How can childlessness affect a marriage?




Childlessness and Artificial Insemination

by Rosemarie Nave-Herz and Corinna Onnen-Isemann

Today medicine not only ensures reliable contraception, but also through artificial insemination that the childlessness of marriages does not increase further in industrialized countries. The reasons for wives to expose themselves - often only after a long period of contraception - to the rarely successful so-called IVF (in vitro fertilization) treatments are mostly based on a traditional family image, the fulfillment of which is often postponed for too long. This is, among other things, the result of a research project on "reproductive medicine from a sociological point of view".

To remain fatefully childless in a marriage has at all times been perceived as something "unnatural", "deviant". In fact, in all European cultures of the past, marriages basically aimed at procreating offspring, so that entering into marriage was so naturally linked to children that childlessness was not even possible as a decision. Anyone who wanted and / or should remain childless was already excluded from marriage, e.g. the temple maidens among the ancient Egyptians or Teutons, the nuns and monks of the Christian and Buddhist monasteries, as well as certain people for whom public marriage bans were in effect at certain times, such as For servants, journeymen, officers, etc. Childlessness in a marriage was - as far as one can see the history of mankind - usually medically conditioned, and it was usually met with an openly expressed or covert disdain. Women in particular were blamed for childlessness in a marriage, and they were the most likely to be ostracized. Childlessness in a marriage was also seen in many cultures as a reason for divorce or as an opportunity to cast off a woman.

Already in the Bible sterility was described as a punishment from God (e.g. Genesis 20, 29 and 31), and the devaluation of childless wives by the appreciation of mothers is demonstrated by the example of Sarah and her maid Hagar, who instead of Sarah had a child of and got it for Abraham and disregarded Sarah for it.

This one-sided attribution of guilt was common in our country up to this century, although fertility disorders in men were already described in ancient Egyptian and ancient Indian medicine as well as in the Talmud, and medical writings from 1647 testify that even then there was very detailed knowledge of marital sterility , caused by the husband, possessed.

The many superstitious recommendations and "medical" remedies show how fearful and associated with sadness the threatening childlessness in a marriage was, especially for women: magic rites, magic potions, pilgrimages, herbs, bath cures and much more were supposed to help.

The devaluation of childlessness and the associated devaluation of unmarried women was still very widespread in the last century. Even the representatives of the first women's movement stuck to the "determination of women" as mothers. The focus of upbringing, for example with Helene Lange, Gertrud Bäumer and other leading women of the first bourgeois women's movement, was clearly the future mother. That is why many representatives of the bourgeois women's movement tried to pave the way to "spiritual motherhood" - as they called it at the time - childless and unmarried women, ie to create opportunities for gainful employment with regard to professions for which "maternal qualities" were necessary : Teacher, social worker, kindergarten teacher, etc. At the same time, very clear signs were set: women could almost only achieve recognition through motherhood - be it in biological terms or in a transferring way (= "spiritual motherhood").

Appreciation of the family after the Second World War

Single and childless women experienced a particular devaluation - especially in the form of pity - after the Second World War. As a result of the disproportionate population structure with regard to the sexes, the old prejudices and labels of the "old maid" revived, namely about women who would have missed the real meaning of a woman's life, being mothers. This development was only possible because after the war the family was not only given a particularly high value in Germany, which was probably due to the long separation between family members and the many emergency and fearful situations caused by acts of war. One longed for peace, security, understanding, for values, the redemption of which was attributed to the family. The high appreciation of the family and thus of being married and having children automatically resulted in the depreciation of the alternative status of "childless". How strongly this ideology prevailed until the 1950s can be seen in the results of an opinion poll. When asked whether they considered singles and childless people "excluded from happiness", 78% agreed in 1953; In 1972, 32% answered yes to the question "Do you think that a woman has to have children in order to be happy?" and in 1984 only 23%.

