For women, finding out that they are unable to have children means something different depending on their social class, recent research suggests.
The whole "infertility journey" differs by social class, from how women find out they are infertile, to how they interpret and cope with the diagnosis, said study researcher Ann V. Bell, an assistant professor of sociology at the University of Delaware.
"It's devastating for all women, regardless of their class, but how that devastation manifests itself is different depending on their SES group," said Bell, referring to socioeconomic status, which is generally a measure of income level.
Bell conducted interviews with 58 infertile women from a range of social class backgrounds, asking them about their experience. [ 5 Myths About Fertility Treatments ]
Women of high socioeconomic status tended to discover they were infertile much more quickly once they began to try to get pregnant, compared with women of low socioeconomic status, Bell said. That's because women with high household incomes tend do a lot of things to actively become pregnant, including using kits to tell them when they are ovulating.
"Because they are so much actively trying…if it's not working after a couple of months, they think something's up," Bell said.
On the other hand, women with low incomes who have unprotected sex with their partner may not think of themselves as "trying" to become pregnant. Because of this, years may go by before the couple realizes something might be wrong.
Lower-income women seek a diagnosis of infertility more as an explanation of what's wrong, whereas wealthier women often seek a diagnosis of infertility in order to get treatment for it, Bell said.
Women in the study with lower incomes told Bell that after their diagnosis, they felt like the odd one out in their communities, Bell said.
"The stereotypical representations of infertility represent it as this white, wealthy women issue," Bell said. "Women of low SES don’t fit that stereotype, so they don't think that anybody like them is infertile," and they feel alone in their communities, Bell said.
In reality, women with lower incomes have slightly higher rates of infertility than women of high SES, Bell said.
In contrast, women with high incomes tend to know more people who are infertile because it is discussed more in their communities, Bell said. In addition, many of their peers delay childbearing, so they frequently know couples who are still childless.
Women of low SES are often unable to have children through infertility treatments because the therapies are typically very expensive. Lower SES women also may have difficulty taking time off from work to see a doctor, Bell said.
High-income women can afford the medical treatments, but often find themselves on an emotional roller-coaster.
"It's sort of this addictive thing," Bell said. "With each new treatment, you get a little more hope that something is going to work."
An earlier study found that many women who undergo fertility treatments develop symptoms of post-traumatic stress disorder.
"In the end, it's almost as if women of high SES are coping with medicalization, and dealing with the medicine and lack of control that is caused by that. Whereas women of low SES focus more on coping with the infertility itself," Bell said.
"And because they've had other losses in their life, and are confronted with hardships everyday," low SES women tend to move on from their infertility diagnosis more easily than women of high SES do, Bell said.
Bell says her work shows that infertility is a diverse and social process.
"We think of it as a medically objective, bodily issue that primary occurs to white wealthy women, whereas in reality it’s a socially constructed process that occurs to women of all walks of life," Bell said.
Bell presented her work last week at the American Sociology Association's annual meeting in New York.
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