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No One Knows

India is fast climbing the global infertility chart, with nearly 28 million couples experiencing problems conceiving. According to WHO, approximately 50 per cent of the cases are due to 'male factor' infertility. Yet, the blame and shame from society still fall on the woman. 

The complex question about IVF is not about technology. It is about how an Indian woman is valued in the eyes of society if she can not bear children, whether it's her or her husband's body malfunctioning.


Sapna is a woman born and raised in Mumbai. She had her father's support to pursue whichever life she wanted. She chose the Bollywood film industry, which is widely known to be infested by men taking advantage of female actors. As a result, she met criticism and suspicion from her extended family and society. 


She has always had good stamina and a sense of self-respect and managed to manoeuvre that slippery road. Her temper could be described as typically an Indian male. However, she has never acted shy, with eyes looking down the way, never backed down in an argument and always stood up for herself. 


The first time I met Sapna was in Rishikesh. She had recently left the industry due to the toxic environment and needed time to get her thoughts in order, what to do and how to support herself. Rishikesh is a spiritual place that many Indians visit to find guidance in their lives. This is where she met the local young man Mukesh.


Mukesh has lived his whole life in Rishikesh, has never travelled anywhere, has worked in tourism since an early age, only has primary education and takes his religion seriously. Sapna is surprised to find a good-hearted, respectful and clever man and never shows signs of trying to change how she looks or behaves. He is different from her previous encounters with Indian men. 

Two years later, I attended their wedding. By then, Mukesh had built a house for his bride, and they started their new life together. However, when they eventually decided to start a family, their hopes and desire were not graced. Not only did Sapna battle with her thoughts on why and what was wrong, but she also had pressure from society. Neighbours were asking questions, speculating and gossiping.


The consequences of the measures Indian women are valued by can be very costly. Both mentally and financially.

This is an ongoing project, and the photos show one of many couples struggling to navigate the wish of having a child in the Indian maze of ignorance, science, religion and superstition.


Sapna is staying with her mother, brother, and his family in Mumbai for the IVF treatment. The official story is that she is helping out with the children while her mother is away. Weeks and months pass. People back in Rishikesh and neighbours in the building are starting to wonder why she has been gone so long and why she left her husband on his own. She hardly ever leaves the apartment to avoid the typical Indian question of when she plans to have children now that she is married. It makes her lethargic and apathetic.


The knowledge of how the human body functions are shockingly lacking in India. In addition, the consequences of the taboo topic of sex are that women lack insight into what happens during the menstrual cycle and how that affects their bodies. Men only know that coitus is necessary for a potential pregnancy.


The discrepancy between the laws in India and how they work in reality is vast. One example of many is that India prides itself on the fact that the country provides free healthcare. However, the only free thing is the cost of seeing a doctor. If any tests or surgical procedures are required, the patient must pay for them separately.


With that said, if a couple is struggling with conceiving, it involves a great deal of financial commitment to find out why, even more when they decide to pursue IVF treatment.

Sapna and her husband have purchased a package of three IVF cycles. She is having dinner at the clinic while waiting for the first egg transfer to be performed.


Mukesh has been very supportive and never pushed for an IVF treatment, instead opting for the adoption option. He also repeatedly told her not to bother about what other people would say. Still, Sapna feels that the blame from society falling on her would be too much to bear.


Sapna is back home after the completion of the second IVF cycle. Her mental state is at its lowest due to tensions with a family member in Mumbai, and staying longer in Mumbai would not be explainable to society. She lies in bed most of the day, sleeping or questioning why this is happening to her.


I suspect Sapna is pregnant. Her appearance has changed, the nausea, the food she loves that doesn't taste good. Mukesh is circling her in protective mode. It's too early to get a pregnancy test done, so we all wait and breathe. Minor bleedings start to appear more or less frequently. The doctor in Mumbai is not very interested in helping her, so she contacts a local gynaecologist who also performs IVF treatments. She sees Sapna a couple of times, gives her a shot to help prevent a miscarriage and orders Sapna total bed rest. 

Four weeks after the implant, it's time to do an ultrasound and take the blood test, which will provide the much-awaited answer. Sapna and Mukesh leave, and I stay in the house. The wait is unbearable. My phone rings. "You are the first person I'm calling, and after our conversation, I will call my family. It's an ectopic pregnancy, and the operation has to be done today."


Our new routine in the house is that Mukesh and I do as much household work as possible. My main task is taking care of the laundry. When the morning chores are done, Sapna and I take some snacks to the rooftop and warm up in the sun. I wait for her to express any emotions to me, but mostly she cries under the blanket.

After a week, she opens up, and we have a short conversation about the feelings after such a traumatic experience, that it is important to grieve, that it takes time and that whatever she's feeling is ok. 


Two years ago, when Sapna and Mukesh decided to start a family, Mukesh wanted to see the local Swami (a respectful title given to a Hindu practitioner with great knowledge). So they went to his house but never got to talk to him for some reason. Now, Mukesh and Sapna have made an appointment with him after the negative results of two IVF cycles.


Without explaining why they want to meet with the Swami, he starts by saying that he knew she would have difficulty conceiving the first time he laid eyes on her three years ago. He also tells her that everything is going to be all right. But she needs to collect Peepal seeds, dry and grind them, and have a spoonful every morning. 

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