Infertility and relationships: the importance of constructions in context

Abstract

In low- and middle-income countries, infertility is a neglected but highly stigmatising condition, which often leads to extramarital affairs, polygamy and divorce. I conducted interviews in Malawi with women with a fertility problem and used discursive psychology to analyse how they described and constructed (extra)marital relationships. Surprisingly, several respondents constructed their relationships as good, and descriptions minimised the significance and blameworthiness of husbands' affairs. This contrasts with the literature's portrayal of conjugal relationship problems as among the main hardships that infertile women endure. Attention to participants' own orientations to relationship 'trouble' is important. Furthermore, discursive practices, such as not complaining or not blaming one's spouse for affairs, appear to limit possibilities for 'speaking out' and 'acting up'. Interventions could facilitate alternative accounts and constructions. This study illuminates local practices of family and intimacy, how people 'do' relationships and intimacy in interaction, and the shared expectations concerning marital relationships and social categories (eg, 'spouse') that the respondents draw on. This is important: sexual and reproductive health interventions should consider relationships and their context-specific meanings.