Local Babies, Global Science Chapters 8 & 9

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Local Babies, Global Science Chapters 8 & 9 von Mind Map: Local Babies, Global Science Chapters 8 & 9

1. Infertility: His and Hers

1.1. infertility and its treatment through IVF and ICSI

1.1.1. elicit gender responses from men and women, may be gender and culture specific.

1.2. Infertility compromises both femininities and masculinities in a society where motherhood and fatherhood is expected.

1.3. Gender dynamics are among the most fundamental arenas of constraint for infertility.

1.3.1. Tension between marital couples.

1.3.2. Male refusal to accept infertility issues.

1.3.3. Women protective of infertile partner.

2. Femininities, Masculinities, and Child Desire

2.1. Egyptians: "most child-loving people on Earth".

2.2. Desire for children high, affection for children high.

2.3. No adult male or female in Egypt will admit to not wanting children.

2.3.1. same true from upper class to poor.

2.3.2. 2-3 children desired, elite desire more in some instances.

2.4. Women with successful careers, marriage and accomplishments still feel their lives are incomplete w/o children.

2.4.1. Men see paternity as an important achievement Proving ones manhood is a "competitive affair" in Egypt. Competitions of virility and and fertility.

3. Conjugal Connectivity

3.1. Islam extolls the virtue of marriage

3.2. Marriage half of the religious equation, with worship and service of God.

3.3. Notion of the married couple not well developed in Egypt.

3.4. Marriage considered fragile until birth of a child.

3.4.1. Therefore infertility poses a serious problem for a married couple.

3.4.2. Infertile marriages are actually more successful than fertile marriages with kids. Companionate marriage is the reason for this Poor and rich alike desire love, romance, intimacy, and friendship in their marriage. Infertile marriages = more intense connection as a result of childlessness.

4. The "Top Secret" Stigma

4.1. Double stigma

4.1.1. Infertility

4.1.2. treatment for infertility

4.2. Stigma: an attribute that makes (her) different from others in the category of persons available for (her) to be, and of less desirable kind.

4.3. Infertile women described as "missing motherhood".

4.4. Men and women experience infertility stigma differently.

4.4.1. Women experience it more intensely.

4.4.2. Enacted stigma (intentional discrimination) is experienced exclusively by women.

4.4.3. Infertile men rarely feel under marital threat as women do (threat of divorce)

4.4.4. Infertile men are rarely reminded or taunted by others of their diminished manhood.

4.4.5. women are reminded of and taunted about their infertility by others.

4.5. Infertility engenders shame

4.5.1. opens them up for shame and dishonor in a society that places great value on honor.

4.6. Infertility treatment fodder for gossip.

4.7. Disappointment with failure an issue among family members and the couple.

4.7.1. Careful guarding of ones successes is important.

5. Dilemmas of Disclosure

5.1. "To tell or not to tell"

5.1.1. To tell whom and under what circumstances.

5.2. Disclosure is tied directly to the issue of donation.

5.3. Who can one trust?

5.4. Most in Inhorms study were "limited disclosers", had to tell somebody.

5.4.1. Full nondisclosers were the minority.

5.5. For most infertile men, it is not to be disclosed to anybody

5.6. Most couples who disclose are already in the midst of treatment before telling family members.

5.6.1. Some wait for successful pregnancy first before disclosing to family.

5.7. Good clinics and doctors are given word of mouth recommendations = more patients.

5.8. Couples worry about future stigmatization of their children, if their means of conception was known.

6. The Stigma of Support

6.1. Stigmatization of psychological support of infertility patients.

6.1.1. Mental illness and psychotherapy stigmatized in Egypt.

6.2. "patient empowerment" through support groups has not taken hold in Egypt

6.2.1. Women worry about lack of anonymity in patient support groups. Some women feel that hearing other women's stories might exacerbate their situation/feelings and suffering.

6.2.2. Patient support groups unlikely to succeed in modern Egypt due to cultural prohibitions.

6.3. "patient solidarity" promoted by doctors.

6.3.1. Groups of women undertaking fertility treatment do it together.

6.3.2. establishment of informal telephone hotline.

6.3.3. Doctors promote these programs to take the load off of themselves with these alternate avenues.

6.4. Egyptians don't like psychotherapy etc due to the feeling in their culture that the people who seek it out are "crazy".