ArticleReproductive health2025
What to expect when you want to be expecting: time-to-pregnancy expectations and anticipated worry and help-seeking among a nationally representative survey of women in Uganda.
Article in Reproductive health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Defining infertility: The varied criteria people in two regions of Uganda use to identify infertility in themselves and others.Social science & medicine (1982) · 2025Article
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6 authors.
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Abstract
backgroundIt is important to understand time-to-pregnancy expectations and when women begin to worry or seek help for fertility-related concerns, particularly in sub-Saharan Africa, where infertility is highly stigmatized and there is considerable pressure to conceive quickly. Yet our understanding of this topic is informed by a small body of literature often involving selective clinic-based samples of those receiving infertility care. This study aims to better understand Ugandan women's expected time-to-pregnancy and their anticipated emotional and behavioral responses to time spent trying as well as its alignment with the 12-month clinical threshold for infertility.
methodsWe use population-based cross-sectional data of women aged 15-49 in Uganda (n = 4227), limiting our analytic sample to women who had ever had sex (n = 3741). Our outcomes of interest were time-to-pregnancy expectations and related worry and help-seeking. We operationalized time-to-pregnancy expectations as a continuous measure, in months, and worry and help-seeking as binary measures, with a 12-month and a 12- and 24-month cut-off, respectively. We fit multivariable Tobit and logistic regression models to identify sociodemographic factors associated with time-to-pregnancy expectations and related worry and help-seeking.
resultsHalf of women think it typically takes less than one month to conceive. The majority anticipated that they would begin to worry (82.4%) and seek help (77.3%) before reaching the 12-month clinical threshold for infertility. Women with children, with perceived difficulties conceiving, and with longer time-to-pregnancy expectations had decreased odds of worrying or seeking help before 12 months. Over 10% of women anticipated that they would seek help after 24 months of trying, with those who had longer time-to-pregnancy expectations having increased odds of seeking help after 24 months of trying. Time-to-pregnancy expectations, worry, and help-seeking were highly normative, with 27-36% of the variability in these outcomes explained by the woman's geographic community.
conclusionOur study suggests that the clinical threshold for infertility may not align with individuals' expectations and concerns related to delayed childbearing in Uganda. More education about conception and suggested care-seeking timelines, along with early psychosocial support, could help women navigate fertility concerns, especially in cultures where delayed pregnancy leads to stigma and social consequences.
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