The experience of infertility creates negative economic, physical, social, and psychological effects, especially for women. This often results in multiple stresses and needs for coping in these women. Because the manner in which women cope with these experiences are not fully understood, existing counseling interventions fail to adequately meet the needs of women experiencing infertility. Eighty-three women receiving varied services at assisted reproduction clinics participated in a study of the relationship between the use of social coping resources, growth-fostering relationships, and infertility stress. The results support the use of social coping resources for coping with infertility stress. In addition, the results indicate the usefulness of understanding the types of growth-fostering relationships that can be an additional resource for helping counselors conceptualize women's experiences and design effective interventions to help women cope with infertility stress.
Infertility, the inability to achieve a pregnancy after one year of regular sexual intercourse without the use of contraception (Cook, 1987; Meyers et al., 1995; van Balen, Verdurmen, & Ketting, 1997) is experienced by approximately 2.1 million married couples in the United States (Center for Disease Control, 1998). Because childbearing is a major, normative transition for both men and women (Korpatnick, Daniluk, & Pattinson, 1993), the experience of infertility constitutes a nonevent transition (Korpatnick et al., 1993) and has been conceptualized as a "crisis" (Atwood & Dobkin, 1992; Butler & Koraleski, 1990; Slade, Raval, Buck, & Lieberman, 1992). This crisis is complex and consists of multiple physical (Robinson & Stewart, 1995), financial (Meyers et al., 1995), social (Atwood & Dobkin, 1992; Cook, 1987; Edelmann & Connolly, 1996; Matthews & Matthews, 1986; Reed, 1987), and psychological stressors (Abbey, Andrews, & Halman, 1991; Brand, 1989; Daniluk, 1997; Domar, 1997; Edelmann & Connolly, 1996; Jones & Hunter, 1996; Keystone & Kaffko, 1992; Shepherd, 1992; University of North Carolina Hospitals, 1998).
Overall, women experience more negative effects than men throughout the entire infertility diagnostic and treatment process (Abbey et al., 1991; Benazon, Wright, & Sabourin, 1992; Berg & Wilson, 1991; McEwan, Costello, & Taylor, 1987; Ulbrich, Coyle, & Llabre, 1990). Common effects include a greater sense of loss of control than men have (Stanton, Tennen, Affleck, & Mendola, 1992) and a greater tendency to blame themselves for the couple's infertility (McEwan et al., 1987). In addition, women are more likely to perceive childlessness as simply unacceptable (Ulbrich et al., 1990). Not surprisingly, then, a variety of authors have noted gender differences in coping with infertility (Connolly & Cooke, 1987; Levin, Sher, & Theodos, 1997; Ulbrich et al., 1990).
Models of stress and coping have been proposed to explain how people appraise stressful situations, attribute the responsibility for stressors, handle the loss of life goals, and process their expectation of control in stressful situations (Brickman et al., 1982; Folkman & Lazarus, 1980; Klinger, 1975; Lazarus & Folkman, 1984; Wortman & Brehm, 1975). Myers and Wark (1996) have used coping models of appraisal in cognitive-behavioral therapy to help couples experiencing infertility, and grief counseling has been used with individuals and groups (Forrest & Gilbert, 1992). In addition, there are studies in which the importance of social support as a coping mechanism for women has been established (Billings & Moos, 1984; Flieshman, 1984; Heppner, Reeder, & Larson, 1983; Ptacek, Smith, & Zanas, 1992; Stanton, 1991; Stanton et al., 1992; Stone & Neale, 1984). However, the types of social relationships that provide support in stressful situations have not been explored, primarily due to a lack of theory and research explaining women's social relationships. …