A comparative analysis of health-seeking behaviors for women at risk of primary or secondary infertility

Health-seeking behaviors are influenced by multiple factors including an assessment of the symptoms, what degree of personal commitment is involved in treatment, and what, if any, alternative methods of treatment are available. In the case of infertility, seeking treatment is likely to occur after the inability to get pregnant or carry a pregnancy to term persists for longer then a year or more. This is after prolonged exposure to the risk of pregnancy fails to provide a successful pregnancy, and the desire for children remains. Most research on health-seeking behaviors for infertility focus on the nulliparous woman who is at risk of primary infertility. This research furthers this examination by comparing the rates of health-seeking behaviors for women at risk of primary infertility to women at risk of secondary infertility. A woman at risk of primary infertility is identified as nulliparous in that she has never been pregnant, or has never had a pregnancy end in live birth. A woman at risk of secondary infertility is identified as parous and has already had one pregnancy end in live birth. Using three pathways that include social factors, biological mechanisms, and contextual effects, I hypothesize that the rates of health-seeking behaviors will vary by infertility risk and that women at risk of primary infertility will have higher rates of health-seeking behaviors for infertility. These hypotheses are based on the Behavioral Model of Health Services Utilization and the Health Belief Model that states health-seeking behaviors are influenced by the presence of enabling and predisposing factors, combined with internal and external cues. Findings from this dissertation suggest that the rates of health-seeking behaviors do indeed vary by infertility risk.