Influence of Spirituality and Resilience on Managing Infertility Stigma Among Married Women in Selected Evangelical Church Assemblies in Zou County, Benin

Abstract

Infertility stigma is generally overlooked by policy makers in Africa. In an attempt to helping intervention, this study examined the influence of spirituality in the religious context of the Church, and resilience, as the woman is managing infertility stigma. The study examined the relationship between spirituality and coping with infertility stigma, assessed the role of resilience in managing the psychological effects of infertility stigma, explored the interplay between spirituality and resilience in coping with infertility stigma, identified the support structures for married women managing infertility stigma, and explored potential for faith-integrated intervention at church. The study was anchored on the Satir Model and the Resilience theories. It employed a convergent parallel mixed-methods design. Data was collected from 384 married women with infertility issues and 45 leaders in selected mainstream Evangelical Church Assemblies in Zou County, Benin. A pre-test involved 45 women with infertility and 5 leaders selected in Come and Lokossa, two sub-counties of Mono. Simple random and purposive sampling were applied. All necessary permissions were obtained and ethical procedures were observed throughout the research process. The data was concurrently collected with quantitative and qualitative methods. The quantitative data was gathered using standardized instruments including ASPIRES, CD-RISC-10, COMPI CSS, DASS21, ISS-SF, and RSES. The qualitative data was collected with open-ended questions during the survey, interviews, and focus groups. The data was analysed concomitantly. The quantitative data was analysed using the Statistical Package for Social Sciences (SPSS) version 30.0, while the qualitative data was processed by the reflexive thematic analysis method. The reliability of instruments was determined by the Cronbach alpha. ASPIRES scored 0.90 on Spiritual Transcendence and 0.60 on Religious Sentiments. The value was 0.91, 0.78, 0.90, 0.98, and 0.94, respectively for CD-RISC-10, COMPI CSS, ISS-SF, DASS21, and RSES. The relationships between variables were established through regression and Pearson correlation analysis. The results were triangulated. All findings were presented through tables, charts, and graphs. The results, showed that spirituality explains 20.3% of the variance in the coping strategies. Resilience and infertility stigma together explain 45.8% in the variance of psychological effects. Stigma relates to psychological effectsat 45.9%, and self-devaluation and social withdrawal presented as risk factors for these psychological effects. Spirituality and resilience mutually interact at 16.60% and influence infertility stigma coping strategies by an indirect effect. Women were yearning for structures engaged in emotional and social support, and wished that intervention strategies include teaching, training, praying, lobbying for access to subsidized fertility care, facilitating access to mental health services, and support to various extents. The findings in this study are informative for marriage and family therapists who seek to prevent, mitigate and provide effective intervention against infertility stigma. More, they set the ground for researchers and scholars for further studies on infertility and related stigma. Church leaders have in this study a valuable resource for effective intervention against stigma. This study is informative at policy level to provide sensitization on stigma and promote access to mental health services for women with infertility.