Infertility in Pakistan: Experience and Health Seeking Behavior among Baloch Women in a Karachi Slum

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Abstract

This thesis explores the experiences, health seeking behavior and ways of coping among Baloch infertile women in a Karachi slum from a narrative perspective. In addition, the validity of current official epidemiological definitions which are based only on the clinical aspects of infertility is questioned, arguing that the experiences of infertility vary from them, and that they are a form of social suffering that needs to be understood in a broader context. It also proposes that the neglect of infertility in public health is rooted not only in its inadequate definitions but also in the reinforcement of ideas related to biopolitics by international organizations that stress the importance of demographic control and that reduce reproductive health to family planning and maternal health care. Ethnographic material and life histories portray infertility as a negative experience manifested in domestic violence and gossip, its suffering being exacerbated through economical deprivations, the malfunctioning health system, marginalization on the basis of ethnicity, and through the failure to fulfill the expected role of mothers. Infertility, therefore, is considered a social problem which involves the whole community. Similarly, the importance of health seeking behavior is rooted in the expectations set on women to do something about their situation; it will be argued that health seeking is also a way in which women reaffirm themselves and disclaim responsibility for the failure to conceive. On the other hand, the coping strategies mentioned by the women included the importance of faith, blaming the husband, talking to relatives and friends, among others. They agreed that although these ways of coping help them to carry on better with their situation, they did not reduce significantly their suffering, nor did they diminish their wish to have an own child.