The New Women's Movement has brought about a change, some of whose representatives are against the assumption of the mother's role as part of women) to this day, as the data of a study we carried out on the reasons for the use of high-tech reproductive medicine show.

Since the end of the last century, the proportion of childless marriages has risen steadily in almost all industrialized countries, and especially in the Federal Republic of Germany. In 1989, 8.4% of marriages remained childless; now it is 18%. According to model calculations, marriages concluded after 1970 even account for a share of 20% of marriages ultimately remaining childless. The increasing childlessness in Germany can be seen even more clearly in cohort-specific considerations of all women: While only 9% of women born in 1935 remained childless, this fact applies to 20.5% of those born in 1955 and about 25% of those born in 1961 rising trend.

The reasons for childlessness can be medical or psychosomatic. The deliberately chosen voluntary childless marriage seems - as we have already established in an earlier project - to be rare in Germany; on the other hand, there has been a sharp increase in temporary childlessness, i.e. the desire to have children is postponed. Often, however, this wish is only possible at all thanks to medical reproductive technology. Had they not been developed and applied, the proportion of childless marriages would have continued to rise. In the last 10 years the number of high-tech reproduction centers in Germany alone has increased tenfold.

Initially only surgical and / or medicinal methods for the treatment of childlessness were available, as well as the possibility of artificial insemination, so since 1981 "in vitro fertilization", also known as "test tube fertilization", has been used in the Federal Republic of Germany. This method attempts to artificially induce pregnancy outside the human body under laboratory conditions. Since then, the treatment canon has expanded to include further procedures: GIFT in 1985, TET / ZIFT in 1986, and then microinjections (ICSI intracytoplasmic spermatozone injections) were added in the 1990s. Since no uniform terminology has been established so far, the term IVF is used synonymously in the following for the methods IVF, GIFT, TET / ZIFT and ICSI.

Wish for children postponed for years

The research project "Reproductive medicine from a sociological point of view" examined the question of the causative conditions for the strong quantitative increase in IVF treatments from a sociological perspective and looked for theoretical explanations for the increasing use of this high-tech reproductive medicine.

Selected gynecologists and reproductive medicine specialists were interviewed, and a document analysis was carried out on the arguments put forward by the statutory health insurances to finance the treatment of childlessness. Above all, however, affected women were interviewed. The sample comprises a total of 52 qualitative and 273 written interviews.

Of the women surveyed who underwent reproductive medical treatment, 62% postponed their desire to have children in this partnership for years and then, when they decided to have a child, found themselves predominantly at an age with less ability to conceive. The gynecologists in the interviews also emphasized that some of their patients had delayed their desire to have children with the help of contraceptives for too long and were now at an age at which their fertility and the ability to conceive were declining. The data of the current study thus initially confirmed the results of an earlier study, according to which the vast majority of childless people do indeed associate a desire for children with marriage, although they had initially postponed their redemption due to their high professional commitment. The data also showed that for those who had chosen this temporary childlessness, a family life with children should have a certain quality, that the women believed that they could only be a good mother if they were no longer gainfully employed.

Both value orientations - traditional family orientation and high professional commitment - are antagonistic and must lead to decision-making conflicts. However, this can mean that limited childlessness is chosen as a conflict resolution strategy - often even unconsciously - in order not to have to decide between divergent value orientations, possibly in the hope of being able to resolve this contradiction at a later point in time.

The decision-making conflict between divergent value orientations - career orientation versus traditional family orientation - is ultimately an expression of the fact that macro-perspective changes become "visible" on the individual level of action in those "temporary" childless couples, namely the different changes in social subsystems. Because the school, training and professional system has changed over time for women and their professional commitment has increased; the family system, including the definition of mother roles, has not changed to the same extent for women.

The selected temporary childlessness can then lead to unwanted childlessness due to intermittent gynecological or andrological changes, e.g. due to illness (one's own or a partner's), due to age or also psychosomatically, as was the case with 62% of the women surveyed, who then went into reproductive medicine treatment.

