Data from the National Survey of Family Growth suggested that 6.0%, or 1.5 million married women, faced infertility in the United States between 2006 and 2010, which is clinically defined as the inability to achieve pregnancy after one year of regular unprotected intercourse for those under age 35 and six months of regular unprotected intercourse for those age 35 and over (Chandra et al., 2013). Infertility not only has physical consequences, but emotional and psychological consequences, including feelings of failure, injustice, and depression and these feelings are long-lasting. These feelings may arise from the importance that individual women tend to place on becoming a parent to a biological child, or the psychological drive to bear a child (Brothers & Maddux, 2003; McQuillan et al., 2008). However, research has also tended to argue that infertility has a profound impact on women’s psychological wellbeing because motherhood is intimately linked to gender identity, especially in pronatalist countries whose societies view biological reproduction as a woman’s primary method of fulfilling predominant norms of femininity (Arendell, 2000; Loftus, 2009; McQuillan et al., 2015; Park, 2002; Ulrich & Weatherall, 2000). When a woman is unable to reproduce, she may face stigma associated with her infertile status, even if she chooses not to publicly disclose her struggles. This stigma may take the form of unwanted questioning from friends, family members, or even strangers regarding when a woman plans on having children if she is within the childbearing years. Using Goffman’s (1963) theory of stigma as my primary framework, I argued that stigma relates to invisible as well as visible illnesses, and that this also applies in the context of infertility, a seemingly invisible illness. Overall, despite the importance of stigma in the context of infertility, women may place a great deal of importance on biological motherhood. In this dissertation, I conceptualized the importance of motherhood as individual women’s psychological motivation towards bearing biological childbearing, and juxtaposed this to structural level stigma, or the social pressure for all women to bear biological children. Prior research has found that some women link having biological children to happiness and life satisfaction (Brothers & Maddux, 2003). When a woman cannot achieve biological motherhood when it is a strongly desired personal goal, she may therefore still feel the same sense of loss as someone facing the pressures of stigma associated with her inability to bear biological children. Given the powerful influence of both stigma and the individual importance placed on motherhood, I sought to explore which of these may have a greater influence on infertility-related outcomes for women. Using the National Survey of Fertility Barriers, a large dataset that includes detailed fertility information, including fertility desires and psychological variables, I analyzed these two factors, personal importance placed on motherhood and the stigma of infertility, and their potential relationship to two infertility-related outcomes using regression. These infertility-related outcomes included: 1) fertility-specific distress, 2) women’s confidence in biomedicine to remedy infertility. In addition, I incorporated the potential moderating effect of social support on fertility-specific distress in the second chapter of the dissertation.
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