When Being Childless Isn’t a Choice

Couples without kids have recently been celebrated in the West, but in some countries they still face ostracism and abuse.

Childless couples sit with newly adopted babies, Fatima (left) and Zainab (right), at the Chhipa Welfare Association office in Karachi, Pakistan. (Athar Hussain/Reuters)

Western couples opting for the “childfree lifestyle” are getting increasing media coverage, with their childlessness often presented as an alternative lifestyle, not unlike being a hipster or a foodie. Guardian writer Jill Filipovic said that the choice not to have children is “admirable.” Others argue that women who choose to be childfree are selfish. A Time article about childfree living featured a “self-satisfied” and “lazy yuppie” couple on the cover in matching turquoise swimsuits.

But in places such as Uganda, India, China, and Uzbekistan, being childfree is unheard of, and not having children can result in derision, ostracism, assault, and even death. In places where being a mother is a prerequisite for being a woman, women are seen as defective and irresponsible for not reproducing. Research from the University of Ado-Ekitii in Nigeria showed that there, it’s considered acceptable for a man to seek fatherhood outside his marriage, either by marrying a second wife, or by having an affair, if his wife isn’t pregnant within a year of marriage.

Even though men are responsible for infertility in 50 percent of all cases, women are the ones who bear the shame. Nigerian novelist Sefi Atta breaks down this cultural phenomenon in Everything Good Will Come and Swallow. The main character in Swallow, Tolani, says to her roommate, “You know that if a woman is infertile she can’t hide it. If a man is sterile, no one has to know. Understand? The wife finds someone else to father her child, and keeps the whole thing secret.” Andrew Dosunmu’s 2013 film Mother of George follows a newlywed Nigerian couple living in New York City as they struggle to get pregnant, addressing pressure that’s difficult to escape even when in a completely different setting.

This burden is not unique to Africa. In Uzbekistan, where “life centers around children and a big family is the definition of personal success,” forced sterilization is on the rise due to a government attempt at population control, but women who are subjected to this violation of their rights face even further discrimination for not being able to have large families as is culturally expected. Adolat, an Uzbekistani woman who was forced to undergo forced sterilization, told the BBC that she considers herself a failure. “What am I after what happened to me? I always dreamed of having four—two daughters and two sons— but after my second daughter I couldn't get pregnant.”

As blogger IndianFeminist101 wrote, “In Indian society having kids is de facto and voluntarily not having kids is so exceptional that there is very little mainstream discussion about it.” In India, as well as Bangladesh and Pakistan, so much of a woman’s identity is based on how many children she has, that those who don’t reproduce sometimes endure awful treatment. Their marriages suffer, they are mistreated by their in-laws and friends, are left out of family events, criticized, prevented from seeking medical care, and occasionally starved.

In many developing countries, there is often no social security for ageing people, the idea being that children take care of the old. People who don’t have children are “viewed as a burden on the socioeconomic well-being of a community,” as Sheryl Vanderpoel, from the Reproductive Health and Research Department at the World Health Organization put it.

Latifat Ibisomi from the University of Witwatersrand and Netsayi Noris Mudege from the African Population and Health Research Center in Nairobi, found that such “a high premium is traditionally placed on having children [that] voluntary childlessness is rare.” In fact, “As a result of their seemingly deviant behavior, voluntary childless people [are] worthy to be harassed, ridiculed, ostracized or even killed.”

Nana Yaw Osei, who founded the Association of Childless Couples of Ghana (ACCOG) along with his wife Doris Osei, put it this way in an interview: “I can tell you that 100 percent there is nobody that doesn’t want to have children. Everyone who gets married wants to have a baby. There is nobody who doesn’t want to have a child.” The reasons for such mandatory reproduction there are largely traditional: A woman is obligated to carry on her husband’s line, it’s selfish not to have children, and parents want grandchildren.

Marcia Inhorn, a medical anthropologist at Yale who focuses on infertility in the Middle East, said in an interview that women in that region who fail to become instantly pregnant are subjected to “taunting, insulting, family pressure, especially from in-laws. For infertile women in Egypt, the mother-in-law is the bane of her existence. Women buy into patriarchy. The mother-in-law and sister-in-law defend their son or brother by making life miserable for his wife. And it’s really painful if she’s living in his family compound.”

Osei echoes this sentiment: “Stigma is a very key thing. I am the firstborn and one of two children. The pressure nearly made me divorce my wife.”

The blame generally falls on women because women’s fertility is visible through pregnancy, while men’s isn’t. Inhorn’s recent work as has focused on emphasizing the men are also responsible for infertility and reducing stigma for infertile couples, regardless of which partner is responsible.

Some infertile couples turn to IVF, but Inhorn says that some, “literally impoverish themselves and their households trying to get treatment [out] of desperation” in what’s known as catastrophic spending.

Attitudes do seem to be changing towards childless people, although slowly. Inhorn says that in the work she’s done in the Middle East, while women still face pressure, education and technology have had an impact. “The rhetoric now is ‘This is just a medical problem.’ There’s a lot of religious acceptance of health conditions.” Unfortunately, fertility treatment still isn’t available to everyone, and sub-Saharan Africa also suffers from high rates of infertility, as well as a dearth of IVF treatment centers. And for those who don’t want to have a child at all, increased access to fertility treatment is not a panacea.

When he started ACCOG a year ago, Osei says he “didn’t even know there were similar organizations about this across the world. I didn’t have one iota of knowledge about that.”

Through founding the organization, he has found international support and is hoping to provide the same for couples in Ghana. He has appeared on the major television networks to announce his childlessness and has encouraged others dealing with fertility issues to adopt. While still in its infancy, the organization already has more than 100 members.

Even though reproductive technologies are always improving, history shows that when a country industrializes, its fertility rates fall. How are societies that place such a high emphasis on having kids going to deal with this inevitability?