Hope and Heartache: Unpacking the invisible struggles of involuntary childlessness and Assisted Reproductive Technology (ART) use in Zimbabwe and New Zealand

The sensitive and challenging issue of infertility affects couples and individuals globally who are of childbearing age from all socioeconomic backgrounds. According to the World Health Organisation, infertility affects one in every six couples, or 48 million couples and 186 million people worldwide. Medical infertility can be classified as primary or secondary, with primary infertility referring to those who have never given birth despite having had coital contact for longer than a year without using contraception. Those who have had at least one successful pregnancy but are now unable to have more children are said to experience secondary infertility.

According to reports, infertility has severe impacts on those who experience it, especially in low- income countries. This study looks at how attitudes about involuntary childlessness and use of assisted reproductive technology (ART) among involuntary childless African couples and individuals in Zimbabwe and Aotearoa New Zealand are shaped by socio-cultural context. The study explores the impact of socio-cultural attitudes and practices in relation to these individuals’ and couples’ desire for children.

Structural infertility and a reproductive justice framework are used as the analytical lenses in this qualitative research, which utilises a comparative case study methodology based on phenomenology to draw on the lived experience of infertile Africans in both countries. The study juxtaposes these experiences with Zimbabwean worldviews on marriage, infertility, family formation, and childbearing to draw out the unique intricacies of each case. Through social networks and snowballing, eight infertile persons (two divorced women, one couple in the process of divorcing, four married women, one married man, and one surrogate mother) participated in semi-structured in-depth interviews in Zimbabwe alongside 16 healthcare professionals. For this part of the study, 25 participants in all were interviewed. In New Zealand, a total of eight participants were recruited: three infertile African women, three healthcare professionals, one African sperm donor and an African community leader. The cases are compared to discover similarities and differences between participants in the two countries, with the aim of understanding the shared and unique experiences of infertile Africans living at home and those from minority ethnic populations living abroad. A total of 33 participants’ voices are recorded for this thesis.

The investigation provides a deeper understanding of how infertility is experienced and how reproductive technologies are perceived in both nations. The interview findings show that all the participants share the desire to have children, and that they sought out various forms of treatment, including traditional and religious faith-based interventions, as well as a preference for genetically related offspring.

Although the use of donated gametes was seen as unacceptable by some participants, the New Zealand policy of open disclosure and identity-release donation was seen as a deterrent to the use of ART. Additionally, participants across both locations preferred to keep their use of ART and infertility a private and secretive matter. As such, the study highlights the need for further research into the nuances of infertility and reproductive justice across different African countries as well as among African migrants living in the global north. The research aims to inform policymakers on the best approaches to improve fertility services for African women and men in these contexts and seeks to identify areas where further interventions are needed.