Moving Out of Childlessness: Women’s Management of Involuntary Childlessness

and their Quality of Marital Relationship

A Thesis Proposal presented to the Faculty

of the Behavioral Sciences Department

College of Liberal Arts

De La Salle University

In partial fulfillment

For the Requirements of the Degree

Bachelor of Arts in Behavioral Sciences

Major in Organizational and Social Systems Development

Penaflorida, Luis Martin A.

Riel, Ella Mey C.

Torres, Duanne Kriselle D.

August 2016

Chapter 1
 INTRODUCTION

Background of the Study

Childbearing is a factor that is significantly affecting the marriage patterns

in the society. Although some couples would wish to have children, some others

voluntarily prefer not to have one. Regardless of whatever choice they have, the couple’s

decision to bear or not to bear a child is affected by structural forces. As a matter of fact,

many societies are pronatalists. This social pressure specifically affects women who

would wish to have children but could not do so for several reasons beyond their choice.

Childlessness is an important topic in the field of sociology as it created impacts on our

society, specifically the institution of marriage and family. Studies have shown that

childlessness has consequences on married couples psychologically, socially and

economically. When these consequences are not managed, these can result to strained

relationships (Nieuwenhuis, Odukogbe, Theobald, Liu, 2009). In other words,

childbearing becomes a factor of stability of marriage and relationships and it is also a

reason why some married individuals give up on their relationship owing to absence of a

child (Oláh & Fahlen, 2013; Agrawal P, Agrawal S, Unisa, 2012). Being childless even

becomes more problematic, when both husband and wife would want to have a child but

one of them is infertile.

As a matter of fact, being childless has more and more become an option

for married couples. Studies have shown that women are now able to become more in

control of their fertility, due to the various methods of contraception that becomes

available to women of different ages (Morgan & King, 2001). On the subject of women

delaying pregnancy whether it is voluntary or involuntary, Gregory (2007) observed the

1
increasing number of women delaying fertility in order for them to be able to and pursue

their personal aspirations in life. Although this is becoming popular, there is still a stigma

attached to not being able to produce an offspring. However, delayed motherhood allows

women to do their other priorities in life thus the decision not to bear a child.

Childlessness is defined by Agrawal et al., (2012) and Rutstein & Iqbal (2004), a

condition that can be understood in three ways which are the following: women who have

never bore a child, those who have lost pregnancy, and those with no children at all. This

phenomenon of being childlessness is not simply biological, but there are also a number

of environmental and cultural factors. Whatever the case may be, at least there are

available healthcare remedies that would widen the options among couples who cannot

bear a child (Agrawal et al., 2012; Unisa 1999).

Our society sees that being a mother is one of the key gender roles that women

must fulfill. This can be seen in the “motherhood mandate”, which maintains that all

women who are in the right age, must be able to give birth and properly raise “two”

children (Russo, 1976, p.11). Our society prescribes that women are expected to have

children when they become married adults. The limitation of the motherhood mandate

however, is its failure to recognize women’s freedom to choose and the inability of some

women to bear a child as a matter of physiological limitations. This could explain why

women are more pressured and are greatly affected and guilty knowing that they are not

able to bear an offspring for various reasons. Women would think that they are being

alienated from the society they live in since they are not able to accomplish their roles as

mothers. (McGuirk, J. & McGuirk, M.E., 1991)

2
 This study is conducted in order to explore how the quality of marital relationship

of Filipino married couples are affected by the strategies or approaches done by the wives

to manage childlessness. This is important due to the fact that the proposed study

provides a literature to a subject, which is seemingly not given attention in research at

least in the Philippines. Majority of the studies found focused only on the couple’s

management of childlessness (e.g. Peterson, Newton, & Schulman, 2006). Studies so far

in the Philippines discuss only how the rate of childlessness has been declining

throughout the years (United Nations, 2001). As a matter of fact, according to the

National Demographic Surveys, childlessness in the Philippines has continuously

declined since 1950s up to this day. Though this trend has been stable from that year on,

there was a bit of rapid change during the 1980s where there is an increase of 1 to 2

percent annually from 1970 until now.

Review of Related Literature

This section of the proposal discusses relevant literature describing childlessness.

It also investigates evidences describing relations of variables. It will consist of seven

parts, which are: (1) Phenomenon of Childlessness, (2) Stages of Infertility (3) Perception

on Childlessness (4) Consequences of Childlessness on Married Couples (5) Management

of Childlessness (6) Factors Shaping Management of Childlessness and (7) Relationship

of Management to Couples’ Marital Quality.

Phenomenon of Childlessness

Childlessness, as defined by Allen & Wiles (2013), refers to a state in which

couples do not have children. Wood & Newton (2006) explain that such a situation is a

3
reflection of diversity of modern families, capacity of individuals in making personal

choices as regard to forming families, and that having a child is not the only basis of

femininity. Likewise, Shaw (2011) share the same idea saying that “the journeys toward

childlessness these women shared reveal a synthesis of agentic decision-making,

personal histories and challenging lifestyle choices bound up within an existential need

to be a woman.”

Childlessness has been continuously growing across the different countries of the

world. According to Bos, Van Balen, & Visser (1995) & Boivin, Bunting, Collins, &

Nygren (2007), there are “approximately 70-80 million couples who are infertile at

present, and that there are more than millions of couples who are primary infertile or

childless.” In the Philippine societal context, childlessness among couples are

automatically presumed as involuntary childlessness given that it is a pronatalist society

owing to the significant influence of the Catholic religion, a religion dominantly

practiced by its people. According to the study of Chancey & Dumais (2009), Voluntary

Childlessness in Marriage and Family Textbooks, 1950-2000, religious affiliations play a

big part in childbearing and procreation in Catholic countries.

There are two types of childlessness, namely, involuntary childlessness and

voluntary childlessness (Baudin, De la Croix & Gobbi 2014; Allen and Wiles, 2013;

Gobbi, 2011; Poston and Trent, 1982). Involuntary childlessness as defined by Baudin De

la Croix & Gobbi (2013) in their words is a condition where “a woman….cannot

procreate because of biological constraints leading to sterility or subfecundity; these can

either be innate, or acquired. We will call the first case natural sterility and the second

social sterility.” Even more, R. Matthews & A.M. Matthews (n.d) emphasized this

4
definition of involuntary childlessness in their study of Infertility and Involuntary

Childlessness: The Transition to Nonparent hood stating that such a situation involves

couples who would like to become parents but are unable to produce their very own

biological child. Such situation may be caused by “infertility, pregnancy loss, stillbirth

or child death” (Van Balen, 2000; Mishra & Dubey, 2014).

To further explain involuntary childlessness, Baudin et al (2013) typified

involuntary childlessness as either “natural sterility” or “social sterility”. They

emphasized that women are considered naturally sterile when they are not able to

produce children due to non-preventable causes such as anatomical, genetic,

immunological or hormonal problems and also preventable causes like reproductive

health problems (Johns Hopkins University, 2006). In the case of social sterility, it is

defined as women lacking enough resources that will enable them to procreate. Baudin

De la Croix & Gobbi (2015) further justified in their following research, Fertility and

Childlessness in the United States that natural sterility can happen and affect anyone.

Social sterility, however, is driven by poverty, which prevents a woman who does not

have enough resources that will enable them to accommodate procreation.

Reading through the collected literatures relating to our topic, it is quite a surprise

that there is no single commonly accepted definition of infertility. For instance, according

to Singh & Shukla (2015), Karmon, Hailpern, Neal-Perry, Green, Santoro, & Polotsky

(2011), and Umit, Izetbegovi, Admir, Spahovic & Cihan, (2015), infertility commonly

refers to the inability to conceive within five years of trying to procreate (World Health

Organization, 2016). Whereas, infertility as defined by Johns Hopkins University (2006)

5
and Greil & McQuillan (2004), is the inability and failure to successfully give live birth

in a 12-month period of unprotected sex.

In addition, there are two categories of involuntary childlessness: infertility and

infecundity. Infertility refers to the inability of a woman to give live birth. The term

“fecundity” refers to the physiological capacity to conceive (Bolumar, Olsen, & Boldsen,

1996; Tuntiseranee, Olsen, Geater, & Kor-Anantakul, 1998; Johns Hopkins University,

2006) which makes “infecundity” the inability of a woman to conceive. Therefore, the

difference between these terms (infertility and infecundity) is that infecundity is the

inability of a woman to fully conceive while infertile women can still conceive however;

they are unable to give live birth. It is crucial that there is a clear understanding of these

because there will be ramifications as to what type of treatment the childless couple will

seek. As was previously stated, the term infertility and infecundity as defined by Johns

Hopkins University (2006) will be used in this paper in view of the fact that the key

difference between the terms will be of significant use and help in determining and

screening the participants in this study.

The causes of why couples could not bear or conceive child varies for women and

men. According to Blundel (2007), one of the problems why women cannot give birth is

due to ovulatory problem wherein women do not ovulate during the menstrual cycle.

Other problems such as cervical problem prevents the meeting of the spermatozoa and

egg cell, this is because that the cervix is the passageway wherein the sperm travels in

order to reach the fallopian tubes and uterine cavity (Blundel, 2007). The most common

problem why women cannot conceive a child is because of fallopian tube problems. If the

fallopian tube of the women is damaged or has a disease, there would be no passageway

6
for the sperm or embryo between the uterus and the ovary (Blundel, 2007). Another

problem is due to uterine problem, which often leads to the miscarriages (Blundel, 2007).

Among couples that are infertile, 30% of them are concerned with male infertility.

Blundel (2007) states that problems such as oligospermia, azoospermia, and dilated

scrotal vein which also known as varicocele are commonly the causes of infertility.

Moreover, he also states that Oligospermia is defined as the state wherein a man’s semen

and sperm lack motility and of poor quality. Other problems involved varicocele wherein

the testes of the men could not maintain the optimal temperature that affects the stored

sperm (Blundell, 2007).

According to Johns Hopkins University (2006) and Singh & Shukla (2015) they

stated that there are two types of infertility: Primary and Secondary. Primary infertility in

definition is “never having had a live birth” and “a lack of conception despite

cohabitation and exposure to pregnancy.” Meanwhile, secondary infertility is defined as

inability to give live birth after having successful childbirth previously. Furthermore,

infertility is the main type of involuntary childlessness according to Boddington &

Didham (2009) and Allen & Wiles (2013), which is affecting about 7% to 15% of,

couples and is increasing with age (Bolumar et al., 1996; Bhatti, Fikree, & Khan, 1999;

Johns Hopkins University, 2006; Umit et al., 2015).

Above all, infertility mostly affects women status and are the ones greatly

affected due to the social stigma carried by the inability to bear a child (Park, 2002; Johns

Hopkins University, 2006) resulting to many women facing divorce and as a result to

that, it is often perceived as a very serious problem among couples (P. Agrawal; et al.,

2012). However, infertility has been relatively neglected not only in terms of it being

7
considered as a health problem, but also as a topic in social science research. Meanwhile,

secondary infertility is defined as the state wherein the woman fails to bear a child,

simply due to the inability to conceive because of the inability to successfully carry a

pregnancy to a live birth following either a previous pregnancy or a previous conception

(Singh & Shukla, 2015; World Health Organization, 2016).

Another type of childlessness is “voluntary childlessness”. It is a state wherein a

couple intentionally chooses to postpone having children, and expect to have no children

given that there are no biological inhibitors to the possibility of childbearing (Kindler,

1999; Kelly, 2009). It refers to the active intentional choice, commitment to the decision,

and permanence regarding to the decision not to have children (Park, 2002; Shapiro,

2014).

However, defining voluntary childlessness is more problematic in context

(Toulemon, 1996; Gobbi, 2011 & Baudin et al., 2013), simply because this particular

situation is not fixed and permanent all throughout married life. Park (2002) stated that

there might be instances that a woman voluntarily decides not to have a child at one

point. But at the moment she decides to have one, she could no longer conceive a child

due to several reasons (e.g. infecundity). There are also couples that right from the start

consciously make the decision not to have a child. Paul (2001), for instance, states that

childless couples do not feel the inclination to become parents because they do not see

themselves as capable of being a father or a mother even if they have the ability to

procreate.

Alternatively, voluntary childlessness is also known as “intentional childlessness”

(Mawson, 2005) as a result from unconstrained choice and decision-making and does not

8
necessarily need intervention from the public (Baudin, De la Croix & Gobbi, 2015).

Individuals who made the decision not to have children and who are not infertile are

referred to as “child-free” (Park, 2002 & Mawson, 2005). Additionally, in accordance to

surveys, most young women expect to have children later in their lives. Women who

express and state intentions in remaining childless earlier are relatively rare (Chancey &

Dumais, 2009). However, voluntary childlessness becomes evident among women

through their decision of postponement of pregnancy regardless of whatever type of

childlessness couples undergo the stages of infertility.

Stages of Infertility

When couples enter into marriage, both individuals are expected to have children

when they are ready to take care of them. However, there are some cases when couples

attempt several times in conceiving or bearing a child but still fail. When couples have

continuously failed in having a child in a year, they are likely to be considered as infertile

(Johns Hopkins University, 2006; Greil & McQuillan, 2004). This may be due to many

reasons that could have happened to either one of the married individuals or both in the

past or biologically. As couples start realizing that they have a problem in conceiving or

bearing a child, they will be likely find strategies in dealing with the issue. This can be

seen in the study of Diamond (1999) that presents the stages of infertility, namely:

Dawning, Mobilization, Immersion, Resolution, and Legacy.

The first stage that couples will experience is Dawning, this refers to when both

married individuals learn about the difficulties they have in bearing an offspring

(Diamond, 1999). This is when couples have accepted that they may not be able to bear

their own biological child due to the fact that they could be experiencing from biological

9
constraints (Baudin, De la Coix & Gobbi, 2013). Mobilization is the second stage

wherein couples begin to take action in dealing with the situation (Diamond, 1999). They

are likely to try different kind of approaches in handling the situation such as seeking

help from the hospital and traditional healing. The couples hope that they are still able to

bear a child if these treatments were to be successful. After the Mobilization stage,

couples will then go to Immersion wherein they consider into doing more test and

treatments that could help them overcome the problem (Diamond, 1999). They will still

continue their treatments, but would also consider other ways into coping with the

problem if all treatments failed. And because of this, couple will go through a lot of stress

and frustrations due to the different approaches they will be doing in the latter part of the

process (Sabatelli, Meth, & Gavazzi, 1998).

Once couples have made the decision to stop finding other solutions and stop their

treatment, they will then be moving to the next stage, which is Resolution. In this stage,

the married individuals have accepted the fact they cannot bear a child and start living

childfree (Diamond, 1999). They are able to proceed into this stage by changing their

view of childbirth and being parents which will help them into rethinking and consider in

pursuing their other aspirations in life (McGuirk, J. & McGuirk M.E., 1991). This helps

them to move forward from the situation they had and give them the opportunity to focus

on their new goals and careers. In cases wherein the married individuals cannot deal with

the thought of living childfree, another option for them to consider would be adoption.

This could give the childless couples a chance to experience to raise a child of their own

and be parents (Brodzinsky, 2011). It will be beneficial to them and also the adopted

child in terms of being one as a family.

