10 years of childlessness: Stigma, cost and hope

So, when are you going to start a family? Editah Trip and her husband, Ken Trip Okoye have been asked this question countless times over their 10-year marriage. Sometimes it is asked in jest, sometimes pointedly and followed by discussions about ticking biological clocks, sands of time draining through the hour glass, and the ideal African nuclear family setup.

Every time this question is asked, their hearts break a little more. Like most couples, when Editah and Ken got married in 2007, they had assumed that children would naturally follow. Being only 24 at the time, Editah, a marketing executive, had even wanted to wait a few years before actively trying for a baby.

Understandably, she was also wary of the childbirth process. "I had lost my older sister during childbirth in 2004, just before I got married. I think that made me a little scared of childbirth. She was just 30 years old at the time –pretty young. She was a pillar in our family; she even helped with my school fees. Her death was a huge blow to the family.

Further adding to my fear, my other sister had also had a few complications in childbirth...nothing much but enough to make me want to shelf having kids for a while. However, I assumed that Ken and I would have two children after a few years; a boy and a girl," Editah says, with a wishful gleam in eyes.

Dashed hopes

Editah talks about how their hope for a child has been crushed over and over. "I've had times when I was so convinced I was pregnant that I would buy the testing kit. One after the other, there would only be one line on the strip. That means it's a negative test.

I would hold the strip up to the light, willing a second line to appear. It never did. Sometimes I'd even buy multiple testing kits from different brands, in case one was faulty. Now I don't even buy them anymore" she says.

Echoing her pain, Ken, a Nairobi businessman says, "It was very difficult for me when she would be elated at the prospect of a pregnancy, only to have her hopes dashed again and again. I had to be the strong one. I implored her to stop taking the tests. They were only hurting her, hurting both of us."

Like Editah, Ken had had a laidback approach when it came to children before they got married. "We didn't even have discussions about having children before we got married. I'm a spontaneous person by nature and my approach was 'let's get married first and figure things out along the way'.

But I assumed we would probably have children in the second or third year of marriage. I wasn't in any particular hurry to have children," he says.

The two first met in church in 2001. Editah was in her final year of high school while Ken was in university. Editah smiles fondly as she recalls their first meeting "I heard him sing in church and liked his voice. I loved to sing too. Later we talked briefly and parted ways" she says. Taking up from where Editah left off, Ken continues the tale. "We only met again three years later.

We were in the same singing group and we quickly became good friends. Our friendship developed into a romantic relationship a year later. Because we had such a great friendship, it was easy to transition into a relationship. We got to know each other without the pressure of a relationship first. Two years later, we got married."

Medical tests and endemetriosis

In the first year of marriage, they took measures to avoid pregnancy. In the second and third years, they dropped all contraceptive methods. "After three to four years, we realised that there was probably something wrong. We went for tests –at first the tests were focused on Editah but later I was also tested. All tests showed that everything was OK with both of us," Ken says.

However, Editah had always had severe cramps during her menstrual period, which up to that point she had taken to be normal. "During this period of trying to conceive, there was a time the pain got very intense. I went to the hospital where it was discovered that I had ovarian cysts. I was treated and the cysts cleared. But the painful menses still continued.

In 2009, I went for laparoscopic surgery to remove more cysts and fibroids and was put on hormonal medication to suppress any further abnormal growths. They removed 12 fibroids and six cysts. The pain still persisted. At some point, I would have pain but my period blood wouldn't come out. I was told that instead of coming out, the period blood was flowing back through the fallopian tubes into the abdominal cavity. Apparently, that led to endometriosis," she says.

She later went for open surgery. "At that point I was in such agony that when the doctor saw me, he immediately sent me to the theatre. The pain was so horrible that I had to be put on morphine. That's when they confirmed endometriosis as the diagnosis. Unfortunately, a cure is yet to be found for endometriosis," she says.

Statistics show that endometriosis affects 176 million women worldwide (that is 10% women worldwide). Medical experts assured Editah and Ken that they could still conceive, despite endometriosis.

Although endometriosis is considered one of the major causes of female infertility, most patients with endometriosis don't experience fertility problems. Only 30-40% of women with endometriosis suffer infertility. With proper treatment, infertility caused by endometriosis can be successfully cured.

Ken and Editah were delighted that they had finally arrived at a proper diagnosis. Editah could finally get the right treatment. The usual course of treatment for endometriosis is hormonal therapy to suppress it and pain killers. "I had to get really painful jabs for the hormone therapy for six months," she says. Unfortunately, hormonal therapy didn't help much.

