Normalization as a Strategy for Maintaining Quality of Life While Coping with Infertility in a Pronatalist Culture

Yael Benyamini*, Miri Gozlan, Ariel Weissman

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Purpose: Infertility could be highly stressful, particularly in a pronatalist culture. We aimed to develop the concept and a measure of normalization (maintaining normal life routines and feeling “normal”) as a strategy that could enable women with infertility maintain their quality of life (QoL) while coping with this condition. We tested its associations with women’s well-being, distress and QoL in Israel, where being childless is socially unacceptable and highly stigmatized. Methods: One-hundred and eighty Israeli women undergoing infertility treatment at a fertility community clinic filled in questionnaires assessing normalization-related coping strategies, QoL, and psychological adjustment (distress, wellbeing). Eight months later, 55 women conceived; 55 women who had not conceived completed a second questionnaire. Results: At baseline, normalization was related to higher QoL and better adjustment. Structural equation modeling showed that QoL was impaired mainly among women who felt different than others, compared, and blamed themselves. Over time, normalization was overall unrelated to conception or to changes in adjustment yet was protective against decrease in well-being among women who already had a child. Conclusions: Infertility is highly stressful in a pronatalist culture like Israel. It requires treatment yet is not disabling. Patients who manage to maintain normal routines and not feel different than other people their age may experience better QoL and psychological adjustment.

Original languageEnglish
Pages (from-to)871-879
Number of pages9
JournalInternational Journal of Behavioral Medicine
Issue number6
StatePublished - 1 Dec 2017


  • Coping
  • Distress
  • Infertility
  • Normalization
  • Quality of life
  • Well-being


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