10
 Although couples may have resolved their problems by moving forward from the

situation or by adopting, they will still be encountering issues that could have been

caused by the difficulties of being infertile. This stage of infertility would be, Legacy,

which is the aftermath effects by the situation that both married individuals encountered

(Diamond, 1999). Therefore, couples are likely to encounter frustrations of not been able

to bear their own biological child and also doubting one’s self and partner when deciding

and doing other activities (McGuirk, J. & McGuirk M.E., 1991). Some would still look

back into their past situation and remember the difficulties they had which could lead

them into having depressive thoughts which could affect their relationship.

Although this could affect the married individuals negatively, this may still have a

positive outcome where the couple may start sympathizing and helping other people who

are also going through the same problems (Diamond, 1999). Since they have gone

through the difficulties they had experienced, they are likely to support other individuals

and also support children who are in care of foster homes. Their experiences may vary

depending on their perception of their condition whether positively or negatively.

Perception on Childlessness

Perception is about how a human being is able to interpret, analyze, and

understand things around him or her depending on how he or she pictured it in his or her

own personal experience (Bodenhausen & Hugenberg, n.d). As a matter of fact, being

able to perceive gives a person the ability to be able to think about how things become

the way they are and how it exists in the real world. In this process, the emotions and

mood of the person start to affect how he or she will take the perception in his or her

situation, hence the end result may be taken positively or negatively (Yi & Gentzler,

11
2016). Furthermore, the perception also changes depending on the situation of the

individual.

Women are the ones who are greatly affected of childlessness (Russo, 1976;

Veevers, 1972). This is because the identity of being a female is always about being able

to conceive a child. This is why women who are unfortunate in conceiving a child cannot

be called a mother, and has not completely fulfilled her role as one (Hird, 2003). If she is

childless, it seems that there is something lacking about her (Doornenbal, n.d.).

Moreover, due to the pronatalist ideology, women are expected to be able to mother a

child because it is what their femininity is all about and it is what they are supposed to do

(Miall, 1986; Nagi, 1966; Curran 1980). Even more, Sudworth (2006) explains that

women who get married is perceived to have higher status than women who are still

single, but when a woman is able to mother a child already, her status is now filled with

security and honor. Hence, childlessness becomes a dishonor (Goffman, 1963). This

means that if a woman is childless because of several reasons, she can be depicted as

flawed or simply not interested to become a mother (Ireland, 1993).

Childless women’s view are different with one another when they find out about

their situation. According to Rich, Taket, Graham & Shelley (2011), childless women

have their five notions about their situation, namely “‘natural’ and ‘unnatural’; woman

= mother; childlessness as a discrediting attribute; feeling undervalued; and the

significance of being childless” (p.226). He emphasized that these notions are evident

because of the pronatalist society, where people tend to stereotype those who are

childless and the faulty thinking about being one is still penetrated in the society.

12
 First notion is what Rich et al (2011) calls as “Natural and Unnatural”, this means

that when a woman is able to conceive a child, her state is perceived as normal or natural.

While if she does not or cannot conceive a child, and is considered childless, her state is

perceived as abnormal or unnatural. Moreover, this concept is also identified on how age

of women becomes a factor as to how others may perceive their childlessness. This

means that a young childless woman is less acceptable to have such situation than an old

childless woman. Alternatively, not in all cases that being childless is unnatural. In

relation to this, Rich et al (2011) emphasizes how women who are “socially unsuitable to

mother”, childlessness may in fact be considered a natural and even desirable position”

(p.236).

Second notion is what Rich et al (2011) presents as “woman = mother”, this

means that every woman is a mother. In this notion, women are prone to experiencing

strain to be responsible enough to conceive a child, and are being expected to fulfill their

motherhood. In fact, according to Ridgeway, Celia, & Correli (2004), motherhood is

indeed expected from women. Which is why, being able to conceive and raise a child

becomes a standard for women, and so if a woman is childless, it automatically translates

to being deviant (Ulrich & Weatherall, 2000).

The third notion according to Rich et al (2011) pertains to childlessness as a

discrediting attribute. In this notion, according to Miall (1985), it is about how a woman

who is infertile or childless starts to be perceived in a negative light by other people;

hence makes childlessness discreditable. Discreditable means that the stigma is being

acknowledged when people started to talk about it (Goffman, 1963). With this, women

started to feel discredited because people perceive their childlessness as a situation they

13
need to [1] justify. Due to having a pronatalist environment, women who are not able to

conceive a child are often expected to explain their situation to others because of the idea

that they need to comply with the social norms (Woollett, 1991). [2] Their childlessness

becomes an indicator why they start to lose their credibility. [3] Their childlessness is an

act of selfishness. In relation to this, Morell (1994) states that a woman who decides to

become a mother is selfless, while the one who decides not to is selfish and only care

about herself. Hence, childlessness becomes correlated with having no empathy for

others.

The fourth notion according to Rich et al (2011) is the feeling of being

undervalued. In this notion, childless women do not feel that they are being valued

equally as those who are capable of bearing a child; this perception is an effect of

Pronatalist Ideology. This is because this ideology emphasizes the idea that a woman’s

identity of her femininity is only fulfilled through conceiving a child (Miall, 1986; Nagi,

1966; Curran, 1980). It appears that the society gives less significance to the choices the

childless women make, than those choices the parents are allowed to have (Rich et al.

2011).

The fifth notion according to Rich et al (2011) is the significance of being

childless. In this notion, women are able to give more importance to establishing security

in their lives due to their lack of having a child to raise. However, on the negative note,

since being childless is associated with “deficiency, and having connotations of a lack”

(Bartlett, 1995 & Campbell, 1985), women do not want to be called childless because of

its negative meaning. These various perceptions of women about their condition may

affect the kind of consequences they may experience on their relationship with their

14
partners. Thus, studies show that their initial reaction when learning their situation varies

when and also the women’s view towards other childless married couples could be

influenced as well due to external factors that labels “childless married couples” as a

unfavorable.

Consequences of Childlessness on Married Couples

Impacts of childlessness not only affect the individual but also the couples as

well. One impact on couples is the effect on the marital quality. Marital quality has never

had a constant definition (Glenn, 1990). Researchers studying marital quality were not

able to come up with an agreement as a regard to the understanding, explanation and

measurement of marital quality. This is also associated with terms like adjustment,

satisfaction and commitment (Vannoy & Philliber, 1992). Different authors see marital

quality as the focus or importance in measuring the relationship of a couple. deTurck &

Miller (1986) who focused on the adjustment of the relationship of both husband and

wife believes that marital adjustment is an important factor in measuring the level of

relationship of couple due to the fact that married individuals encounter various changes

in their relationship with each other and other significant people as well. Although many

studies have different interpretations of marital quality, all studies have a common

understanding; that marital quality is how married couples perceive their marriage,

whether positive or negative (Johnson, Amoloza, & Booth,1992).

Childlessness is major reason why some couples have difficulty in maintaining

their relationship. According to Mercy (2013) and Winberg (1990), childlessness often

leads to the end of the relationship of a married couple. Based on the study of Peterson,

15
Newton, Rosen, & Schulman (2006), couples will be going through a lot of stress in

maintaining the relationship they used to have before encountering this problem. He also

adds that they will also have misunderstanding with one another since that both

individuals will have different perspective and level of stress to the issue that will lead to

more problems in terms of their relationship. Married individuals forget the importance

of their marriage as they lose hope of finding progress and happiness with their partner in

the latter part of their lives together due to the missing variables of their relationship

(Becker, 1994).

But not in all situations that being childless is at all negative. Having no children

also affects the relationship of the married couple positively. Like any other crisis,

infertility may bring up difficulties for the couple, this problem of theirs could be a big

influence in strengthening their relationship (McGuirk,J. & McGuirk M.E., 1991;

Repokari, Punamaki, Unkila-Kallio, Vilska, Poikkeus, Sinkkonen, Almqvist, Tiitinen, &

Tulppala, 2007). This means that childless couples tend to have a better relationship with

their partners because of the advantages of not having children. Harvey (2008) stated that

childless couples have the benefits of having more free time with each other, freedom to

do the things they want and the money to spend and save. Couples are able to explore and

try out new things since they do not have to worry about other things except for

themselves. Diamond (1999) mentioned that the couples do not have to worry about the

activities they will do since they do not have any responsibility such as taking care of

children and sending to school for education. He also adds that childless couples will also

be able to save and spend more money since they do not have to pay for college tuition

fees and future savings. Becker (1994) was also able to see that married couples are able

16
to see life in a different perspective and are able continue with their lives more actively.

Aside from these advantages, the support of one another during the grievance in being

childless will also improve the couple’s relationship (Donkor & Sandall, 2009;

McGuirk,J. & McGuirk, M.E., 1991). Both married individuals will be experiencing

difficulties during the process managing of the situation, which will help them in building

a better relationship and a sense of trust for one another (Peterson, Newton, & Rosen

2003). Whether the consequences of being childless may be negative or positive, the

couples will take action in order to deal with being childless.

Management of Childlessness

There are two ways on how couples manage their problems of infertility, namely:

management of the situation of childlessness and management strategies in order to have

a child. Management of the situation of childlessness include self- management strategies

such as distancing, self-controlling and accepting the responsibility, effective

communication, denial or wishful thinking, talking to others about their infertility and

“passing as normal.”(Donkor & Sandall, 2009, p. 86; Peterson et al, 2006; Sydsjo et al,

2011). Meanwhile, management strategies in order to have a child include pursuing

medical related strategies, relying on traditional strategies, seeking professional

counselling, and other options such as adoption and surrogacy (The ESHRE Capri

Workshop Group, 1994; Okonofua, Harris, Odebiyi, Kane, & Snow, 1997).

17
Management of the situation of childlessness

According to the study conducted by Peterson et al. (2006), that there are three

common self- management strategies done by women in order to deal with infertility,

namely, distancing, self-controlling and accepting responsibility. Distancing is when

either the husband or wife sets space between them which aims to ignore the situation

that both couple are in. Self-controlling, is an approach wherein couples try not to show

their true emotions and feelings about the problem. And lastly, accepting responsibility is

when the wife or husband takes the responsibility of the problem they have. Although

these strategies are common for some couples, these may not be much effective due to

the fact that majority of those approaches ignores the importance of communication and

the accountability of an individual. According to studies, effective communication of

couples is one best management strategy because it enables them to strengthen their

relationship through trust and respect (Pepe & Byrne, 1991; Sydsjo, Svanberg, Lampic, &

Jablonowska, 2011; Abbey, Andrew, & Hallman, 1995; McGuirk,J. & McGuirk, M.E.,

1991).

According to Donkor & Sandall (2009), denial or wishful thinking is a form of

self-management in dealing with infertility. This is when an infertile woman denies her

situation in terms of not accepting her case of infertility. Donkor & Sandall (2009)

further explains that denial may happen when a woman refuses or avoids going to events

that might remind her of her being childless or her being infertile.

Another form of strategy is talking to others about their infertility Donkor &

Sandall, 2009). Women rarely touch this method of strategy on dealing with the situation;

they refuse to talk to others about their infertility. This being said, women do not like to

18
talk to others for comfort or help when the topic is about infertility. One of the many

strategies used by women is “Passing as normal” (Donkor & Sandall, 2009, p. 86). This

particular strategy refers to when women tries to keep their problem to themselves and

keeping it as a secret from others. This means that most women would just keep their

problem from other people but remain open to discuss with their husbands or partners.

Another strategy common to women is “taking control” (Donkor & Sandall,

2009, p. 86). This pertains to women keeping themselves busy with other activities and

just focusing on things that would not remind them of their infertility. Lastly,

Fate/acceptance/blame is another form of strategy commonly used by women. This refers

to women fully accepting their infertility and just living a childless lifestyle. Some

women tend to rely on their religion and fate to God, through praying to God for

blessings, while others blame their childlessness on God’s will. In the study of Donkor &

Sandall (2009), women who stated that they depend on their religion and religiosity for

their coping of infertility were mostly Christians.

Self-management does not only dwell on the emotional aspect of dealing with the

situation. Some couples tend to sport active lifestyles (Mawson, 2005). In relation to this,

Nowak, Rynkiewiez, Radzinska, & Starosta (2009) states that among women who sport

an active lifestyle, 26% of them were childless. Active lifestyle include “religious ideals,

love of nature and active lifestyles, career, and adventure/exploration of life

opportunities” (Mawson, 2005, p.18). It was later on noted that childless couples pursue

having unique lifestyle or merely contributing to social work instead of being sad and

worrying about not having children (Mawson, 2005). How couples manage with

19
childlessness may vary depending on the socio-demographic factors of the childless

individual.

Management Strategies in order to have a child

Management strategies in order to have a child consist of medical related

strategies, traditional strategies, professional counselling, and other options which include

adoption and surrogacy.

One of the strategies in order to have a child is medical related strategies. Medical

infertile treatment for male and female vary. For female medical infertility treatments,

this includes tubal transfer, In Vitro Fertilization (IVF), Frozen Embryos, and Artificial

Insemination while treatments for male infertility are Intracytoplasmic Sperm Injection

(ICSI), drug treatment, and Insemination. These treatments will be discussed thoroughly

on this area.

Repairing tubal scarring and correcting other abnormalities of reproductive organs

are referred to as surgical techniques. Artificial insemination is defined as using the

husband’s semen or at times, using a donor’s semen to conceive a child. Lastly, In vitro

fertilization techniques refer to the process of recovering mature ova, after the recovery,

it is then fertilized in a lab, finally it is reimplanted in the uterus (Holbrook, 1990;

Himmel, Ittner, Kochen, Michelmann, Hinney, Reuter, Ringert, 1997).

To further expound on in-vitro fertilization (IVF), it is a highly advanced

reproductive technology that has several complexities in terms of its commercialization

and ethical matters. IVF refers to a process wherein a doctor activates a woman’s ovaries

with the use of certain medications and removes some of her eggs in a surgical manner

called laparoscopy (Holbrook, 1990). After the process of removal of eggs, the doctor

20
then places the eggs on a petri dish then proceeds to the fertilization of the eggs. The

embryos as a result from the fertilization process are then implanted into the womb.

(Holbrook, 1990; Himmel, Ittner, Schroeter & Kochen, 1999) The cost of IVF treatment

runs around $5000 or roughly Php 235,000 per attempt.

There have also been several variations of IVF, which may be also called as tubal

transfers. The first is Gametic Intrafallopian transfer (GIFT), it is a process wherein eggs

are taken, then combined with sperm, and finally injected into the fallopian tube with

hopes of conception after the process. Another tubal transfer is Cervical Intrafallopian

transfer (CIFT). The process of CIFT is by transferring the gametes or the sex cells

directly into the tubes.

Although the development of In Vitro Fertilization has been rapid with almost

200 clinics performing the treatment worldwide, IVF’s supposed outcome has been

ineffective and unsuccessful in most cases whereas both forms of tubal transfers (GIFT

and CIFT) achieve higher percentage of pregnancy (Holbrook, 1990; Himmel et al.,

1999). Frozen Embryos is a method created because of complications that arise in IVF

treatments. With the procedure of IVF, multiple fertilized eggs are wasted due to

simultaneous implantation while on the other hand; frozen embryos can save fertilized

eggs because the doctors can freely implant fewer eggs several times increasing the

possibility of pregnancy (Holbrook, 1990). However, there is just one problem with the

use of frozen embryos, which occurs when the couples do not know what to do with the

leftover embryos after the woman was able to achieve pregnancy.

