Infertility as a transformational process: a framework for psychotherapeutic support of infertile women.

The purpose of this qualitative descriptive study was to investigate the phenomenon of infertility as experienced by infertile women. A purposive sample of 25 infertile women participated in the study. Data were extracted from taped interviews and the researcher's observational field notes. Data analysis was conducted according to the techniques described by Miles and Huberman (1994). Participant responses to interviews were categorized by examining the interview transcripts and identifying significant statements and meanings. Themes which emerged from the statements were then ascertained and cross-case comparisons were made in order to confirm or to reconsider these themes. Five key themes emerged from the data: failure to fulfill a prescribed societal norm, assault on personal identity, mourning, transformation, and restitution. The women experienced infertility as a transformational process in which they mourned their loss of reproductive function and parenting roles and struggled to make restitution for the perceived stigma and powerlessness associated with nonfulfillment of a prescribed societal norm, the exclusion from cherished societal rituals, and the deprivation of ties of descent. Findings from this study have provided a framework for increased awareness of the phenomenon of infertility and for the essential components of supportive counseling or psychotherapy, regardless of the outcome of the infertility experience.