An Article I wrote for Mumbai Mirror on August 27th, 2018. The article was motivated by the sharing of many women who I met at the Times Fertile Conversations Meet to raise awareness about  taboo subjects such as infertility.

According to WHO data, there are about 20 million infertile couples in India. But couples who, for various reasons, delay having a baby (delayed being a very subjective term, since Indian families feel that post-marriage, even a year’s delay is a long one) tend to get labelled ‘infertile’ or their marriage becomes the stuff of gossip.

The toll can be tremendous: Understandably, the pressure to have a baby can put an immense emotional strain on any couple. According to a study which was cited in a Harvard Medical School Mental Health Letter, women who suffer from infertility feel as anxious or depressed as those diagnosed with cancer or hypertension, or those recovering from heart attacks. The psychological toll can pour into a couple’s sex life, can lead to social isolation and, sometimes, to social rejection too.

At an infertility awareness event, I observed that one of the most common concerns raised by childless women was the social ostracism they experience. Sharing her story, one of the women said: “When I wasn’t able to get pregnant we visited every doctor under the sun…and some babas and fakirs too. But the moment the doctors suggested we start infertility treatment, everyone — from my in-laws to my maid — looked at me with condescension.” It is as if the inability to conceive is seen as some grave character flaw.

Stress only compounds the problem: Perhaps the saddest fallout of this is that the stress this leads to complicates the issue further. Stress can directly impact one’s chances to conceive. A study conducted by the NGO, Population Council, found that stress lowers sperm count by overwhelming the cells that make the male hormone, testosterone. The study’s director, endocrinologist Matthew Hardy found that stress hormones overpower the enzymes responsible for ensuring that cells in the testes produce testosterone, which is necessary for sperm formation.

Stress can also have an indirect impact on fertility. Couples could lose interest in sex entirely or adopt unhealthy lifestyle habits such as smoking, alcoholism or emotional eating to cope, all of which further exacerbate the problem and reduce their chances of conceiving. For example, if either of the partners loses sleep because of the pressure he or she is under, he or she may consume more coffee than usual, and researchers have established that drinking four or more cups of coffee a day reduces a couple’s chances of conceiving by as much as 26 per cent.

What couples can do to counter this pressure

1 Prepare yourself: Work on your answers to those inevitable questions. For example, ‘What is your reason to delay starting a family?’ Your answer could be a career goal, or you may want to just get fitter/healthier or more financially stable first. Having an answer ready will help you resist the urge to make up a story or blurt out something different from what your spouse has said. Whatever your personal reasons to delay having a child or choosing to live child-free, remember, it is your decision to make, and not someone else’s.

2 Introspect: Ask yourself if you’re being oversensitive. The stress they’re under can make couples misread even genuine concern (such as that of a doctor or an old friend) as judgement.

3 Split the load: Make a pact with your partner to ensure that neither of you has to shoulder the ‘blame’. Even if the doctor says one of you may suffer from a fertility problem, it’s a bad idea to announce this to others. The two of you should decide what you want to tell people about the situation, if you want to say anything at all. Whatever your choice, present a strong, united front.

4 Take positive action: If both of you are keen to have a child and there is a genuine fertility problem, then, rather than worrying about what people will think or say, turn your attention to finding a solution. Fertility experts can present you with various options based on your circumstances. Consult a specialist and get the necessary medical checkups done, and then weigh your options carefully.

You know the pressure’s getting to you when you’re fighting with each other more often than usual, or when your sex life starts to wane. The pressure can make it even tougher to plan to have a baby because you may actually start wondering whether you want to stay in the relationship in the first place. So, the first thing to do is to stay calm. Before you worry about becoming parents, it’s vital to, first, go back to being a happy couple.

█ Whatever your personal reasons to delay having a child or choosing to live child-free, remember, it is your decision to make, and not someone else’s