Artificial Insemination is chosen as a medical treatment when the source of

infertility is the husband. The procedure, however, is performed on the woman. This

21
method refers to the injection of semen from a donor into the genital tract of the woman

(Holbrook, 1990). If the man was to be the infertile and his wife still had the ability to

conceive a child, some couples would consider in taking Artificial insemination by donor

(AID) as an option. In this treatment, an anonymously donated sperm is injected into the

woman's uterus during her fertile period (McGuirk,J. & McGuirk, M.E., 1991). Despite

the fact that the procedure would be uncomplicated, many couples still have doubts

whether to continue with this treatment since many people see it as similar to rape since

“women lack the self control over their bodies, while a stranger's semen is inserted into

their uterus” (McGuirk,J. & McGuirk, M.E., 1991, p.146). In recent studies, single

women who want to get pregnant and have a child are also using this method. Most of the

women who have attempted artificial insemination achieve pregnancy but may start to

experience to undergo many attempts for the conception to finally occur (Noble, 1987;

cited from Holbrook, 1990).

Drug treatments used for infertile men with various congenital testosterone

deficiencies such as idiopathic hypogonadotropic hypogonadism or Kallman’s syndrome,

gonadotropin-releasing hormone (GnRH) is given to activate and stimulate

spermatogenesis and generation of pituitary release of episodic secretion of

gonadotropins (FSH, LH). “Another possibility is to apply HCG (human chorionic

gonadotropin), which has LH-like activity for stimulating intratesticular production of

testosterone.” (Himmel, et al. 1999, p.113). Intracytoplasmic Sperm Injection or ICSI is

a medical treatment for infertile male where the procedure is done by injecting a

spermatozoon or sperm into the oocyte plasma (Himmel et al., 1999; Kamischke &

Nieschlag, 1999; Zegers-Hoschild, Adamson, Mouzon, Isihara, Mansour, Nygren,

22
Sullivan, & Vanderpoel, 2009). This method has become one of the most successful used

for treating male infertility (Kamischke & Nieschlag, 1999).

Furthermore, another kind of strategy women undertake is traditional .In context

of the Bible, Christians and Catholics believed that if they continue to have a strong faith

in God, they would still be able to bear a child even when they are already confirmed as

infertile. This can be seen in the book of Genesis 17: 15-21 wherein Abraham and his

wife, Sarah, were both not physically capable of conceiving a child due to their old age.

Due to Abraham’s strong faith and loyalty to God, his wife was then able to bear a child

who was named Isaac. This instance goes to show that their faith is what led them to

eventually have a son. This is one of the several reasons why some infertile couples turn

to religious and faith healing practices in hope for them to be able to conceive and

successfully bear a child.

Furthermore, religion and spirituality or religiosity among infertile couples is

essential parts of culture and influence on how they experience and interpret infertility.

Religion is a doctrinal framework which gives guidance to sacred beliefs and practices

that emphasize on a higher being or God. (Roudsari & Allan, 2011). Moreover, religion is

composed of system of beliefs that shape how believers devote and worship. While on

the other hand, spirituality or sometimes referred to as religiosity is the connection of the

people with their God through beliefs and practices. Some infertile couples often turn to

religion for comfort and blessings as they believe that it will give them strength to hold

on to their hope and provide meaning to their infertility issues and experiences. (Roudsari

& Allan, 2011)

23
 Most women rely on their fate and religion when coping with infertility (Donkor

& Sandall, 2009). “Spiritual healing attests to spiritual awareness and accompanies the

giving and receiving of healing and has applications for treatment of infertility,

pregnancy, and labor and delivery” (Benor, 1996, cited in Hollywood, 2009, p. 38). In

the study of Jocano (1967), he states that in situations of eminent childlessness, religious

catholic couples longing to be blessed with children often turn to participate in the

famous prayer and dance fertility festival they call “Sayaw sa Obando.” The Obando

Fertility Rites is a dance and a prayer ritual that is held annually during the month of May

in the province of Obando, Bulacan. The feast lasts for three consecutive days

specifically every May 17, 18 and 19 wherein they dance along in the streets to the tune

of bamboo instruments playing as they are dressed in traditional Filipino costumes.

The purpose of this ritual is to ask for blessings from the Patron Saints San

Pascual Baylon (St. Pachal), Santa Clara (St. Clare) and Neustra Senyora de Salambao

(Our Lady of Salambao) while singing the song “Santa Clara Pinung Pino.” The style of

their dancing imitates the images of the Patron Saints mentioned above. Saint Pascual is

the Patron Saint of all Eucharistic Congresses and societies (O’Brien, Fickel, Arkins, &

Lane, 2014). He is also the patron saint of chefs, cooks and watching over family

kitchens. Saint Paschal Baylon’s feast day is May 17.

On every 18th of May, the Patron Saint Clare is celebrated. Saint Clare is the

Patron Saint of good weather due to her name, which is “Claro” in Spanish, which means

“clearing of the skies”. The practice on the day of the celebration of Saint Clare is

offering of the eggs at the feet of Saint Clare. This is believed to clear any stormy

weather. Eggs are offered because the name of Saint Clare is taken from the Spanish

24
word “Claro” which means egg white. Most of the participants of this feast not only ask

for children, but also ask for spouses or mates (delos Reyes, 2005). Every 19th of May is

devoted to the celebration of Our Lady of Salambao. She is the Patron Saint of the Sea

where most people get their source of living, especially the fishermen. She is also

considered to be the Patron Saint of the Childless in an unexpected turn of events. Our

Lady of Salambao is a symbol of source of life.

In addition, according to the British Infertility Counselling Association (2007),

professional counselling is a treatment where infertile couples are able to consult to those

professionals who tend to be more capable in understanding their childlessness’ situation.

During these consultations, the couples are more likely to understand how they can

control their emotions to have a more positive grasp about their childlessness. This is due

to the fact that these health professionals or counsellors are knowledgeable about how a

continuous process of support is helpful in making the couples become more aware about

their situation (Malik, 2003). More specifically, these professionals talk about how

“support, advice, guidance and the clarification of life goals” (European Society of

Human Reproduction and Embryology) are some of the approach that will make the

couple deal with their situation more effectively (Joy & McCrystal, 2015). Given these

points, counselling as a management strategy of their involuntary childlessness gradually

improve the whole well-being of those who make use of it as a treatment (Thorn, 2009).

As a matter of fact, according to Bokaie, Farajkhoda, Enjezab, Heidari, & Karimi

(2012) and Kalus (2002) other options such as child adoption is an act where an infertile

couple chooses and locates a child that is not biologically related to them. The main

reason is that adoption is one way for these childless couples to experience how to

25
become parents of the adopted children, through this, the couples are given the

opportunity to take good care of the children they will adopt, and to guide them in their

growth (Brodzinsky, 2011). To be able to understand how they can help these children,

they should first analyze how and why the biological parents of these abandoned children

decided to abandon them (Child Welfare Information Gateway, 2013).

Adoption is one remedy to solve the problem of infertility (Kalus, 2002). He

emphasized that these childless couples feel the urge to adopt because of their lack of

offspring, in which resonated with having the male as an infertile himself, the female as

an infertile herself, or both the couples as infertile themselves. Yassini, Taghavi Shavazi

N., Taghavi Shavazi M., Pourmovahed, & Sliiri (2015) emphasizes that adoption is the

best alternative method in solving infertility because not only that it lessens the

psychological impact but also lessens the possible expenses of the couples if they decided

to make use of medical treatments. As a matter of fact, couples who are not successful

with having medical treatments then resort to the act of adoption (Bell, 2012).

There are various ways to adopt a child, take Adoption in the Philippines as an

example. In this country, adoption can be done through these three ways, which are

Agency Adoption, Relatives Adoption, and Independent Adoption (Domestic Adoption

Act of 1998). According to McDermott (1993), Agency Adoption means that the

biological parents of the child give up their rights as parents to the agency, and that the

agency will have the right to find new adoptive parents for the child. He explains that in

this type of adoption, the agency takes into account if the soon-to-be parents are capable

of raising a child. Also, couples are expected to take many tests before adopting a child to

26
make sure that they are qualified to continue with this kind of adoption (McGuirk,J. &

McGuirk, M.E., 1991).

The second type of Adoption in the Philippines is called Relative Adoption.

According to Child Welfare Information Gateway (2013), this type of adoption is the

type of adoption where the relatives of the child’s biological parents are given an

opportunity to adopt the child if they are able to prove to the child-placement agency that

they have the sources and capability to raise the child. It also states that, “A relative shall

be an individual who is legally related to the child by blood, marriage, or adoption

within the fourth degree of kinship, including only a brother, sister, uncle, aunt, first

cousin, grandparent, great-grandparent, great-great grandparent, great-aunt, great-

uncle, niece, nephew, grandniece, grandnephew, or a stepparent”. With this, the child-

placement agency will now observe the foster-parents to see if they are truly capable on

childrearing.

The third type of Adoption in the Philippines is called Independent Adoption.

According to McDermott (1993), it is the type of adoption where the biological parents

have the opportunity to meet the couple who will adopt their child. He emphasizes that

this face to face meeting will be beneficial to both parties because they are able to have a

glimpse as to what type of people the biological parents and the adoptive parents are.

However, the things they will be talking about will remain confidential because “in most

states, the decision about whether or not to exchange identifying information is left to the

discretion of the parties” (McDermott, 1993, p.148). For the part of the biological

parents, they will be able to see the kind of parents the adoptive parents could be, and be

able to identify what kind of lifestyle they could provide for their child. As to the

27
adoptive parents, they will be able to have a sense of security that they will not lose the

child they will adopt. As a result of this, it would be much easier for them to explain to

the child about the history of his or her biological parents.

Surrogacy, on the other hand, is about how a woman conceives a baby for another

woman (Anleu, 1992). The arrangement of this process involves artificial insemination of

a woman who agreed to be inseminated with the husband’s sperm, and then carries the

baby for nine months, and give the baby to the parents once she gives birth to the

genetically related child (Anleu, 1992 & Gulino 2015). With this, the woman who

conceived the child is perceived in a negative light because of the act she committed.

This is due to the fact that Surrogacy is perceived as selling of babies where a woman

involved is hired to fulfill the process (Markens, 2007).

Factors Influencing Women’s Management of Childlessness

The management of infertility may be influenced by some socio-

demographic factors namely: age (Durning & Williams, 2004), educational attainment

(Durning & Williams, 2004), yearly income (Frank, 1990) and religious affiliation (Singh

& Shukla, 2015). It was noted that in the study of Durning & Williams, (2004), age was

used to determine influences and contributions to fertility adjustment or management. It

was indicated that this significant variable (age) greatly affects couple's decision on

management of childlessness. Age plays a big factor in decisions of adoption. According

to Frank (1990), older couples tend to just adopt instead of pursuing medical treatments.

Aside from age, another variable that affects couples decision in dealing with infertility is

education (Durning & Williams, 2004)

28
 A study in India showed that women, who were able to reach or finish secondary

education and are financially capable, were likely to seek infertility treatment from

private sectors rather than from hospitals owned by the government (Singh & Shuklah,

2015). This makes couples who lack educational attainment and does not have enough

resources depend more on government hospitals and clinics for their infertility treatment.

It was also noted that infertile couples who lack resources tend to seek treatments

from temples, religious or traditional healers and participate in fertility rituals for child

blessings (Singh & Shukla, 2015). In addition, several factors such as yearly income,

personal beliefs, and length of treatment become factors in treatment seeking decisions.

Although couples who receive low income per year are more constrained to pursue

medical treatments that are expensive such as IVF treatments or other surgical methods.

However, these couples are more open-minded to adoption and accepting a childless

lifestyle (Frank, 1990). Ulbrich, Coyle, & Llabre (1990) states that the employment status

of the wife affects how the couples adjust to the situation since the earnings of the wife

gives them both a mutual understanding on how they should deal with their childlessness.

Moreover, other variables such as personal beliefs, partner’s beliefs, physician’s

advice, emotional stress, and probability of treatment being effective plays a big factor in

the decision of management of infertility (Frank, 1990). However, religious beliefs or

religiosity, opinions of family and friends, ethical beliefs and legal implications do not

affect the decision of women’s management of childlessness. In opposition to Frank

(1990), Donkor & Sandall (2009) stated that infertile women relied on their faith and

religiosity on dealing with infertility. In the event in which couples take action on their

29
being childless, couples’ chosen management strategy may have varying effects on their

relationship status and marriage.

Management of Childlessness and Couples’ Marital Quality of Relationship

As couples handle their situation of being childless, their relationship with another

is affected due to the different outcomes they will be encountering. Some strategies could

lead to the misunderstanding of couples and some to the improvement of the quality of

marriage of the couple. The results of their relationship of one another depends on how

the couples dealt with the situation they are handling during their times of difficulties

(McGuirk, J. & McGuirk M. E., 1991).

Studies have shown that some management strategies could have a negative effect

towards the relationship of both married individuals. One of these effects is the poor

communication of individuals with another (Peterson, et al, 2006; Pepe & Byrne, 1991;

Abbey et al, 1995; Schmidt, Holstein, Christensen, & Boivin, 2005). This is because of

the strategies that some couples are doing involves them to not express their feelings to

one another as they keep it to themselves which could lead them to the misunderstanding

and conflicts. In addition to this, it becomes a burden to the married since their lack of

communication will only increase their stress regarding their incapability to have a child

(Schmidt et al., 2005). Other than poor communication, many couples go through stress

and depression when managing childlessness (Peterson et al., 2006). Because of the poor

communication of the married individuals, couples start to feel that they are not being

supported by their partner which could have a great effect towards how couplers adjust to

the situation and with each other. McGuirk,J. & McGuirk, M.E. (1991) mentioned in his

study that couples are still going to experience frustrations, as they could not bear a child.

30
The reason for this is that time, effort, and money were wasted and still they cannot have

their own biological child.

Although these management strategies of childlessness affect the relationship

negatively, there are still few positive effects that are evident to the marital quality of the

couples’ relationship. Some couples learn from how they manage from their situation.

This means “Couples, as a result of resolving their infertility, are able to reevaluate their

life goals and thus choose an alternative to conception that best helps them reach those

goals” (McGuirk, 1991, p.131). This gives couples a chance to choose a different path in

their lives as they could take the opportunity to follow their aspirations in life and look

for other ways to improve their relationship with one another. Whether the management

strategy may be successful or not, there will be married individuals that will continue

their support for their partners which will likely improve their relationships (Donkor &

Sandall, 2009).

Diamond (1999) states that the couples were able to improve their relationship

due to the improvement of their communication with one another. The result from their

strategies such as going to the therapy could help them in realizing other problems they

had with each other aside from being infertile (Diamond, 1999; Schmidt et al., 2005).

The couples who are able to maintain the mutual relationship throughout the management

period will have better understanding towards one another. The main reason is that the

couple was already able to overcome a major problem that lead them to become more

prepared to face other difficulties they might encounter in the latter part of their marriage

(Diamond, 1999; McGuirk,J. & McGuirk, M.E., 1991). Whether the treatment of

infertility may be successful or a failure, both individuals will be likely to have a better

31
relationship due to the hardship they have experienced (Peterson et al., 2003). But of

course, the quality of the relationship will only improve if both married individuals are

involved in the treatment and management of childlessness (Pasch, Dunkel-Schetter, &

Christensen, 2002). As was stated, the strategies of how couples deal with childlessness

have an affect on their quality of marriage.

