Infertility as a social and public health issue

In Western countries, being involuntarily childless, or not meeting childbearing desires, is largely considered a biomedical problem, synonymous with notions of illness and disease. This is reflected in both the definition of infertility, as well as treatments offered in hope of providing a "cure"" pregnancy, and the birth of a child. However, infertility is not only a reproductive medical issue but also a social issue. Increasingly social science research reveals the importance of understanding how sociocultural discourses and practices shape lived experiences of infertility for both individuals and couples. Most societies have strong pronatalist ideologies, meaning childbearing is highly valued, with beliefs, attitudes, and actions taken to support parenthood and encourage fertility. When people cannot meet this expectation, it can have negative consequences to how people view themselves and how they are viewed by others, with implications for psychological well-being and couple relationships. Despite this, infertility has not yet been prioritized as a public health issue. While biomedical interventions to address infertility have proliferated in recent years, social science research has illuminated that the distribution of such treatment is far from equitable. In this chapter, these issues are explored. In particular, attention is paid to how identities such as gender, race, and social class shape the experiences of, and access to resources for the treatment of infertility.