fertility

World of the Body: fertility

The French word ‘fertilité’ entered the English language in 1490 to characterize the richness of the soil. By the seventeenth century, writers adapted ‘fertility’ to describe creative imaginations. In the course of the nineteenth century, the term ‘fertility’ came to account for the number of children a woman bore. In this period, too, fertility and another French term, ‘fécundité’, were used to refer to female procreative abilities. In 1866 J. M. Duncan differentiated fecundity from fertility with this explanation: ‘… by fecundity I mean the demonstrated capability to bear children … fertility implies fecundity, and also introduces the idea of number of progeny’ (The Oxford English Dictionary, 1989, 2nd edn). After 1866, especially among demographers, fertility increasingly came to refer to the number of live children a woman delivered.

Technically, fertility simply denotes successful production of offspring. This requires the development in the potential parents of mature eggs (ova) and sperm, sexual intercourse, the opportune encounter between sperm and egg in the woman's body, fertilization, implantation of the embryo in the uterus, successful antenatal development, and a safe birth. In the human female, the opportunity for fertilization lasts only a day or two following ovulation (the release of an ovum), which occurs about every 28 days, in the middle of the menstrual cycle. Sperm are present in vast numbers in the semen, so that, despite many hazards along the way, some survive the necessary journey to the egg. Given the typical frequency of coitus between habitual partners of reproductive age, the odds are in favour of pregnancy occurring within a few months of the first encounter, in the absence of contraception or any specific physical cause for infertility.

Fertility, however, is not simply the expression of a woman's bodily capacity to procreate (fecundity). Recent anthropological and feminist theory advocates understanding fertility as the product of individual actions situated within a particular historical and cultural context. Women and men, responding to local and global changes in the political economy and available resources (e.g. social networks, abortifacients, and contraceptives), act as individuals to produce the family arrangement they prefer (Greenhalgh 1995).

Women and men promote or control their fertility to meet particular needs and concerns at different moments in their life cycle, and these needs and concerns alter depending upon their sexual partner and the changing circumstances of their lives. A woman might attempt, for example, to limit her fertility with an extramarital partner, but not her spouse. Or a widow might attempt to control her fertility after her husband's death in her attempt to retain a particular social standing in her community or limit the economic strains on her household.

People negotiate the circumstances of their fertility differently according to their social position and their personal needs, interests, and concerns. In many societies, bearing a child grants a woman adult status in her community, provides her with a legitimate place in the adult community, and garners her political power in her household and sometimes in her community. The desire to have a child has led many women who wish to conceive to seek the assistance of herbalists, ritual experts, and clinics. The efficacy of fertility treatments depends not only on the male and female partners' reproductive capacities, but also on their financial ability to pay for the treatment and the quality of the drug or procedure. Places where women and men can have their fecundity tested and treated abound throughout the world.

The desire to limit fertility exists in concert with the wish to procreate, and many women experience both desires in their lifetimes. Women in countries around the world seek contraceptives and abortions to limit their fertility, with or without the consent of their partners. A recent study by Bledsoe and colleagues in West Africa, for example, found that some women who have just had a miscarriage elect to use contraceptives for a period to give their bodies a chance to recuperate before they choose to become pregnant again.

Beyond individual preferences, however, fertility responds to a number of factors. Chief among them are health, nutrition and environmental factors. A woman's nutritional status, age, and experience of disease contribute to the probability of subfecundity (reduced capacity to conceive), miscarriages, and stillbirths. The tragedy experienced by residents of the Love Canal, New York State, where unsuspecting families lived on toxic waste dumps, provides an example of how environmental hazards have increased the incidence of miscarriage.

Cultural and religious values relating to the onset and duration of sexual relationships, use of contraceptives, and frequency of coitus (with a fecund male), determine a woman's exposure to the possibility of pregnancy. Obviously, women who begin their reproductive careers immediately after the onset of puberty have a greater window of opportunity to experience pregnancy than women who delay childbearing. Additionally, women in societies that condone the sexual relationships of women before, between, and after marriages could feel more comfortable being pregnant during more of their childbearing years than women living in less open communities. However, the ease with which a women can contract sexual liaisons does not directly translate into a socially sanctioned pregnancy and birth. Experiences of miscarriages and the duration of breastfeeding are also factors in the time during which a woman can get pregnant. The longer the breastfeeding period, the longer the possibility of lactational amenorrhoea — the time when a women is unlikely to be ovulating and therefore to get pregnant. Referred to as the ‘proximate determinants of fertility’ by demographers, myriad factors impinge on a woman's reproductive experiences.

Governmental programmes and policies that attempt to limit or promote women's fertility also affect the number of children a woman bears. For example, China's urban policy of one child per family sends a strong message to the community about the importance of controlling fertility. In contrast, when a country limits women's access to contraceptives or abortion, as some states in the US do, some women are forced to bear children they are not able to raise.

Women's fertility outcomes are also a response to international pressures. The economic crises of the 1980s and 1990s that plagued many African countries forced many Africans into extreme poverty. The recognition that poverty limits a woman's or couple's ability to care for many children leads women and men to limit the number of children they have. In Kenya, for example, where an unstable government is unable to pay international debts and secure internal peace, demographic studies conducted during the 1990s linked the decline of women's fertility to the current economic crisis. Kenyan women and men faced with growing uncertainty in their everyday lives are electing to limit their fertility.

— Sheryl A. McCurdy