This concerns how these ways of management could affect specifically on the

marital adjustment and marital commitment of both married individuals. Marital

adjustment refers to how couples deal with unusual situations that could bring difficulties

in the relationship (Spanier, 1976). Being infertile is one of the many problems that some

couples face, which eventually affect how they both perceive their marriage. Since both

married individuals are affected by the condition of childlessness, this could influence

how satisfied they are with their marriage. This also implies as to how the couples react

to each other in terms of their commitment in their relationship. Lastly is marital

commitment, it is defined as to how the married individuals feel dedicated and faithful to

their partners (Surra & Hughes, 1997). Since both married individuals are affected by the

condition of childlessness, this could influence how satisfied they are with their marriage.

This also implies as to how the couples react to each other in terms of their commitment

in their relationship.

Synthesis

Childlessness is defined as a state wherein couples do not have children. Studies

show that there are two types of childlessness, namely: voluntary childlessness and

involuntary childlessness. Voluntary childlessness refers to the situation where couples

made a decision to not have children. While involuntary childlessness refers to the

32
situation where a couple cannot have a child due to several reasons beyond their control.

There are two categories of involuntary childlessness: infertility and infecundity. The

difference between these two terms is that infertility refers to the condition when a

woman cannot give live birth, while infecundity refers to the inability for a woman to

conceive a child.

The literature shows that when couples start to become fully aware that

they might have difficulties in having their own child, they are likely to seek treatment in

order to deal with the situation. The treatment can be identified depending as to what

stage the couples are already in. Diamond (1999) presents that these can be seen in stages

of infertility namely: [1] Dawning, [2] Mobilization, [3] Immersion, [4] Resolution, and

[5] Legacy.

The women’s initial reaction upon knowing their situation and their view on other

childless couples shows how they perceive childlessness.  Study show that there are

common five notions on their situation, namely: [1] whether if it is “natural” or

“unnatural”, [2] if being a mother is important in one’s womanhood, [3] childlessness as

a discrediting attribute, [4] the feeling of being undervalued and [5] significance of being

childless.

The review showed that there are negative and positive consequences of

childlessness that married couples could be experiencing. Childlessness usually brings

stress in maintaining a good relationship due to the hardships that couples will be

experiencing, which could also lead to the end of the relationship. However, being

childless does not only affect the couples negatively. According to studies, couple could

still have a better relationship because they would be able to focus on other things such as

33
their career and aspirations in life without worrying about the children that they should be

taking responsibility of.

The management of childlessness is an approach wherein couples do in hope to

deal or solve their problem of being childless. There two ways in which management of

childlessness is dealt with and these are: management of the situation of childlessness and

management strategies to have a child. Management of the situation of childlessness

include self- management strategies such as distancing, self-controlling and accepting the

responsibility, effective communication, denial or wishful thinking, talking to others

about their infertility and “passing as normal. Meanwhile, management strategies in

order to have a child include pursuing medical related strategies, relying on traditional

strategies, seeking professional counselling, and other options such as adoption and

surrogacy. These management strategies, however, are affected by various factors such

as: [1] age, [2] education attainment, [3] yearly income and [4] religious affiliation.

Studies show that the marital relationship is affected by how couple manages their

situation of being childless. The management of childlessness by couples could affect

their quality of their marriage either negatively or positively. One of the common reasons

why the marital quality of couples is affected by the some management strategies

negatively is due to having poor communication. However, some couples may improve

their relationship because of the mutual hardship they experience from dealing with

infertility.

Studies of infertility in the Philippines examine factors and consequences on

adoption, emotional and coping response to infertility, and causes and perception of

infertility. This study therefore is a response to the research gaps found in previous

34
studies namely: [1] majority of studies focused on the effects of infertility to couples and

few on the management of childlessness and marital quality, and [2] most studies on

childlessness abroad are quantitative in nature. Most studies on the subject matter were

done relatively for the past ten years and there might be changes on how we perceive this

particular situation at the present time.

Conceptual Framework

35
 Figure 1. Conceptual Framework

This particular study examines how Filipino women manage childlessness could

be in two different types, namely: management of the situation of childlessness and

management strategies in order to have a child (Okonofua et al., 1997; British Infertility

Counselling Association, 2007). Management of the situation of childlessness include

self- management strategies such as distancing, self-controlling and accepting the

responsibility, effective communication, denial or wishful thinking, talking to others

about their infertility and “passing as normal.”(Donkor & Sandall, 2009, p. 86; Peterson

et al, 2006; Sydsjo et al, 2011). Meanwhile, management strategies in order to have a

child include pursuing medical related strategies, relying on traditional strategies, seeking

professional counselling, and other options such as adoption and surrogacy (The ESHRE

Capri Workshop Group, 1994; Okonofua, Harris, Odebiyi, Kane, & Snow, 1997).

In order for the couples to choose their strategy of management of childlessness,

there are various factors that affect their decision. Studies have shown that there are

36
socio-demographic characteristics that may influence the management of childlessness

which are: age, education, financial capabilities, and religious affiliation which then

shape the women’s management of childlessness.

Age plays a significant factor that influences on how couples decide as to how

they can deal with their condition of being childless (Durning & Williams, 2004).

According to Frank (1990), when couples are both in old age, they are more likely to

adopt a child compared to younger couples.

Educational attainment has an effect on how couples seek fertility treatment.

Individuals may have different knowledge in seeking for treatments and adjustment to

infertility. According to the Durning & Williams (2004), individuals who are able to

achieve a good education shows that they become more selective in choosing what kind

of treatment they want to make use of. Less educated childless individuals tend to seek

help from traditional healers, religious institutions and join infertility rituals in order to

help them in their condition (Singh & Shuklah, 2015).

The financial capability or yearly income of married individuals shows that if the

couple does not have enough resources, they are more likely to rely on religious and

traditional practices or choose to rather go to any government hospitals for treatment

(Singh & Shuklah, 2015). However, it was shown in the past studies that couples who are

well-off really make it to a point to seek medical treatments because they can afford it.

Religious affiliation also has a relationship to how couples manage their situation

because some women become dependent on their religion and faith (Donkor & Sandall,

2009). Couples who believe solely in their faith tend to attend religious festivals

37
attributed to the seeking of blessings from their Gods which in hope will grant them their

prayers of having children.

Another variable that affects Filipino women’s management of childlessness is

the type of involuntary childlessness, which refers to whether if the husband or the wife is

the source of the fertility problem. It also defines whether if the issue would be infertility

or infecundity (Johns Hopkins University, 2006). This is to show on what kind of

approach the married individuals will practice and how they will deal with their situation.

Apart from the type of involuntary childlessness, perception is also considered as an

influencing factor to the management.

It will be explored if the various perceptions of childlessness are being

experienced by Filipino childless women. Perception on childlessness presents the

different point of views of women about her situation, whether she takes it positively or

negatively. These views may vary depending on their initial reaction upon knowing the

problem and views on other childless married couples. According to Rich et al. (2011, p.

266), women usually experience five notions about their situation, these are the

following: “‘natural’ and ‘unnatural’; woman = mother; childlessness as a discrediting

attribute; feeling undervalued; and the significance of being childless”. These notions

may be associated with the childless Filipino women’s initial reaction on their situation,

as well as their views on other childless married couples. It is emphasized how the

situation of childlessness embarks and influences the stress of women who want to

manage their situation to be able to move out from the negative connotation of being

childless (Frank, 1990).

38
 The last variable that will be explored is Marital quality which is stated by

Sabatelli et al. (1998) is the importance of measuring the relationship in terms of marital

adjustment, and marital commitment (Vannoy & Philliber, 1992). According to previous

studies, the management affects the communication and trust of married individuals for

one another (Peterson, et al, 2006; Pepe & Byrne, 1991; Abbey et al, 1995). However, it

also shows that the management could improve the relationship of couples due to the

different coping techniques that would involve them in supporting one another (Donkor

& Sandall, 2009).

Statement of the Problem

39
 This study primarily aims to describe the various factors that explain the

management of Filipino married women to address their involuntary childlessness. This

shall also look into how these management strategies may pose implications on the

quality of the marital relationship. Specifically, it aims to answer the following questions:

1. What are the socio-demographic characteristics of Childless Filipino Married

women who are involuntary childless?

2. What is the nature of involuntary childlessness these women experience?

3. What are their perceptions regarding childlessness?

4. What management strategies do they employ to address their situation on

being childlessness?

5. What is the Quality of their Marriage?

6. How does management of childless Filipino women vary in terms

socio-demographic characteristics, nature of involuntary childlessness and their

perception on childlessness?

7. How does management of Involuntary Childlessness

influence Marital Quality?

40
Definition of Terms

1. Socio-Demographic Characteristics

In this study, the term refers to women’s age, education attainment, place of

residence, religious affiliation, duration of marriage, occupation, and yearly income.

Age- in terms of years, as of last birthday

Educational Attainment - refers to highest degree of education achieved by the

Filipino Women (e.g. grade school graduate, high school graduate, college

graduate, Master’s Degree or Doctoral Degree),

Yearly income - in terms of estimated yearly salary in pesos

2. Nature of Involuntary Childlessness

Involuntary childlessness is a condition in which couples are not able to bear an

offspring despite attempts to be impregnated (Baudin et al., 2014). In this study,

involuntary childlessness is defined as a state wherein married couples do not have any

biological child due to various reasons. The nature shall be determined in terms of the

type of involuntary childlessness the couple is facing and the source of infertility or

infecundity. Moreover, it is classified in this study as infertility (the state wherein a

woman is unable to give a successful live birth) or infecundity (the state wherein a

woman is unable to fully conceive).

Type of Involuntary Childlessness - this refers to whether if it is infertility or

infecundity

Source of Infertility - this refers to whether the husband or wife is source why the

married couple is not able to have a biological child.

41
3. Perception on Childlessness

Perception is an interpretation, analysis and understanding of an individual about

his or her personal experience. In the context of childlessness, perception can be

understood as either negative or positive. Negative views can involve feeling of low self-

esteem (undervalued), presence of discrediting attributes, and whether or not the

condition is something natural or unnatural (Rich et al., 2011). In this study, this refers to

the initial reaction of their situation and how they perceive other childless married

couples, whether positively or negatively. Examples of negative perceptions may include

stigma, pessimism, loneliness, stress, and anxiety whereas positive perceptions could

include acceptance of their condition, being hopeful that their childlessness will be

remedied, being optimistic about the situation, display of confidence, and being more

intimate with their partners.

4. Management of Childlessness

This term refers to the treatment assigned or chosen by the childless couple

depending on the type of childlessness experienced, namely, medical treatments, faith

healing, sporting an active lifestyle, among others (The ESHRE Capri Workshop Group,

1994). In this study, this term refers to the strategies used by these Filipino women in

dealing with their situation of childlessness or not having a child. Example methods that

will be explored are infertility medical treatments, counselling, religious/faith healing,

seeking help from traditional healers, self-management, and socially focused active

lifestyle and adoption.

42
5. Marital Quality

Marital quality refers to how married couples perceive their marriage, whether

positively or negatively (Johnson et al., 1992). It is defined as the measurement of a

concept of couples’ relationship with regards to the terms such as marital adjustment and

marital commitment (Vannoy & Philliber, 1992). In this study, this refers to how the

women perceive how satisfied or not satisfied they are with their relationship in terms of:

Marital adjustment, and Marital commitment.

Marital Adjustment - this refers to how couples accommodate situations that they

face

Marital Commitment - refers to how married individuals give and promise

themselves to stay with their partner

Significance of the Study

This study adds up to a scant base of literature regarding Involuntary

Childlessness. One, most of the studies focused on married individuals while this

proposed study looks at the perspective of women. This is due to the fact that the “ill

effects of childlessness are far more severe for women than they are for men” (Ram,

2005, p.2). This is why the research team decided to focus on how women manage their

involuntary childlessness. As a matter of fact, not many studies, particularly in the

Philippines, look at the ramification or consequences of childlessness on marital

relationship. Therefore, these gaps justify why we need to conduct this research.

Theoretically, results of the study may shed light as regard to the stages of infertility as

43
proposed by Diamond (1999) which may be similar or different to the experiences of

women in the Philippines.

Scope and Delimitation

The study will only focus on Filipino married women who have not been able to

bear child for two years and onwards and are only under the involuntary type of

childlessness. According to literatures, failure of conception in a year was considered as

infertile (Johns Hopkins University, 2006; Greil & McQuillan, 2004), but in this research,

two years will be standard for the infertility of individuals. The researchers also examined

married women who have adopted a child or children due to the fact that adoption is also

a management strategy to deal with involuntary childlessness. The study will also tackle

various variables such as the age, educational attainment, yearly income, religious

affiliations, nature and source of the issue of involuntary childlessness in order to see

how these shape the management strategies or approaches done by married women to

deal with childlessness.

44
 Chapter 2

METHODOLOGY

Research Design

This qualitative research study will be descriptive in purpose to gain insights

about how Filipino women manage involuntary childlessness. It will likewise explore

how the management strategies could vary in terms of their socio-demographic

characteristics. The study will make use of in-depth interview to understand the

relationship of the socio-demographic characteristics, type of involuntary childlessness,

and their perception on childlessness to the management strategies of Filipino women in

handling their situation, and how these treatments of coping affect their marital quality

with their partners. An interview-guide will be used in the collection of data.

Population and Sampling

This study involved sixteen (16) Filipino wives who are involuntarily childless,

who were chosen with the use of purposive referral and snowball sampling. The selection

of interviewees was based on the following criteria: [1] Filipino woman who is married

for at least two years, [2] has never had a biological child, and [3] still wanting to have a

child.

Instrumentation

45
 The tool that was used in this study is an interview guide. The interview guide

consists of five parts. The first block is socio-demographic characteristics of the

informants, which is composed of the age, education, yearly income, and religious

affiliation. The second block in the guide is the nature of involuntary childlessness that

focused on the source of issue (husband or wife), and whether it is infertility or

infecundity. The third block is Perception on Childlessness; the woman defined their

perception into two kinds: their initial reaction upon knowing the situation and their view

towards other childless married couples. This refers to how the childless women view

other childless couples’ situation of childlessness, whether positively or negatively. The

fourth block is the management of childlessness which focused on women’s management

of the situation of childlessness and management in order to have a child. The final block

is the marital quality of the couple, which examined other domains namely, marital

adjustment and marital commitment. The interview guide was in English, however in

consideration of informants who are more comfortable in communicating in Filipino, the

interview guide was also translated into Filipino. This involved the researchers to ask

questions both in English and Filipino depending on what language the informant is

fluent with. A set of open-ended questions were developed for this research study. Before

the interview was conducted, the researchers conducted a pretest to ensure the validity of

the instrument. This was conducted with three informants who share the same

characteristics with the intended population.

Table 1. Instrument Guide Matrix

46
 Block Variables

I. Profile of the Informants

● Age
● Education
● Yearly Income
● Religious Affiliation

II. Nature of Involuntary Childlessness

● Type of Involuntary Childlessness
(Infertility or Infecundity)
● Source of issue (Husband or Wife)

III. Perception on Childlessness ● Initial Reaction on their situation

● Women’s View on other childless married
couples

IV. Management of Childlessness ● Management of the situation of

childlessness
● Management Strategies in order to have a
child

V. Marital Quality ● Marital Adjustment

● Marital Commitment

47
Data Gathering Procedure

Before the data collection was conducted, the researchers prepared a letter of

consent that was given to the informants. The purpose of the letter was to show what the

study is about and to let the informants know that the information that they will be

sharing will only be used for academic purposes and will remain confidential. The

research team began to search for possible potential subjects of the study by asking

family members, friends, or acquaintances if they have any contact information of

childless married women who are likely to share their experiences. After the research

team found potential informants, they were contacted through phone calls and text

messages. The potential informants were invited and asked if they were interested in

participating in the study. Upon the acceptance of the invitation, the researchers

scheduled with them their interview dates.

