El procedimiento teórico

Matthews and Matthews’s (1986) paper is one of the earliest theoretical papers arguing the need for academic study on infertility and involuntary childlessness similar to that conducted on parenthood. They contend that the development of ARTs led researchers to investigate fertility treatment and infertility, or medical causes of infertility.

However, little attention or investigation has been paid to the social as well as the psychological consequences of involuntary childlessness. The authors draw on symbolic interactionism and emphasise the importance of understanding the passages infertile couples go through, the process that interplays between self, identity and social roles, and “the often psychologically painful transition to non-parenthood” (p.

642).

2.4.3.1 Self and identity

Letherby (2002) concurs with Matthews and Matthews’s (1986) notion and highlights an awareness of differences but overlapping consequences of “the biological condition of ‘infertility’ and the social experience of ‘involuntary childlessness’” (p. 277). The author points out that “as the life course continues, ‘infertility’ and ‘involuntary’

childlessness may take on a different significance” (p. 285), and when medical or biological solutions are not achieved, the evaluation of experiences will become “the social experience” (p. 282) of involuntary childlessness.

This notion was captured in Letherby’s (1999) exploratory study of 65 self-identified infertile and/or involuntarily childless women, which shows a complex perceived sense of self and identity. The women who participated in the study include 12 biological mothers (either secondly infertile or children with ARTs) and eight social mothers (who had children through adoption, fostering or with step-children), as well as 45 women without children (those who had had failed medical attempts or

unexplained infertility). Of the 65 women, data on 24 were gathered through

interviews, and 41 by correspondence. A grounded theory (GT) oriented analysis was conducted. All women (age range from early 20s to early 70s) – both mothers and non-mothers – shared a sense of being ‘others’ and strangers in society. The paper reports on the influence that the dominant social discourse of motherhood has on expected motherhood and the participants’ highly-stigmatised sense of self.

The perception of infertility shifts in various social and relational contexts. Todorova and Kotzeva (2006) used interview data of nine (eight primary and one secondary infertile, aged 22–41) women, and investigated their two to 12 years of infertility and treatment experiences. The study employed IPA (Smith, Flower, & Larkin, 2009).

Four emergent themes referred to complex identity constructions, drawing on both medical and social contexts. For example, the experience of fertility treatments exhibits an incomplete sense of self with emptiness that needs to be fulfilled, and a self-governed identity is found as a determinant during the treatment. Therefore, the childless situation brings a sense of self being separated from society, which further influences relational connections between the self and other, and with a partner or husband. Although the participants in this study still hoped for children, the paper

highlights socially influential identity processes that derive from “separate, autonomous and agentic” (p. 136) experiences of infertility.

2.4.3.2 Relationships

Relationships with others and society are highlighted in existing literature typically by making comparisons between parents and childless individuals. Klaus and Schnettler (2016) used a longitudinal survey to examine social support and social networks among 5,782 individuals in Germany, of which 655 (11%) were childless. The authors were interested in looking at both men and women aged 40 and over in order to

investigate the social relationships happening in their mid and later lives. This comparative study revealed positive outcomes of childless adults, in that these

individuals tended to have greater stability among their “friends and collateral kin” (p.

102) than those who were parents. Further, childless individuals tended to receive more effective support from their friends and collateral kin compared to the support that parents received from their own children. The paper reports evidence that life without children does not always have negative social relationships or social isolation.

Albertini and Mencarini (2014) used the data of 33,759 individuals from the 2003 Italian Gender and Generation survey. The age range shown in the study was from 30s to 70s and beyond, with a mean age of 53.7. This was also a comparative study

between childless individuals and parents (of both genders), investigating support given and received in their lives. The results agreed with the positive finding of Klaus and Schnetter (2016) noted above. However, data further pointed to the notion that childless individuals, particularly those in their 50s and 60s, showed a tendency to have fewer personal relationships with others. Although this was not identified as a factor leading to social isolation, the paper suggested the need for organisational or health professionals’ involvement in supporting them in their later lives.

Although similar findings have been addressed in other studies, these seem to be drawn from sociological and demographic data with a focus on aging and

gerontological concerns (e.g., Dykstra & Hagestad, 2007a, 2007b; Wenger, Scott, &

Patterson, 2000), neglecting the qualitative differences between voluntary and involuntary childlessness.

Social relationships often develop through online communities. Malik and Coulson (2013) specifically focused on women living with permanent involuntary childlessness and examined messages posted in one of the biggest and most active online support communities. A total of 224 online messages (with 49 identified using unique names) were analysed, using thematic analysis. This qualitative study revealed the importance of online communities as a safe platform for social connections. The analysis showed deeper levels of shared concerns as well as positive feelings accompanied with the feelings of belonging within this online community. The themes presented were

‘feeling like an outsider’, ‘a whole lifetime of loss’, ‘coming to terms with childlessness’, and ‘finding a safe haven online’. The paper illustrates women’s

tendency to isolation in their everyday social contexts. However, a shortcoming of this, may be that online-message-based data collection lacks participant homogeneity. As the author pointed out, it is difficult to obtain further information on individuals due to their anonymity. In addition, and intuitively, there may be an online community discourse specific to this support group. If this is the case, there may be women who share involuntary childlessness, but find difficulties in sharing their positions in the discourse, therefore idiographic accounts for such women are potentially difficult to capture.

2.4.3.3 Social expectations

Women living in their midlife without children are often viewed as career-oriented, non-normative people rather than family-oriented, normative people (Newton &

Stewart, 2013). Riessman (2000) conducted fieldwork in Kerala, southern India on infertility. The social interactions of 31 married infertile women (aged 22 to 57) were examined using a GT (Charmaz, 1990) approach. The infertile women were found to be facing and negotiating ways of dealing with normatively constructed beliefs and values, as well as social expectations. Reflecting on her research, Riessman refers to the point that investigations of life without children needs to take into account the importance of social influences on women rather than looking at their lives as a consequence of infertility or a medically-influenced life course.

Loftus and Andriot (2012) investigated psychosocial influences and the impact that “a failed life course transition” (p. 241) had on women who were infertile. The authors

interviewed 40 women aged between 25 and 46 (mean age = 33.8), and the data were examined using qualitative data analysis software. The emergent features the paper reports on include: ‘retreating to men’, ‘rejection’, ‘failure’, and ‘exclusion’. Unable to have their own children, these women equate a sense of failure with that of failing to meet a social expectation. The impact of the loss of expected discourses with mothers were also reported. An inability to share this gendered status of womanhood was found to be a significant issue on social interactions, particularly resulting in difficulties with keeping positive relationships with other women with children.