"I still have pain every time I'm on my periods. I try to manage the condition with a healthy diet, exercise, and even herbal medicine. Some months the pain is really bad, but there are months it is not as much. And I still haven't conceived yet. But the doctors still say that we shouldn't worry," Editah says.

Throughout Editah's struggle with endometriosis, Ken was extremely supportive. "When she is in pain, it hurts me too. I feel helpless. I try to support her by being there for her physically and emotionally. I massage her back, bring her hot water bottles, encourage her, and pray for her...I just do my best," Ken says.

Willing to wait

If hormonal therapy doesn't work for women hoping to cure endometriosis-related infertility, the doctor might suggest fertility options like IVF (In Vitro Fertilization). "We talked to a doctor last month and he broached the topic of IVF. But honestly, it's not something we're willing to consider at the time. We are still young and the experts tell us there's nothing to worry about.

We've known other couples who are waited for 10, 15, or even up to 20 years before they got children. We are willing to wait," Ken says.

Is there a time limit to how long they are willing to wait? "No, I'm a very patient man. Editah also has a lot of faith that when the time is right, God will bless us with a child. Children are gifts from God. It's upon Him to decide when he wants to give them, or whether to give them at all," Ken says.

Have they considered adoption or surrogacy? "We've talked about adoption. It's something we want to do, regardless of whether we have biological children or not," Editah says.

"For us, adoption is not a way to deal with our childlessness, but a way to extend a helping hand to a needy child. It won't be something new for us- we are already taking care of some orphaned nieces and nephews.

We pay their school fees, invite them into our home over the school holidays, and we also visit them," Ken adds.

Regarding surrogacy, they have never considered it an option. "I feel like going the surrogacy way is saying that I want to have a biological child at any cost. I would rather adopt a child than use a surrogate," Editah says.

Ken agrees "In addition, we are conflicted about the morality of using a surrogate. We are willing for God to bless us with a biological child in his time. If that doesn't happen, we will accept the situation."

Societal pressure

Like most childless couples, Editah and Ken are tired of society's casual prodding on when they are going to join the parenthood bandwagon. "There's a lot of pressure to have children coming from different sides. Luckily, our families have been very supportive of us. Never have I been made to feel like an outcast by my husband or my in-laws.

I know our parents worry because they want us to give them grandchildren, but they support us nonetheless. But the extended family and other people have surprisingly a lot to say. Once a lady approached me and told me she'd seen what caused me not to have children in a vision, and asked me to give her some money to pray for me. Some people give me unsolicited advice on sex positions to use, foods to eat, and herbs to take. I used to take the herbs and had acquired quite a cache of them.

 But I had such a bad reaction to one of the herbal remedies that I had to be rushed to the hospital to have it flushed out of my system. Since then, I stopped taking any alternative herbal medication," says Editah.

Editah says that in most cases where a couple is childless, the woman is the most emotionally affected. "Most women going through infertility don't really want to talk about it openly. Infertility- whether permanent or temporary- is stigmatized in society. The first two years of trying to conceive were the hardest for me," she says, "I felt sorry for myself. Whenever I saw a mother with her child, it would hurt me."

Ken also experiences pressure, but handles it well. "Men will joke that maybe I'm shooting blanks and speculate that I'm probably cheating on my wife. There's also a relative who suggested that I get a second wife. But my objective when I got married wasn't just to have children.

We have grown as a couple- started businesses together, bought property, and travelled the world. I couldn't have done all that without Editah by my side. We are happy with each other. For me, that is great bargain, whether we have kids or not. God has really blessed us." he says.

Ken and Editah feel that the struggle to conceive has strengthened their marriage. "This has given us time to bond with each other. Facing childlessness has made us a team. We can also be more spontaneous than we would be if we had children," Ken says.

To support other couples going through infertility, Editah and Ken started the Waiting Wombs Trust, a non-profit organization. "Through the trust, we bring together other couples going through the waiting process, those who have suffered miscarriages, and those who have waited and were eventually blessed with children.

We share our stories and experiences to encourage each other. For people going through infertility, the experience can be very isolating. Through sharing with each other, couples learn that they're not alone in the journey," Ken says.

"We also partner with doctors and other experts who can give couples advice. We are currently looking for people and organizations to partner with. We have realized that many couples are childless because of conditions which can be treated quite easily, but they can't afford the treatment.

We hope to find people who can help such couples. Right now, we have a Facebook page, which is our main platform."

They wish people could be more sensitive towards childless couples. "Just because a couple is childless don't make assumptions about them. For most of them, it isn't a choice. Don't make hurtful comments. We will continue trusting and waiting on God to bless us with a child when the time is right.. " Ken concludes.