During the interview, the women were asked first to sign the letter of consent in

order for them to understand the agreement and terms of the study. This was followed by

the actual interview, which was audio-recorded to avoid non-recording issues. After the

interview was conducted, the audio-record of the full interview was transcribed and

translated. All interviews that were conducted took approximately thirty minutes to

finish.

Data Analysis

The collected data were in the form of words, phrases, texts and

statements. Thus, the method of analysis used was coding. This process involves the

organization and categorization of data into similar patterns, context and themes. As a

matter of fact, Roudsari & Allan (2011) states that coding is indeed the process of data

48
analysis wherein the data collected will be analyzed and transcribed in order for codes to

be produced and categorized accordingly. With this, coding enabled the research team to

reduce and condense the data into simple yet unabridged input. Furthermore, the research

team were able to see the relationship between the variables based on the patterns seen in

the study.

Methodological Limitation

The research team were able to ask the women questions that were quite sensitive

on their part, which lead them to limit their responses only to the extent of their

comfortability, which means that they were not able to share their whole experience. The

research also encountered another difficulty due to the age gap and gender difference

between the interviewers and the informants. This means that the informants may only

feel comfortable if the interviewers will be of the same gender and age as them. Thus,

there is no validation to find out the veracity of their responses. Since the study only

looked into the women’s perspective, this limits the validation of the data since it ignores

how their husbands deal with situation and how they view their marital quality.

49
 Chapter 3

PRESENTATION OF RESULTS

This chapter presents the results of the in-depth interviews with the Filipino

Childless Women residing in Metro Manila. This is divided into seven major sections:

Profile of the Filipino Childless Women; Nature of Involuntary Childlessness of the

Women; Perception on Childlessness of the Women; Management of Childlessness

among Filipino Women; Quality of Marital Relationship; Management of Childlessness

and Profile of Women; Management of Childlessness and Nature of Involuntary

Childlessness; Management of Childlessness and Perception on Childlessness; and

Marital Quality and Management of Childlessness.

Profile of the Filipino Childless Women

The research study has sixteen (16) informants, with an age range of having 25 as

the youngest, and 64 as the oldest. The mean age is 44. Each of the women went through

schooling. More specifically, there were 3 high school graduates, 11 were college

graduates, and 2 had post-graduate degrees. A greater number of 13 Filipino childless

women were Roman Catholic, 2 of them have other Christian denominations and only 1

of them does not have any religious affiliations.

50
 Table 2

Profile of the Filipino Childless Women

Characteristics Frequency
(N=16)

AGE
25 - 34 6
35 - 44 2
45 - 54 5
55 - 65 3
Mean Age: 44

EDUCATIONAL ATTAINMENT
3
High school Graduate
11
College Graduate
2
Post Graduate

RELIGIOUS AFFILIATION
13
Roman Catholic
2
Other Christian Denomination
1
No Religious Affiliation

DURATION OF MARRIAGE
2-12 years 7
13-24 years 5
25-35 years 3
36-46 years 1

OCCUPATION
White-Collar Work 11
Blue- Collar Work 2
House Wife 3

ESTIMATED YEARLY INCOME

Less than a million 5
1 Million to 5 Million 8
6 Million and above 3

51
 There were 7 women who have been together with their husbands for less than 12

years, 5 of them have been with their husbands for 13 to 24 years, 3 of them have been

with their husbands for 25 to 35 years, and lastly, there was only 1 of them who is

together with her husband for 36 to 46 years. Most of the women were white collared

workers, while 2 of them were blue collared workers. The other 3 chose to stay at home

and become housewives, to be able to fully take good care of their husbands.

The annual income of these women including their husbands' ranged from P60,

000 to P56, 000,000. Regardless of this range, majority of the Filipino women, together

with their husbands’ income, have an annual income of P1 Million to P5 Million while 5

of them earn less than a million, and the 3 of them earn P6 Million and above,

respectively.

Nature of Involuntary Childlessness

The nature of involuntary childlessness in this study is categorized into two types,

one is infertility and the other is infecundity. Infertility refers to the state wherein the

woman is unable to give live birth while infecundity is the state wherein a woman is

unable to conceive. This also shows whether if the wife or husband is the source why

they cannot bear a child.

Evidences show that half of the Filipino women explained that the reason they

could not have a child was due to infecundity, while the other half of the women

confirmed that it was because of infertility. Majority said that the source and reason why

they could not bear a child was because of their physiology, while other women stated

that it was due to their husbands’ physiology problems. Lastly, one woman stated that her

52
reason for not a child was not only due to her but her husband as well, since the issue lay

between the physiologies of both.

There were different specific reasons why their physiology prevented them from

having children, and one of these is a problem with their reproductive organs. This issue

is common to the majority of the women who had problems either with their uterus,

production of egg cells, or their ovaries. This was very difficult for the women since this

was the main reason why they could not have children in the first place. One of the

women in her 60s shared her reason as to why she could not have children during her

youth, and she states that:

“Well the problem is because of my ovaries. There were cysts,

so I had to go through an operation and remove it. Then I
cannot have a child.”

Other than having problems with the women's reproductive organs, some of the

women’s husbands also had cases where they had difficulty in getting their partners

pregnant because they either have low sperm count, low motility or low morphology. A

woman from Caloocan City shared that she could not get pregnant since her husband has

a low sperm count:

“Naaksidente kasi yung asawa ko noon, nakuryente siya. Sa

tingin ko dahil doon, nagkaroon ng problema. Pagsinusubukan
namin magkaanak, hindi na ako nabubuntis. Nagpacheck-up
kami sa doctor at sabi daw na dahil sa aksidente niya, nag low
sperm count daw siya. Kaya ngayon wala kaming sariling anak.”

(“My husband was involved in an accident, he got electrocuted.

I think it caused the problem. When we try to have kids, I do not get
pregnant. We went to the doctor for check-up and we found
out that he has a low sperm count because of the accident. That
is why until now, we still do not have our own child.”)

53
 Another common problem that the women mentioned why their physiology

became a hindrance in having their own child is because of their age and health. Some of

the women explained that they married their partner in a later age and only decided to

have kids when they were already at the time when bearing a child becomes quite

difficult. A woman who resided in Malabon shared her experience about her doubts in

having kids due to her old age:

“Kasi sa case namin, late na kami nagpakasal and I was already

in my late 30s. At napag-isipan lang namin na magkaanak is
when I was around 44. So medyo nag-alanganin na kami
mag-asawa. We were afraid na baka mag-karoon pa ng
problem ang baby if sinubukan parin namin. Hindi lang ang
baby ang mahihirapan kung di kami rin.”

(“In our case, we got married late and I was already in my late 30s.
And we only decided to have our own kids when I was around 44.
So we had doubts about it. We were afraid that there could be problems
with the baby if we still tried having one. Not just the baby who would
have a difficult time but us as well.”)

Although all reasons of the Filipino women were all regarding theirs and their

partners’ physiology, one of the women added that another reason why she cannot bear a

child was that it was God’s plan for her. She believed that there was a different calling for

her, and she shared:

“I think it’s the plan of God for me and my husband. I have asked
God why is that I cannot have children and He made me realize
that I had children of my own already, the younger ministers
of the church. This was God’s plan so that me and my husband
could give our full service to the church and take care of the
new generation of ministers.”

54
Perception on Childlessness of the Women

Childlessness may be seen by people in different kinds of perspectives, however

in this study, the women have two views on childlessness; these are the initial reactions

on their situation and their views on childless married couples, whether positively or

negatively (See Table 3).

Table 3
Initial Reactions on their Situation

Initial Reactions

Stressed
Depressed to not have kids while
growing up
Regretful to not have decided to have kids in an
early age
Despaired with their situation

Feeling of Emptiness
Disappointed of not being able to have
kids
Confused with the reasons and causes
Shocked with the experience
Hurt because cannot fulfill her womanhood

Optimistic
Hopeful soon could still have a child
Faithful to God because they believed it was
God’s Plan
Believed in Miracles that they could still have a
child

After finding about their situation on not being able to have children, the childless

Filipino felt different kinds of emotions. Majority stated that they felt stressed because

they believed that they were depressed when they learned about their difficulty. A

55
woman who chose to get married late also stated that she also felt regretful of the

situation and she explained that:

“ I was really depressed when I couldn’t have a baby. I always

wanted one… I blame myself for it. I regret getting married late
and focusing on my job more, now I am alone, my husband’s
dead and I don’t have a child.”

Other than being stressed, some women felt empty upon knowing their situation. They

were disappointed since they could not have a child and also confused and shocked with

the reasons. One of the woman felt hurt for she cannot fulfill her womanhood who as she

shared that:

“Well disappointed ako. As a woman, masakit rin talaga, kasi gusto rin
Talaga maging nanay noon. Sa tingin ko hindi ko na fulfill ang
pagkababae ko.”
(Well I was dissapointed. As a woman, it is really hurtful, and I really
wanted to become mother before. I think that I was not able to fulfill my
womanhood.)

There are also women who were optimistic of the situation, they believed that

miracles could still happen and it could have been also God’s plan. They still continue to

put their faith God as they pray for blessings and miracles.

The women have different views on other married couples that were also childless

(See Table 4). These different ideas could be categorized into five. The most cited is a

suggestion that other childless married couples should learn how to accept their situation.

Specifically, they believe that other couples must move on with their lives and some also

say that this gives them the opportunity to adopt or help a child. The second view would

be in terms of opportunity for marriage improvement. They believe that being childless

gives other couples more time for each other and that they can know their partner better.

56
One of the people who shared this was from woman in her late 40s, and she said:

“Sa tingin ko opportunity yan para makilala mo lalo yung

partner mo. Parang kami! Dahil sa aming pagiging childless, mas
naramdaman at nakita ko na si Joger ay responsible and
very supportive.”

(From what I see, it is an opportunity for you to know your partner.

Like us! Because of our childlessness, I felt and see that Joger is
truly very responsible and very supportive.)

Another view it about seeing it as an opportunity for personal improvement, they

explained that other couples are able to have more personal funds since they do not have

kids to save for, they also stated that they are given the chance to focus on their self-

interests and on their careers. A woman who is a church minister in a Christian Church

mentions:

“I think it must be God’s plan. People should learn how to accept

it and know that there must be other things that God has planned
for us aside from having children. Although it may be hurtful,
I think that God is giving sign that they have a different calling.”

The fourth notion would be that they also feel relatable to the situation. The

women said that they feel sorry and sad for them too since they do not have kids to grow

old with, also they mentioned that they feel like they are having a difficulty in accepting

their situation too. And the last view is that they see them as undervalued. They believe

that childless couples are seen negatively; also that some couples would end up cheating

with their partner, and other family members will also pressure couples.

57
 Table 4
Views on Other Childless Married Couples

Views

Couple Must Learn How to Accept Opportunity for Marriage Improvement

Couples should move on with their life Believes that couples give more time
Couples are given an opportunity to for each other
adopt or help a Child Believes that childless couples can
know each other better

Opportunity for Personal Improvement Relatable to the Situation

Gives couples more personal funds since Feels sorry and sad for them too
they do not have kids because they have no
Gives the chance to focus on interests companionship when aging
Gives the opportunity to focus on Feels that it would also be difficult
their career for them to accept the situation
Gives the opportunity to focus on their
career

Sees them as Undervalued

Believes that childless couples are seen
negatively
Believes that some couples could cheat
with their partner
Believes that others are pressured from
other family members

58
Management of Childlessness

In instances wherein couples face difficulties in conceiving or bearing a child, the

women are the ones mostly affected. In that case, these women do self-management

strategies as a way of dealing with their situation of childlessness. These women also

seek help from professionals, participate in fertility traditions and use different kinds of

strategies to manage their being childless and to get pregnant.

The women have different avenues of dealing with the situation of childlessness

(See Table 5).

Table 5

Management of the Situation of Childlessness

Management

Pursuing other interests

Focusing on Work
Travelling to other countries for leisure
Devoting time to church
Engaging in social work

Focusing on self
Accepting the Responsibility
Distancing or isolating self from possible
encounters regarding their being
childless
Having an active lifestyle
Having a positive mindset

Focusing on relationships
Spending quality time with husband
Spending time with family and friends

59
 Women who are childless are not far from pursuing other interests; some women

deal with their being childless in the hopes of getting their mind off of it. Some women

often take on travelling for leisure purposes, some are focusing on their work and jobs,

some are devoting their time going to their church and some are engaging on social work.

These activities and past time do not only distract them from their current situation of

childlessness, but it is also a way for them to express the love that is supposedly for their

child. A businesswoman in her 40’s shared her experience on engaging in social work:

“Since hindi kami magkaanak, ang ginagawa ko is binibigay ko

ang pagmamahal ko at blessings sa mga nangangailangan.
Tumutulong at nagvovolunteer ako sa mga projects ng mga Red
Cross at ibang NGO. That way, nafu-fulfill ako as a person.
Natutuwa ako kasi may natutulungan ako at may napapasaya,
and that is enough para sumaya ako. ”

(“Since my husband and I cannot conceive a child, I just share my

affection and blessings to those in need. I help and volunteer to
various projects hosted by Red Cross and other NGOs. In that
way, I feel fulfilled as a person, it makes me happy that I get to
help and make others happy. The feeling of fulfillment alone is
enough to make me happy.”)

A real estate agent in her 50’s mentioned that devoting time to her church is a way

for her to be closer to God. She also said that upon frequent visitations and volunteering

to work for her church, she found her happiness because she was assigned to conduct

study groups for children.

She shared:

“Naisip na i-devote ko nalang yung oras ko sa church.”

(“I thought of just devoting my time to our church.”)

60
 Women tend to focus on themselves, which includes accepting the responsibility

of the cause of childlessness, distancing or isolating themselves from possible encounters

of being asked about their being childless, having an active lifestyle, and just staying

optimistic about their present situation.

A woman in her 60’s expressed her dismay and acceptance of the situation as

well. She said:

“Sinisisi ko rin ang trabaho ko noon eh. Sinisi ko ang trabaho ko

pagkatapos nung huling miscarriage ko. Yung trabaho ko
kasi mabigat at nakakapagod talaga, tapos buntis pa ako. Ayan,
I had a miscarriage. Ang masama pa doon ay alam ko naman na
hindi dapat ako masyado nag hirap mag trabaho pero ginawa ko
parin kahit alam kong sa edad ko (39 years old) ay delikado na nga
ang pagiging buntis. Kaya wala rin akong ibang masabi at maisip
kundi sisihin ang sarili ko mga desisyon ko. Tinanggap ko nalang na
ako ang may kasalanan.”

(“I was blaming my job before. I blamed my job after I had my last
miscarriage. My job was very hard and tiring and at the same time,
I was pregnant. There, I had a miscarriage. The bad thing about it is
that I knew I should now have been working very hard and tiring
myself while I was pregnant. Considering my age at that time (39
years old), I still continued tiring my body and myself even if I
knew about the dangers and consequences while I was pregnant.
Well, I did not have anybody else to blame but myself. I just
accepted the truth and accepted that it was my fault that I had
miscarriages.

