Social Stigma and Health-Seeking Behavior among Women Experiencing Infertility in Ibadan, Nigeria: A Qualitative Exploration of Lived Experiences

Abstract

Background: Infertility in Nigeria transcends biological impairment, constituting a profound social and psychological crisis, particularly within the pronatalist Yoruba context of Ibadan. While biomedical factors are well documented, the interplay between social determinants and their impact on health-seeking trajectories remains underexplored.
Objective: This study explores the lived experiences of women receiving infertility care and examines how social stigma shapes their health-seeking behaviour, while critically evaluating the applicability of Andersen's Behavioural Model in this context.
Methods: A qualitative design was employed, utilizing in-depth, semi-structured interviews with 24 women seeking fertility care at public and private clinics in Ibadan. Data were analyzed thematically, guided by an integrated framework combining Andersen's Behavioural Model, Goffman's Stigma Theory, and the Health Stigma and Discrimination Framework.
Results: Findings reveal infertility as a "crisis of identity" marked by the "naming burden" and emotional distress. Social stigma operates as a dynamic "triple threat" (enacted, anticipated, and internalised), creating a "seclusion barrier" that drives concealment and treatment discontinuation. Crucially, the study identifies deviations from Andersen's model: healthcare facilities are often perceived as "predatory" rather than neutral resources, and prolonged infertility triggers "treatment fatigue" rather than linear urgency, leading to care withdrawal.
Conclusions: Effective interventions must move beyond biomedical access to address the predatory nature of care markets and the cyclical dynamics of stigma. Policymakers are urged to integrate psychosocial support and foster culturally sensitive, stigma-free environments to improve fertility care utilization in Nigeria.