practices in Somali society and the potential continuity of traditions associated with the perpetuation of kinship. It concludes that fertility rituals are part of a wider context of interaction with sacred landscapes, objects and archaeological sites, often associated with past legends in the Horn of Africa.

Psychosocial and contextual determinants of health among infertile women: a cross-cultural study.

The purpose of this study was to assess the impact of emotional intelligence, social support and contextual factors on the general health of infertile women. A sample of involuntarily childless women aged 25-45 living in the UK (n = 148) and Pakistan (n = 164) completed a self-administered questionnaire. Although there were no significant differences in total scores on the General Health Questionnaire (GHQ), British women reported greater anxiety, insomnia and social dysfunction, and Pakistani women reported greater depression and somatic symptoms. Important differences in putative correlates of GHQ scores were found between the samples. British women reported significantly greater emotional satisfaction, greater satisfaction with medical information, greater satisfaction with medical care, and greater actual received support Pakistani women reported greater emotional intelligence. Regression analysis to identify correlates of higher GHQ scores revealed that greater received social support was a common correlate of better GHQ scores among British and Pakistani women. Additional correlates of better GHQ scores among British women were greater emotional intelligence and more emotional satisfaction in their relationships (overall R(2) = 0.41). Additional correlates among Pakistani women were greater education, greater perceived available social support and a nuclear family system rather than an extended family (overall R(2) =0. 40). Results suggest that psychological facets of infertility should be addressed as part of a holistic approach to the care of infertile women. They highlight a need to improve social support and to incorporate emotional intelligence training in therapeutic interventions to improve the psychological well-being of infertile women.

Traditional practices used by infertile women in Turkey.

BACKGROUND: Numerous traditional methods are used in the treatment of infertility around the world. AIM: To identify the traditional practices of infertile women using one clinic in Ankara, Turkey. DESIGN AND METHODS: The population comprised all women (5700) who attended one infertility outpatient clinic in 2007. The sample was calculated using sample calculation formula and 410 women were included in the study. The survey method was used for data collection. FINDINGS: Of the responding women, 27.3% had tried a traditional practice, and 67.8% who tried traditional practices used an herbal mixture. The reason for the women's use of a traditional practice was 'hope' (66.9%), and 15.2% of them had experienced an adverse effect related with traditional practice. Maternal education level, perceived economic status, duration of marriage all significantly affected the use of traditional practices (P<0.05). The women who had received unsuccessful medical treatment for infertility and who had experienced side effects after medical treatment had a higher rate of use of traditional practice (P<0.05). CONCLUSIONS: Almost one in three of the women who responded to the questionnaire had tried traditional methods, and some experienced adverse effects related to the practice. For couples with infertility problems, educational programmes and consultation services should be organized with respect to their traditional culture. Women should be informed about the hazards of traditional practices and avoidance of harmful practices, and continuous emotional support must be provided for infertile couples. In the future, nursing staff should play a much larger role in these supportive services.

Giving birth: the voices of Ghanaian women.

Childbirth is significantly influenced by women's cultural perceptions, beliefs, expectations, fears, and cultural practices. Our purpose in conducting this focused ethnography was to determine the perceptions of Ghanaian childbearing women. Twenty-four mothers who received health care at the Salvation Army Clinic in Wiamoase, Ashanti, Ghana, participated in audiotaped interviews. Patterns of thought and behaviors were analyzed, describing the realities of the lives of Ghanaian childbearing women. Themes included centering on motherhood, accessing health care, using biomedicine, ethnomedicine, and spiritual cures; viewing childbirth as a dangerous passage; experiencing the pain of childbirth; and fearing the influence of witchcraft on birth outcomes. Culturally specific knowledge obtained in this study can be utilized by health care providers, health policymakers, and those designing health care interventions to improve the health and well-being of childbearing women in developing countries.

Kiyang-yang, a West-African postwar idiom of distress.

In 1984, a healing cult for young barren women in southern Guinea Bissau developed into a movement, Kiyang-yang, that shook society to its foundations and had national repercussions. "Idiom of distress" is used here as a heuristic tool to understand how Kiyang-yang was able to link war and post-war-related traumatic stress and suffering on both individual and group levels. An individual experience born from a traumatic origin may be generalized into an idiom that diverse sectors of society could embrace for a range of related reasons. We argue that, for an idiom to be understood and appropriated by others, there has to be resonance at the level of symbolic language and shared experiences as well as at the level of the culturally mediated contingent emotions it communicates. We also argue that through its symbolic references to structural causes of suffering, an idiom of distress entails a danger for those in power. It can continue to exist only if its etiology is not exposed or the social suffering it articulates is not eliminated. We finally argue that idioms of distress are not to be understood as discrete diagnostic categories or as monodimensional expressions of "trauma" that can be addressed.

Choosing therapies: a Senegalese woman's experience with infertility.

In this article I examine a Senegalese woman's experience in selecting treatments for infertility. A critical-interpretive approach is employed to place in context this woman's therapy selection process. Treatments are revealed through illness narrative, interviews, and participant observation. This case study illustrates the variability of choices available and the factors influencing the selection of different therapies over time. These factors include availability of different therapies as well as the meanings of infertility and the therapies. The social, economic, and political access to treatments permitted this individual to seek therapies that gave meaning to why she was experiencing infertility. The decision-maker predominantly chose a traditional form of treatment, gris-gris, amulets worn about the body. After continual use, she found them ineffective and then used allopathic medicine with various other treatments including prayer, plants, and spirit divination. Overall, this decision-maker's strategies are rooted in the belief that she must ardently search for a solution to Allah's challenge of infertility. (To ensure the confidentiality of all individuals mentioned in this research, I have changed their names in this article.)