Some women resort to focusing on their relationships with people. These include

spending time with their husband, either going on dates or travelling with them and

finding time to bond with their family and friends. Women are inclined to turn to their

social relationships as a way of dealing with the situation. One woman in her 50’s shared

how and why she’s spending quality time with her husband, she said:

61
 “ Sa sitwasyon namin ng asawa ko ngayon, na walang anak,
parang mag kasintahan lang kami. Nakakatuwa nga eh. Kahit
sa una na malungkot kami na hindi kami magkaanak,
nakakahanap naman kami ng tuwa ngayon. Yung mag katext
kami pag parehas kami nasa trabaho, nangungumusta ganun,
tapos pag walang trabaho naman kapag Sunday, nag d-date
kami. Nanunuod kami ng movies, kumakain sa labas, mga
simpleng bagay masaya na kami.”

(“ In our situation now of being childless, we act as if we are

not married, like he’s just my boyfriend and I’m just his
girlfriend. It’s wonderful even if at first we were really sad
about not having children, we still manage to find happiness in
our situation. There are times when we would text each other
during work just to ask how our day is going, and when it is
our day-off, usually on Sundays, we watch movies and eat out.
Just doing simple things make us happy.”)

Other than managing their situation of being childless, women wanting to have

children look into different kinds of fertility treatment. There are four categories of

dealing with not having a child (See Table 6). Some women opt for engaging in medical

related strategies such as artificial insemination, in- vitro fertilization, use of fertility

medications and vitamins and the like as a way for them to get pregnant. Some women

prefer taking on professional counselling to mentally and emotionally deal with not

having a child. Traditional strategies such as going to Traditional Hilot, participating in

“Sayaw sa Obando” fertility dance are also common among women in hopes of

miraculously conceiving and bearing a child. Other options include adoption and

surrogacy.

On one hand, most women who want to get pregnant are more inclined to

exploring medical related strategies. A 25-year-old businesswoman mentioned:

“We still go see the doctor. I am trying out fertility

62
 medications. If all else fails, there is in-vitro fertilization and
surrogacy. Money and science can do a lot nowadays”

Table 6
Strategies in order to have a child

Management

Medical Related Strategies

Use of fertility medications and vitamins
In Vitro Fertilization
Artificial Insemination
Undergoing laparoscopy for fallopian tube
Enlargement

Traditional Strategies
Praying to God for blessings and miracles
Going to traditional “hilot”
Participating in “Sayaw sa Obando”

Professional Counselling
Talking to a psychologist
Talking to a priest

Other Options
Contemplating on adopting a child
Trying surrogacy

Only few women believe in professional counselling as means of dealing with not

having a child. It appears that women who gave up on exploring medical related

strategies and practicing and participating in various traditional strategies resorted to

professional counselling as their last resort in order to deal with their not having a child.

A woman in her 50s shared her insights:

“Masasabi ko na lahat ng methods na-try ko na, ginawa ko na. Nag

pa-laparoscopy ako ng dalawang beses kasi sabi nila (mga doktor)

63
 yung fallopian tube ko daw ay maliit masyado para makapasok ang
sperm. Pagkatapos naman ng laparoscopy, wala parin, kaya nag try
kami ng asawa ko mag AI (Artificial Insemination). I tried AI for four
years kasabay ng fertility medicines. Pero wala talaga eh. Pati
yung hilot
na gawa na rin saakin. Wala tumabla. Ngayon malapit ako sa church
namin, dun ako nag papacounselling sa pari namin. Saka ko lang
na- accept ang pagiging baog ko.”

(“I can say that I have tried everything to have a child. I had
Laparoscopy twice because the doctors said that my fallopian tubes
are too narrow for the sperm to be able to enter. After my surgeries,
I still did not get pregnant. That is when my husband and I decided
to try AI (Artificial Insemination). The process took really long,
the first year of AI was allotted for observation and monitoring of my
body and cycle… In short, I tried AI for four years along with fertility
medicines. Unluckily, it still did not work on me. I even tried going to
traditional hilots but it also did not work. Nothing worked on me.
Now that I grew close to my church, I regularly visit our priest for
counselling. That is the only time when I completely accepted that I
would not be able to conceive or bear my own child.)

Findings from the study show that women are no strangers to practicing

and participating traditional strategies such as going to traditional “hilots”, praying to

God for a miracle, and participating in fertility festivals and dance like “Sayaw sa

Obando.” A wife with a high school diploma shared:

“Nag sisimba lang ako lagi at nag dadasal. Nag papahilot

rin ako dati, kasi nga hindi ko kaya yung medical treatments.
Sabi ng nanay ko at mga kaibigan ko umeepekto daw yung hilot sa
matres.”

(“I just hear mass and pray all the time. I also tried traditional
“hilot” before because I cannot afford medical treatments.
My mother and friends told me to do it because it works.”)

64
 Furthermore, there are only few women who venture on other options such as

adopting a child and surrogacy. Basing on interviews, adoptions are really challenging for

both the wife and the husband because it’s hard for the wife to convince their husband of

adopting a child because most men do not want to take care of a child that is not theirs,

biologically speaking. Women who wanted to adopt also shared that men are not really

open to adoption because it is either they take care of their own child or not have a child

at all. A recently retired nurse shared her experience with her husband:

“Nalungkot talaga ako kasi gusto ko talaga magka-anak.

So sinabi ko kay James na mag adopt nalang kami. Pero
ayaw niya, ayaw niya mag alaga ng bata na hindi niya
anak. Napaisip rin ako, baka tama nga siya, hindi na
dapat kami mag adopt kasi matanda na kami..”

(“I was really sad because I always wanted kids. I told

James that we could just adopt but he did not want.
I convinced him but he was just not open to taking care
of a child that is not his own… It made me think that
maybe he is right, we should not adopt because of our age.”)

Quality of Marital Relationship

The Quality of Marital Relationship may be measured through the Marital

Adjustment and Marital Commitment of the couples. This shows how couples, or the

wives, in particular are satisfied in their marital relationship with their husbands, despite

of having such condition, which is childlessness. Majority of the women shared that

despite their situation, having good communication with their husbands is one way to

having good relationships with their partners (See Table 7). To achieve this, one has to be

able to compromise thoughts and opinions, listen to each other’s point of views, avoid

arguments, and to try to understand one another. In terms of marital adjustment,

65
generally, they see their marital relationship as positive because they are engaging in

some strategies in order to adjust. A housewife shared her thought:

“Still the same walang ng bago kasi maluwag namin na tinanggap

ang sitwasyon na hindi kami magkaka-anak. Masaya at maayos
pa rin kami nagsasama. Wala naman nagbago sa pagsasama
namin kasi supportive pa rin kami sa isa’t isa at nauunawaan
namin ang bawat isa. Mas lalo namin minahal ang bawat isa,
di naging hadlang ang pag tanggap namin sa katotohanan
na hindi kami pwedeng magkaanak. Pag may problema,
naguusap kami ng masinsinan”

(“Still the same, nothing has changed because we both

wholeheartedly accepted the situation that we may never have
a child anymore. Besides, we are happy and we live happily
together. Nothing changed in how we treat each other because
we have always been supportive of each other, and we really
try to understand each other’s thoughts. As a matter of fact, we
have loved each other more, and our situation has never been a
hindrance to our relationship. If there’s a problem, we just talk
privately about it.”)

Moreover, these Filipino women believe that in their situation of being childless,

the social stigma that they experience somehow adds pressure to their marital

relationship. Because of this, the Filipino women directly stated that they still try to work

things out through showing love and care, bargaining to one’s wishes, being open to

suggestions and recommendations, and to still willing to try various strategies to change

their situation according to their liking.

Most women also shared that Acceptance and Optimism about their situation is

one of the most important keys to having good marital relationship. Their childlessness

does not completely hinder them from achieving their best potentials as partners. In this

case, the women shared that their situation strengthened the bond with each other and that

they became happier with each other because their situation tests actually tests their

66
accommodation about it. Likewise, they also shared that they became closer with each

other; more contented about the quality time they spent together, and how they become

more comfortable interacting with each other.

Table 7

Marital Adjustment of the couples

Marital Adjustment

Communicating with each other

Compromising thoughts and opinions
Listening to each other’s point of views
Avoiding arguments
Understanding one another

Working things out

Showing love and care
Bargaining to one’s wishes
Being open to suggestions and recommendations
Willing to try various strategies

Accepting their situation

Strengthening the bond with each other
Being more happy with each other
Being closer with each other
Becoming more contented about the time spent with each other
Being more comfortable in interacting with each other

The quality of their marital relationship is positive when it comes to marital

commitment. In fact most of the women knew right from the beginning that they would

be committed to their husbands. In addition to this, the women make use of certain

techniques or strategies in order to develop their commitment to their partners. Most of

the women knew right from the beginning that they would be committed to their

husbands (See Table 8). As a matter of fact, they do dedicate most of their time for their

67
husbands. According to these women, they want to shower their partners with love and

trust, they live happily despite their situation, they love spending quality time with their

partners, they honor fidelity because they don’t tolerate cheating in the relationship, and

that both individuals cooperate with each other.

Table 8
Marital Commitment of the couples

Marital Commitment

Dedicating love and trust to each other

Living happily
Spending Quality Time with each other
Fidelity is honored
Cooperating with each other

Bonding through experiencing other interests

Dividing house chores equally
Servicing the church once a week
Taking good care of other relatives’ children
Enjoying options that enhance the relationship

Blaming each other’s faults

Having a hard time believing each other’s thoughts
Not completely accepting the situation
Was not supportive of the decisions made by the other
Talking negatively towards each other

Another way to maintain commitment, according to these Filipino women, is

through spending enough time to pursue and experience other interests. Some of which

are dividing house chores equally, servicing the church once a week, taking good care of

other relatives’ children, and enjoying options that could enhance to relationship.

On the negative note, few of these women shared that their relationship became

shaky and unsteady because of their situation of childlessness. They explained that

68
despite their love for each other, there were still instances where their commitment was

being tested to its optimal. To put it in another way, these women specifically said that in

some circumstances, they started blaming each other’s faults. And because of past

instances where infidelity was evident, mistrust started to build up between them and

their husbands. Since then, they already started to have a hard time believing each other,

and to perceive their situation as quite unacceptable. Notably, one of them became less

supportive of the decisions made by the other, and talking negatively towards each other

became more and more indisputable.

Management of Childlessness and Profile of Women

The women had different backgrounds with one another and their own

experiences in managing their childlessness. How women manage their situation of

childlessness could be shaped depending on their age, educational attainment, yearly

income, and religion. Those in the younger age group or who are aged 25 – 44 years old

pursue their other interests in order to manage their situation in being childless. This

includes travelling to other countries and focusing on work. In terms of strategies in order

to have a child, they do more medical related strategies such as In-Vitro Fertilization, the

use of fertility medications and vitamins and also artificial insemination. Similarly, the

older age group or who is aged 45-64 also focus on their other interests in order to

manage their situation. However, their strategies in order to have a child are different in

comparison to the younger group. The older age group does more traditional strategies

that includes praying to God for blessings and miracles, hilot, and sayaw sa obando.

There is no difference in terms of managing their situation of childlessness between the

young and old age group. The difference between these two groups is that the younger

69
age performs more medical strategies while the older age group focuses on traditional

strategies (See Table 9).

Table 9
Management of Childlessness and Profile of Women (Age & Educational Attainment)
Management Age Educational Attainment
of
Childlessness Younger Older High school College Post-
(25 – 44 (45 – 64 Graduate Graduate Graduate
Years Old) Years Old)

Management Pursuing Pursuing Focusing on Focusing on Pursuing

of the Other Other Self Relationship Other
Situation of Interests Interests Pursuing Interests
Childlessness Other Focus on
Interests Relationship

Strategies to Medical Traditional Traditional Medical Medical

have a child Related Strategies Strategies Related Related
Strategies Strategies Strategies
Traditional
Strategies

In terms of their educational attainment, those who have only finished high school

focus both on themselves and their other interests. They also do more traditional

strategies specifically, praying to God, when they try in to have a child. Those with

college degrees give more attention to their relationships with their partner. Women who

are college graduates do more medical treatments in order for them to have a child.

Unlike those who only finished high school and college, post-graduates pursue their other

interests and focus on their relationships. Post-graduates also practice both medical and

traditional strategies for them to have a child. Results show that the management of the

situation of childlessness and strategies to have a child vary depending on the educational

attainment of the women.

70
 When it comes to yearly income, those who earn less than a million pesos every

year tend to mention that they focus on other interests rather than focusing on themselves

and their relationships (See Table 10). In terms of the strategies used in order to have a

child, they do more traditional strategies. Women, who earn one million to five million

pesos yearly, give more attention to their relationship. They manage their being of not

having a child through medical treatments and practices. While those who earn six

million pesos and more yearly does not only pursue their other interests but also they

focus on their relationships and themselves. Moreover, they also do medical strategies

specifically fertility medication, intake of vitamins and undergoing In-Vitro fertilization

rather than traditional ones and other strategies. This shows that the women’s yearly

income has a relationship on how they manage their childlessness.

Women who are Roman Catholics mentioned that they give more focus on

themselves in when handling their situation in being childless by having a positive

mindset and living actively. When it comes to their strategies in order to have a child,

according to them, they do more traditional strategies. Those who are affiliated with other

Christian Denominations focus on their other interests. They also both practice medical

and traditional strategies in order for them to have a child. Lastly, the woman who did not

have any religious affiliation focuses on herself, relationship with her husband and her

other interests. And in terms of what she does when still trying to have a child, she does

more medical treatments such as taking fertility medication and trying In-Vitro

fertilization. Women who were affiliated with Roman Catholicism most likely used

traditional strategies, while those who were affiliated with other Christian Denominations

71
used medical strategies the most. The woman who did not have any religious affiliation

only did medical strategies.

72
73
Management of Childlessness and Nature of Involuntary Childlessness

Women try to use various management strategies to address their situation of

childlessness whether they are diagnosed with infertility or infecundity. Their

management of the situation of childlessness also varies depending on the source of

infertility, that being the wife or the husband. The management of the situation of

childlessness is subcategorized into three and these are pursuing other interests, focusing

on self and focusing on relationships. Aside from women’s management of the situation

of childlessness, women also seek strategies in order to have a child. The strategies are

clustered into four groups. The first is medical related strategies, second is traditional

strategies, third is alternative options and last is professional counselling (See Table 11).

The women, who are unable to give live birth to a child or infertility due to her

physiological issues, mentioned that they manage their situation of childlessness by

pursuing other interests specifically by focusing on work and travelling for leisure. Other

than this, they also focus on themselves and on relationships by having a positive mindset

and spending quality time with husband. When it comes to the strategies to have a child,

they tend to say that they use fertility medications, pray to God, contemplate about

adopting, and one said about talking to a psychologist in terms of professional

counselling. This is also almost similar to those women who cannot give live birth

because of their partner.

74
 Table 11
Management of the Situation of Childlessness and Strategies to have a child in terms of
Nature of Involuntary Childlessness and the Source

Nature of Involuntary Childlessness and Source of Infertility

Management Infertility Infecundity
Source is the Source is the
Wife Husband Wife Husband
Management of Pursuing other Pursuing other Pursuing other Focusing on
the Situation of interests interests, interests self
Childlessness Travelling to
other countries

Strategies to Medical Medical Medical

have a child Related Related Related
Strategies Strategies Strategies,
Going to
traditional
“hilot: and
Professional
counselling

Women who are unable to give live birth due to their husband’s incapacity are

more likely to travel to other countries in terms of pursuing other interests. With regard to

focusing on self, they gravitate more to having an active lifestyle and having a positive

mindset in terms of focusing on self.