Reproductive medicine has thus produced a paradoxical effect: through the development of contraceptives, it initially offered the possibility of reliable prevention of pregnancy, but for some women at the price that it was only with their help that the incapacity for conception that had meanwhile occurred again can be canceled.

The respondents strived for a correction with enormous personal stress; her wish related to founding a "normal family", to her own biological child. Adoption has seldom been considered. The extent to which the "nuclear family" (= parents with biological children) is still an ideal and the mother's role can have top priority, despite the plurality of life forms practiced in our society, becomes particularly clear in the case of reproductive medicine patients. Incidentally, it is predominantly the women's desire to have children that acts as the "motor" of the desire to treat childlessness.

Stress-causing and stress-producing life event

The data also confirm the findings of other studies: High-tech reproductive medicine is a stressful and stressful life event for the women concerned. In addition, every step of the treatment is linked with renewed uncertainty, but above all with the unpredictability of success.

The psychological stress is only "one side of the coin"; many women also complain of physical impairments and, above all, of the organizational "stresses and strains". Above all, reproductive medical treatment in some marriages seems to lead to independence or to the instrumentalization of sexuality for the sole purpose of procreation, which was formulated very clearly in some interviews. But there are also statements to the contrary. Some women report that IVF treatment had positive effects on the emotional marital relationship, creating greater closeness and openness.

Due to the great psychological, physical and other stress factors associated with reproductive medicine treatment, the question arises why women, even after an unsuccessful first treatment, still have a second, a third and sometimes a fourth treatment to be paid for by the health insurance company. Among the reasons for continuing the treatment, the women interviewed named in particular the fear of later self-reproach; 79% affirmed the statement "although I am not doing very well during the individual treatment phases, I will not stop the treatment before the end of the possible attempts in order not to reproach myself later". The fear of failure and the hope of success obviously influence the "cost-benefit balance" in favor of a new treatment if the pregnancy does not occur. In addition, the "benefit" becomes more and more desirable the more "costs" are invested. Presumably, therefore, affirmed the statement, "from every single step (in the treatment cycle) I draw new courage for the next" 77% of the respondents - a hope that reminds one of the expectation of happiness in the lottery - albeit with slightly greater chances of winning. Because the success rates of high-tech reproductive medicine for the treatment of childlessness are low overall. The "baby take-home rate" fluctuates between 10% and 15% per year.

Nevertheless, as shown, traditional family formation with the birth mother remains a cultural goal with high priority. In the past there were other "ways" to build a family, which were accepted to a much greater extent than today: adoption of children (e.g. illegitimate ones; but also giving away children from poorer, large families to wealthy, childless relatives was not subject to any taboo as today). These "paths" are hardly "feasible" to achieve the cultural goal of "family education". Adoption opportunities have decreased radically; but are also - like the foster children - not seen by many as a "substitute" for "their own" children. In this respect, it can be explained that reproductive medicine is sometimes seen as the only remaining form of adaptation to the culturally prescribed goal of "family formation / parenthood", at least as long as this is not itself questioned.

The authors

Prof. Dr. rer. pole. Dr. phil. h.c. Rosemarie Nave heart, Sociologist at the Institute for Sociology in Oldenburg, was appointed to the University of Oldenburg in 1975. Her scientific career began in 1965 when she became a research assistant at the Max Planck Institute for Human Development in Berlin. This was followed by a first lectureship in Oldenburg (1967-1971) and an appointment to a chair in sociology (Cologne 1971-1975). In the 1985 summer semester she was visiting professor at the University of Sussex / England. She has declined further appeals. She is a member of numerous scientific commissions and currently Vice-President of the Committee on Family Research of the International Sociological Society (ISA).

Dr. Corinna Onnen-Isemann received her doctorate from the University of Oldenburg, received a scholarship from Harvard University / Boston and is currently a post-doctoral candidate in sociology.