Reconstructing the Functionality of Fertility in Family and Social Context Among Sub-Fertile Women in Mainland China: A Qualitative Study

Background and Purpose:Fertility functionality has been seen as the incentives for fertility attitudes and planned behaviors. Prior studies described familism as main characteristics of Chinese traditional childbearing values among general population. However, modernity and sub-fertility/infertility can both changed people’s perceptions on fertility functionality, which still remained inadequate. This study attempted to reconstruct the functionality of fertility in family and social context among Chinese women with sub-fertility.

Method and Design:A qualitative approach was adopted in this study. Fifteen in-depth interviews were conducted among sub-fertile women with initial treatments in Tianjin, China. Grounded theory methods guided data collection and analysis as theoretical foundation.

Results:During interviews, women with subfertility introduced childbearing importance through explaining how reproduction achieved personal identity as well as maintained relational harmony in marital, familial and social lives. Two themes emerged from data analysis: ‘childbearing as human nature’ and ‘childbearing for relationship harmony’. Childbearing underlined the nature of being a human with needs of experiencing developmental transition, being a woman who had motherhood and womanhood to achieve, and being a social person who had internalized social norm that marriage led to a live birth. Also, childbearing served as a necessity to maintain relationship harmony in marital, familial and social life. Specifically, sub-fertile women attempted to maintain marital relationship, realize filial piety and build normalcy in social life through childbearing.

Conclusion and Implications: Subfertility threatened personal integrity as a female and a social person, more importantly; subfertility impaired and compromised relational harmony in the marriage, family and social life for Chinese sub-fertile women. Reconstruction of childbearing function provided valuable insights into how Chinese women perceive and interpret their subfertility experiences, which might benefit the clinical healthcare to face an imperative challenge of caring growing numbers of sub-fertile/infertile population. Additionally, it is recommended that husband and extended families should be engaged in professional supports and counseling to enhance infertile women’s welfare in sub-fertility experiences.