Women who cannot procreate due to their husband’s misfortune still try to use

strategies to have a child in terms of medical strategies specifically, using fertility

medicines and vitamins. These women try other traditional strategies such as praying to

God for miracles in hopes of blessing them with a baby. If all else fails, these women are

also more open to adopting a child as an alternative option.

75
 Women who are unable to conceive due to their physiological issues tend to just

focus more on work as means of pursuing other interests. They also keep a positive

mindset in terms of focusing on self and spend quality time with their husband in terms of

focusing on their relationships.

These women who are diagnosed with infecundity lean more towards taking

fertility medications and vitamins, and trying out In-Vitro Fertilization for their medical

related strategies. In terms of traditional strategies, these women are more inclined to

going to traditional Hilot. In addition, these women are also more open to the idea of

adopting a child and surrogacy as an alternative option. Talking to a priest in terms of

professional counselling is a strategy used in order to have a child. Women who are

unable to conceive due to their husband’s affliction are more inclined to just have a

positive mindset in terms of focusing on self.

Management of Childlessness and Perception on Childlessness

The women had three different reactions when they found out about their situation

of being childless; these are stressed, feelings of emptiness and optimistic (See Table 12).

The women who were stressed tend to mention that they pursue their other interests and

focus on themselves in order to manage their situation. This includes travelling, focusing

on work, having a positive mindset and also living more actively. In terms of the

strategies in order to have child, the mentioned that usually pray to God for blessings and

miracles, thus they do more traditional strategies. Similarly to the stressed women, the

women who felt empty when they learned about their situation also mentioned that they

pursue their other interests as well. However, they tend to focus more on their

relationship rather pursuing other interest since majority have mentioned that they spend

76
more quality time with their partner. When it comes to the strategies in order to have a

child, they mostly mentioned that they pray. For those who were optimistic of the

situation, they also seek their interests when handling their situation. Specifically on

focusing on their work. They tend to say that they do traditional strategies in order for

them to have a child.

Table 12

Management of Childlessness and the Women’s Initial Reaction to the Situation

Women’s Initial Reaction

Management of
Childlessness Stressed Feelings of Optimistic
Emptiness

Management of the Pursuing Other Focus on Pursuing

Situation of Interests Relationship Other
Childlessness Focusing on Self Pursuing Other Interests
Interests

Strategies in order to Traditional Traditional Traditional

have a Child Strategies Strategies Strategies

Those who view other childless married couples that they must learn to accept

their situation tend to pursue other interests and focus on their relationships when

managing their situation of childlessness (See Table 13). They do more medical related

strategies such as fertility medications and vitamins, and In-Vitro fertilization in order for

them to have child. Women who see as an opportunity for marriage improvement mostly

mentioned that they focus on their relationship to handle the situation. In the strategies in

order to have a child, they do traditional strategies such as praying, but do more medical

related strategies. For those who see it as an opportunity for personal improvement, they

77
give more focus on themselves and also pursue their other interests. They also tend to do

more traditional strategies when they are trying to have a child. Similar to this, those who

view other childless couples as relatable to them also focus on themselves and pursue

other interests. However, they do not only perform traditional strategies but also medical

related strategies. Lastly, women who see them as undervalued focus on themselves. This

includes, thinking positively, distancing and also acceptance of responsibility in order

manage their situation. When it comes to their strategies in order to have child, they do

medical related and traditional strategies.

78
79
Marital Quality and Management of Childlessness

The women had various strategies on how they manage their situation of

childlessness and to have a child. Their idea on how they accommodate their situation

varies from each other. The first major row shows women’s marital adjustment methods

according to their preferred management strategies (See Table 14). The first sub-group is

Pursuing other interests, the women expressed that through this management strategy,

they were able to adjust their relationship with their husbands through communicating

with their partners, more specifically through compromising thoughts and opinions, and

listening to each other’s point of views as well. It goes for the second subgroup, which is

the Focus on Self, and the third subgroup, which is Focus on Relationship. However, for

the third sub group, even though most of the women shared that they tried to understand

their husbands, some women have been honest about how they just try to avoid arguing

with their husbands, to maintain the harmonious relationship they have with each other.

With these management strategies, the women also shared that to be able to adjust

the marital relationship; both men and women must learn how to work things out. As a

matter of fact, most of them mentioned that being able to show love and care, bargain to

one’s wishes, being open to one’s suggestions and recommendations have great

importance to maintain a healthy relationship. Despite this, there are still other women

who pursued other interests were still very willing to try various strategies to change their

situation.

80
81
 The women had various strategies on how they manage their situation of

childlessness. Despite their situation, these women were still determined to make their

relationship work. The first major column shows the various management strategies,

which is then divided into three The first sub-group is pursuing other interests, the

women expressed that through this management strategy, they claimed that they love to

dedicate their love and trust to each other through living happily and cooperating with

their husbands as well. Most women who focused on themselves, and their relationships

shared that to be able to establish a commitment with their husbands, both sides should

know how to spend quality time with each other, both honor fidelity, and are able to

cooperate with each other. According to these women, the most mentioned way to have

an established commitment is to live happily, despite the situation.

With these management strategies, women also shared that to be able to maintain

an established commitment as a couple, bonding through experiencing other interests is a

good start in achieving it. Some examples are servicing the church once a week, taking

good care of other relatives’ children, enjoying options that enhance the relationship, and

dividing house chores equally.

Furthermore, the women pursued various strategies to have a child. These women

manage to have a child differently from each other. Management to have a child is

clustered into four. The first cluster is medical related strategies, the second is traditional

strategies, third is professional strategies and lastly, other options which include adoption

and surrogacy. These strategies also shape the marital quality of the couples in terms of

marital adjustment. Women who are pursuing Medical Related Strategies mostly tend to

compromise their thoughts and opinions with their husband in terms of communicating

82
with each other. In terms of working things out as means of marital adjustment, these

women are more inclined to showing love and care for their husbands and are also open

to suggestions and recommendations. In addition, women who rely on traditional

strategies are also more inclined to compromise their thoughts and opinions with their

husband in terms of communicating with each other. For the women who pursue

professional counselling, compromising their thoughts and opinions with their husband as

a form of communicating with each other is their main avenue for marital adjustment. As

regards to accepting their situation, these women are more inclined to strengthening their

bond with their husband, being closer with each other, and being more comfortable with

each other. Women who are open to exploring more on other options such as adoption

and surrogacy are also more inclined to compromise their thoughts and opinions with

their husbands as a form of communicating with each other. In terms of working things

out, these women are also more inclined to showing their love and care for their husband,

being open to suggestions and recommendations and are willing to try various strategies.

Strengthening the bond with each other and being more comfortable interacting with each

other as a form of accepting about their situation are mostly the marital adjustment

practice these women use.

With regard to marital quality in terms of marital commitment, the women had

various strategies on how they manage their situation of childlessness. Despite their

situation, these women were still determined to make their relationship work (See Table

14). Women who pursue other interests expressed that through this management strategy,

they claimed that they love to dedicate their love and trust to each other through living

happily and cooperating with their husbands as well. Most women who focused on

83
themselves, and their relationships shared that to be able to establish a commitment with

their husbands, both sides should know how to spend quality time with each other, they

both honor fidelity, and are able to cooperate with each other. According to these women,

the most mentioned way to have established commitment is to live happily, despite the

situation.

With these management strategies, some of the women shared that to be able to

maintain an established commitment as a couple, bonding through experiencing other

interests is a good start in achieving it. Some examples are servicing the church once a

week, taking good care of other relatives’ children, enjoying options that enhance the

relationship, and dividing house chores equally.

84
 Chapter 4

DISCUSSION AND INTERPRETATION

This chapter is divided into two major parts (1) Management childlessness

varying in terms of socio-demographic characteristics, and (2) Marital quality of women

in terms of the management of childlessness. In this section, the findings of the study are

discussed and interpreted in accordance to the Review of Related Literature. This

sections presents the similarities and differences between the data and the existing

literature gathered by the research team.

Management of childlessness varying in terms of socio-demographic characteristics

Findings reveal that age has a significant role when it comes to the women’s

management to have a child. Findings show that the younger women are more inclined to

explore and pursue medical related strategies such as the use of fertility medicines and

vitamins, Artificial Insemination, In-Vitro Fertilization, and laparoscopy for fallopian

tube enlargement. Meanwhile, older women tend to be more inclined in doing traditional

strategies such as praying to God and asking him for miracles, going to traditional hilots,

and being active in fertility festivals like “Sayaw sa Obando.” Some of these women

have already past their biological clock but also shared that they did medical related

strategies in order for them to have child when they were younger. One of the older

women shared that they she was contemplating on adopting in order for them to have

their own child. This is supported by the study of Frank (1990), wherein he mentions that

older couples are more open-minded to adoption. Thus showing the relation to the study

of Durning & Williams (2004), age does play a significant role in choosing the type of

strategy to be used to have a child. However, age is found to have no effect on women’s

85
management of the situation of childlessness. Results from the study show that both older

women and younger women opt to just pursue other interests particularly focus on work,

travel to other countries for leisure, devote time to church, and engage in social work.

According to numerous studies, women’s choices of management of the situation

of childlessness and strategies to have a child depend on their social demographic

characteristics such as age, educational attainment, yearly income, and religious

affiliation (Frank, 1990; Durning & Williams, 2004; Singh & Shukla, 2015). Another

factor is the woman’s perception on childlessness. The notion of women on childlessness

shapes how they manage their situation (Frank, 1990; Rich et al., 2011). According to

Rich et al. (2011), women may view childlessness either positively or negatively. If

women see their situation as significance to their situation, they are more likely to be able

to give more focus on their lives and interests. While those who view it as stigma to

society, their way of handling the situation would be also different. Studies have

presented that the aforementioned variables play a significant role in shaping the

management of childlessness among women.

Results show that another variable that plays a significant role in management of

childlessness is educational attainment. In terms of women’s strategies to have a child,

results from the study show that women who finished college and postgraduate studies

are more predisposed to seeking medical related strategies while women who have only

finished high school tend to pursue traditional strategies instead. In terms of women’s

management of the situation of childlessness, the women who only finished high school,

practice the same strategies in dealing with their situation as the women who finished

college and postgraduate studies, which is focusing on relationships. To be more specific,

86
these women focus on relationships with their husbands, their families and their friends.

According to Singh & Shukla (2015), couples that lack educational attainment and have

constrained resources have limited choices in terms of strategies to have a child, which

makes them to seek treatments from temples, religious or traditional healers and

participate in fertility rituals for child blessings.

Another variable that has a notable impact on women’s management of

childlessness is their yearly income. Findings from the study present that the higher the

couples’ income is, the more they tend to embark on the use of medical related strategies

in order to have a child. On the other hand, couples who earn less than 1 Million per year

tend to stick to traditional strategies such as going to traditional Hilots and praying to

God for a miracle in hopes for them to have a child. This supports the study of Singh &

Shukla (2015) that infertile couples who lack resources tend to seek treatments from

temples, religious or traditional healers and participate in fertility rituals for child

blessings. It was also stated in a study by Frank (1990), that couples that receive low

income per year are more constrained to pursue medical treatments that are expensive

such as IVF treatments or other surgical methods. Even more, in terms of management of

the situation of childlessness, women who have an annual income of 6 million pesos and

above tend to pursue other interests, focus on self, and focus on relationships.

Meanwhile, women who have an annual income of 1 to 5 million pesos are more likely to

focus on relationships and women who earn less than 1 million pesos are more likely to

focus on relationships.

Results show that religious affiliations also shape the women’s management of

childlessness. In terms of management to have a child, Roman Catholic women prefer to

87
venture on traditional strategies especially praying to God and participating in the famous

prayer and dance fertility festival called “Sayaw sa Obando”, whereas the woman who

has no religious affiliation prefers to explore on medical related strategies. Women who

belong to other Christian denominations are more freely choosing between the use of

medical related strategies and traditional strategies in their management to have a child.

With regards to management of the situation of childlessness, Roman Catholic

women are more inclined to focus on themselves particularly choosing to accept the

responsibility of the cause of the situation, distancing or isolating themselves from

possible encounters with other people regarding their being childless, having an active

lifestyle and having a positive mindset. However, women who belong to other Christian

denominations are more likely to pursue other interests such as travelling for leisure,

engaging in social work and the like. For women who have no religious affiliations, it

was found that they tend to explore on a variety of strategies in dealing with their

situation. Specifically, they focus on themselves, pursue other interests, and focus on

relationships. Donkor & Sandall (2009) also stated that infertile women relied on their

faith and religiosity on dealing with infertility.

Perception of the women also shapes their management of childlessness. Results

show that they had different reactions when they found out they could not have their own

children. One of their initial reactions was that they were stressed. This is quite common

for women to be stressed when they are faced with the situation of not being able to bear

a child (Sabatelli et al., 1988; Peterson et al., 2006). In order for the women to manage

their situation, majority of them would pursue their other interest and also focus on

themselves.

88
 Similarly, women who felt emptiness pursued their other interest but also focused

on their relationships. Although some authors showed that childless married women leads

to issue with their relationship (McGuirk,J. & McGuirk M.E., 1991; Repokari et al.,

2007), findings show that women who felt empty of their situation fill their gaps by

spending more quality time with their partners. Other than being stressed and feeling

empty because of their situation, some of the women also felt optimistic and also pursued

their other interests. Furthermore, although women had different reactions when they

found out about their situation, they commonly focus on their other interests. This proves

Mawson’s (2005) study where he showed that childless couples tend to live more

differently and go after what they are passionate about. Although majority would go

through medical related procedures or continue with traditional strategies, one of the

women who felt empty contemplated on adopting a child. She explained that she sees it

as an opportunity for her and her husband to help a child and eventually help themselves

in the long run.

When it comes to the strategies they used in order to have a child, majority of the

women chose to do traditional strategies when they were stressed, feeling empty, or

optimistic towards their childlessness. Specifically, they had strong faith and continued to

pray to God for blessings and miracles. This was also supported by the work of Donkor

and Sandall (2009) wherein they argued that most women rely on religion when handling

childlessness.

The women’s views on other childless married couples have a role on how they

manage the situation of their childlessness. Findings reveal that women who suggested

that couples must accept their situation tend to pursue other interests just like those who

89
view it as opportunity for personal improvement and see it as relatable to their situation.

Similarly to the study of McGuirk (1991) and Harvey (2008), childless couples rethink of

their situation and pursue their other aspirations in life since they have the freedom to do

the things they desire and the funds they have to spend. Those who focus on their

relationships are the women who also see that childless couples must move on and those

who view it as an opportunity for marriage improvement. They stated that one of the

positive consequences of being childless is that they are able to have more quality time

for each other, thus they could improve their relationship. This gives support to the study

of Harvey (2008), where he stated that the benefits of being childless improves the

relationship of couples since they have more free time with each other.

Women who see it as an opportunity for personal improvement and sees other

childless couples as undervalued mostly mentioned that they focus on themselves in order

to handle the situation. This also includes having a positive mindset, living more actively,

accepting the responsibility, and also distancing. This can also be seen in the work of

Peterson et al. (2006), wherein distancing enables them to ignore the situation, and also

acceptance of the responsibility so that they can move on with the situation and

eventually improve themselves.

When it comes to the strategies in order to have a child, excluding the women

who sees other childless couples as an opportunity for personal improvement, almost all

women with different views do medical related strategies and traditional strategies in

order for them to have child. Although some of these women may view childlessness as

positive, they still want to have child of their own. This is why they still try their best in

order for them to have children. Another reason why women manage their childlessness

90
is that it is still seen as "deficiency, and having connotations of a lack” by others

(Bartlett, 1995 & Campbell, 1985). Women who see it as an opportunity for marriage

improvement practices traditional strategies, specifically praying to God. Donkor and

Sandall’s (2009) study shows that some women want to take control of the situation, thus

asking for the support and blessings of God whether being childless is for them or not.

91
Marital quality of women in terms of the management of childlessness

In the occurrence where a married couple is having difficulties in having a child,

the women in the relationship are the ones who are more afflicted. Hence, these women

may start to consider various management strategies to be able to deal with their situation

of childlessness, and to maintain the harmony in the marital relationship they have with

their husbands.

The women mentioned definite management strategies that they did in order to

deal with their situation of childlessness. They have specified that pursuing other

interests, focusing on themselves, and focusing on their relationships are some of the

strategies that helped them cope with their situation. Findings reveal that those women

who chose to pursue their other interests tend to travel for leisure, devote time to go to

church, and engage in social work in their communities. This supports the study of

(Donkor & Sandall, 2009, p. 86 & Mawson, 2005, p.18), where they stated that being

able to take control of the situation is one of the strategies that any childless women could

have, in order to deal with their situation. The studies pertained that women who are in

this situation tend to allow themselves to do activities that will not make them think about

their situation all the time; activities that they could make them forget about their

infertility and/or infecundity.

Results also show that although they lack something as married couples, they still

tried to focus on the relationships they have with their husbands. As a matter of fact,

during the duration of their marriage, they chose to spend quality time with their

husbands, and also with their family and friends, as a way of dealing with their situation.

92
 Through this way, the social relationships that they establish among the people

around them, make it easier for them to handle their situation. Lastly, another strategy

that they do is to focus on themselves. In this strategy, women shared that they either

accepted the responsibility of their situation or eventually distanced themselves from

other individuals. Not only this will help them to handle their situation but also improve

on themselves. This supports the two strategies Peterson et al. (2006) stated in his study,

where he stated that Distancing, and Accepting Responsibility are two of the three

strategies that childless women do to deal with their situation.

On the other hand, there are also various management strategies these women do

in order to have a child. These are strategies that are more specific and technical, which

needs greater length of resources. Most of the women mentioned that to be able to have a

child, seeking medical treatments was their best option. Some of the medical treatments

that they undergone were In Vitro Fertilization, Artificial Insemination, Laparoscopy for

Fallopian Tube, and Enlargement. Moreover, they also made use of fertility medications

and vitamins. This is supported by the study of Holbrook (1990) where he states that

these treatments increase the possibility of pregnancy. Another treatment that was able to

enhance the Marital Adjustment of the couples was Counselling. Findings show that the

couples who undergone this treatment were much happier and were more inclined to

strengthen their bond with their husbands, to become much closer with each other, and to

become more comfortable with each other.

This is supported by the study of Malik (2003) where he stated that couples who

undergo counselling were more likely to compromise their thoughts and opinions, which

lead them to having control of their emotions to deal with their childlessness in a positive

93
manner. He emphasizes that the continuous support being given to the couples by their

respective counsellors help them to become more mindful of what they have to do.

Moreover, Diamond, (1999) and Schmidt et al., (2005) also proves that the management

of going to therapies help childless couples in dealing with their situation, leads them to

further evaluate the things they should do to maintain as an established relationship with

each other. Thus, couples start to become versatile in adjusting to their situation.

On the other hand, Marital Commitment is also shaped with how the childless

couples managed their situation. Findings show that majority of the women involved in

the study has a good relationship with their spouse no matter what strategy they do in

dealing with their childlessness. This is supported by the studies of Diamond (1999),

McGuirk.J & McGuirk, M.E., (1991) where they state that the couples who remained to

stay together through the coping period are more likely to become more empathetic with

each other, which eventually lead them to become more inclined to face the various

situations they could be possibly involved in the future. However, there are still few

women who shared that they still had difficulties in accepting their situation and have

frustrations with their partner. This is more likely because of the stress and

misunderstandings that both couples face through the phase of managing the situation

(Peterson et al., 2006).

94
 Chapter 5

Summary, Conclusions, and Recommendations

This last chapter presents the summary of the research problem including the

findings, conclusion, and recommendations.

Summary

The prime purpose of this study is to describe the various factors that explain the

management of Filipino childless married women in addressing their involuntary

childlessness and how these management strategies shape the quality of their marital

relationship with their husbands. The study involved sixteen childless married women

who reside within Metro Manila. The data was gathered through conducting an in-depth

interview with the use of an interview guide complete with questions and probing. The

informants were acquired through purposive referral and snowball sampling.

The data shows that the mean of the age of the women is 44 years old. Majority of

them were college graduates, earns about one million to five million pesos yearly, and are

affiliated with Roman Catholicism. Data also shows that there is an equal number

between women diagnosed with infertility and women diagnosed with infertility. In

addition, most of the source of involuntary childlessness is the wives rather than the

husbands.

In terms of the perception of the women, there are three ways on how the women

reacted when they learned about their situation: stressed, feelings of emptiness, and

optimistic. Other than this, the women also had different views on other childless married

couples. These views include: couples to learn to accept their situation, opportunity for

95
marriage improvement, opportunity for personal improvement, relatable to their situation,

and sees them as undervalued.

Generally speaking, the women's quality of marital relationship is considered to

be positive because when it comes to marital adjustment and marital commitment, they

do particular techniques and strategies in order for them to foster their relationship with

their husbands.

There are two ways of how women manage their childlessness, these are:

management of the situation of childlessness and the strategies in order to have a child.

Evidences show that management of the situation of childlessness includes pursuing

other interests, focusing on self and focusing on relationships. Meanwhile, the strategies

in order to have child includes medical related strategies, traditional strategies,

professional counselling and other options.

In this study, the socio-demographic characteristics of women according to age,

educational attainment, yearly income and religious affiliations play a significant role on

women’s management of childlessness. Women who are younger are more open to

venture on medical related strategies while older women prefer to practice traditional

strategies. In terms of educational attainment and yearly income, women who have

achieved a higher education and have a yearly income of 1 million pesos and above tend

to venture more on medical related strategies. However, in terms of management of the

situation of childlessness, majority of childless women regardless of age, educational

attainment, and yearly income, practice similar strategies in management of the situation

of childlessness, which is why they focus on relationships with their husband, family and

friends. Above all, religious affiliations of women play a big factor in their management

96
of childlessness. Roman Catholic women tend to venture on traditional strategies,

whereas women who have no religious affiliations prefer to explore on medical related

strategies.

Findings also show that their initial reaction on their situation and their view on

other childless married couples shapes how they manage with their situation. Those who

are stressed, felt empty, and optimistic when they found out about their situation pursue

their interests and also practice more traditional strategies in order for them to have a

child. Other than their initial reactions, those who had a notion that couples must learn to

accept their situation, see it as an opportunity for personal improvement, and also see it as

relatable to their situation pursue their other interests. Majority of the women practice

medical related strategies but also do some traditional strategies as well, to be able to

have a child.

It was found that the various strategies on how these women manage their

childlessness opens up an opportunity to evaluate the kind of marital relationship they

have with their partners. With the various strategies, women tend to adjust the

relationship through working things out. Mostly mentioned that the various management

strategies they have performed helped them to evaluate the relationship they have with

their husbands. In addition, these management strategies where women and their partners

started to explore options, they became more inclined to compromise their thoughts and

opinions with their husbands through having good communication with each other.

Hence, most of these women, with all the strategies they perform to act upon their

situation, became more inclined to show their love and care for their husbands, which

lead them to remain having a harmonious marital relationship with their partners.

97
Conclusion

Results show that the management of childlessness varies depending on the socio-

demographic, nature of involuntary childlessness, and perception on childlessness of the

women. However, among these three variables, the socio-demographic of the women is

what shapes the management the most. Age, educational attainment, yearly income and

religious affiliations are factors as to how the women manage with their situation and

what they do in order for them to have a child. Both younger and older women tend to

pursue their other interest for them to manage their situation. Younger women often do

more medical related strategies while the older women perform more traditional

strategies. In terms of educational attainment, women who only finished high school,

graduated from college, and are post-graduates all focus on their relationships. When it

comes to strategies in order to have a child, both college graduates and post graduates do

more medical related strategies while those who only graduated from high school manage

their being without a child by leaning more into traditional strategies. The yearly income

also reveals that the more they earn, the more likely they will do more medical related

strategies. When it comes to religion, majority of the women were Roman Catholics, so

findings only show that those who are affiliated with a religion do not only perform

medical related strategies but traditional strategies as well.

Although the women had different reactions upon knowing their situation and

views towards other childless couples, majority of them commonly pursue their other

interests when managing their situation. However, there still some who focus on

themselves and their relationships. In terms of the strategies in order for them to have a

98
child, majority of them do medical and traditional strategies regardless their differences

in their reaction and their views.

Findings show that no matter how they manage their childlessness, the quality of

their marital relationship with their husbands is positive. In fact, most of the women knew

right from the beginning that they would be committed to their husbands. In addition to

this, the women who make use of certain techniques or strategies eventually developed

their commitment for their partners. Majority of them also stated that they are more

dedicated and more trustful to one another. Thus, the management of childlessness does

not entirely hinder the women from having a good marital relationship with their

partners.

Recommendations

Based on the findings and conclusions, the research team has come up with the

following recommendations to help the future investigators in expanding more insights

and information about the study.

Recommendations for future studies:

1. Extend the scope of the population. This study only focused on Filipino childless

women who reside within the National Capital region, thus limiting the possible

gathered data that may cultivate a broader knowledge of information for the

development of this study. Through considering other population as informants,

newer and possibly more conducive insights could be gathered for future studies.

2. Increase the number of informants. This will increase the accuracy of the data

covered in the study.

99
 3. Consider other domains of Marital Quality, since this study only focused on

Marital Adjustment and Marital Commitment. Through this, the future studies

will be able to provide more explanation on possible occurrences that were not

specified in this study.

4. Conduct a study about Voluntary Childless Women to be able to have a better

understanding of the situation of the other type.

Recommendations for Health Professionals and Organizations

1. The Government may develop an updated and permanent record concerning the

population of Involuntary Childless Filipino women. In this case, they would be

able to provide projects and assistance to aid the situation of the Filipino childless

women or couples.

2. Establish educational seminars or programs in a local and national level, so that

the stigma attached to being childless will be lessened or better yet, eliminated in

the community.

100
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APPENDICES A

GENERAL CONSENT
Dearest Informant,

Greetings!

We, Luis Martin Peñaflorida, Ella Mey Riel, and Duanne Kriselle Torres, are

students currently taking Bachelor of Arts in Behavioral Sciences Majoring in

Organization and Social Systems Development at the Behavioral Science

Department, College of Liberal Arts of De La Salle University in Manila, would

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 like to invite you to be one of our informants in our undergraduate thesis entitled

Moving Out of Childlessness: Women’s Management of Involuntary

Childlessness and their Marital Quality. The interview is designed to gain insights

about how Filipino women manage their involuntary childlessness; which will

explore socio-demographics, types of involuntary childlessness, perception on

childlessness, and their relationship to the management strategies of Filipino

married women, as well as its relationship to their Marital Quality. Your

participation in our study will involve participating in an interview. We promise

you that your responses will be always kept confidential.

Many Thanks!

Sincerely,

Penaflorida, Luis Martin Riel, Ella Mey Torres, Duanne Kriselle

Behavioral Sciences Department

De La Salle University

APPENDICES B
INTERVIEW GUIDE

Moving Out of Childlessness: Women’s Management of Involuntary Childlessness

and their Quality of Marital Relationship

Greetings! We, Luis Martin Peñaflorida, Ella Mey Riel, and Duanne Kriselle Torres,
currently taking Behavioral Science Majoring in Organization and Systems Development,
would like to thank you for your participating in our interview and giving information
regarding Women’s Management of Involuntary Childless and their Quality of Marital

114
Relationship. All information that you will be giving will remain classified and will be
only be used for our research.

A. Socio-demographic Characteristics of Filipino Women

I will now be asking questions regarding yourself and work

(Itatanong ko po ngayon tungkol sa iyo at pagtrabaho.)

Personal Characteristics of Filipino Women

1. Age: _______________
2. Highest Education Attainment:
__ Elementary __ High School __ College __ Masters’ ___ Doctorate
3. Place of Residence: ___________
4. Religious Affiliation: ___________
5. Duration of Marriage: ___________

Work- Related Characteristics of Filipino Women

6. Occupation: __________
7. Estimated Total Income (Yearly):_________

B. Nature of Involuntary Childlessness of Filipino Women

Let’s now talk about childlessness.

(Ngayon po, pag-usapan naman natin ang iyong pagiging walang anak. )

1. Why do you think you are not able to bear a child?

(Sa tingin mo, bakit hindi ka makapagdala ng anak?)
(PROBE: reasons of being childless such as type of involuntary
childlessness)

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 2. What really is the reason behind your being childless?
(Ano po ba talaga ang rason kung bakit hindi kayo magka-anak?)
(PROBE: source of infertility or infecundity)

C. Perception on Childlessness of Filipino Women

3. What was your reaction when you found out you have difficulties in
bearing a child?
(Ano ang inyong naging reaksyon noong nalaman mo nahihirapan kayo
magkaroon ng anak?)
(PROBE: views such as acceptability, natural or unnatural, woman =
mother, childlessness as a discrediting attribute, undervalued and
significance of being childless.)

4. What do you think of married couples who do not have children?

(Ano ang tingin niyo sa mga mag-asawa na walang anak?)
(PROBE: specific difficulties or benefits with partner or other family
members; negative or positive reactions.)

D. Management of Childlessness among Filipino Women

5. What do you do in order to handle situation on being childless?
(Anu-ano ang mga bagay na inyong ginagawa sa kasalukuyan kaugnay sa
inyong sitwasyon ngayon?)
(PROBE: acceptance, praying, etc)
6. What other things or strategies do you do to handle childlessness?
(Ano pa po ang inyong ginagawa kaugnay sa inyong sitwasyon ngayon?)
(PROBE: medical treatments, counselling, etc.)

E. Quality of Marital Relationship

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 7. What can you say about your relationship with your husband now?
( Ano po ba ang masasabi ninyo tungkol sa relasyon niyo sa inyong
asawa?)
(PROBE: Satisfaction in terms of commitment)
8. What can you say about your commitment to each other?
( Ano po ang masasabi niyo sa commitment niyo sa isa’t isa?)
( PROBE: satisfaction in terms of commitment)
9. If there are negative circumstances that come your way, how do you handle
such situations with your husband?
(Anu-ano ang mga bagay na iyong ginagawa, sa tuwing may mga
negatibong pangyayari na dumarating sa inyong buhay mag-asawa?)
(PROBE: answers such as adjusting and discussing the problems)
10. What do you think of you and husband’s accommodation to the situation?
(Ano ang sa tingin mo sa inyong pag-isaayos?)
(PROBE: answers their view towards their adjustment to the situation)

117