Social Support and Resilience in Women Who Have Infertility
Safitri M., Sulis Mariyanti and Bayu Sasongko
Faculty of Psychology, University of Esa Unggul, Jl. Terusan Arjuna No. 9 Kebun Jeruk, Jakarta Barat, Indonesia
Keywords: Social Support, Resilience, Women, Infertility, Emotional Dimension.
Abstract: Women are often positioned as the party most responsible for marriages that have not been blessed with
children because normal women have a tendency to become real mothers and become pregnant. An infertile
woman is considered as someone with an abnormality because it is related to her nature to conceive and give
birth. The purpose of this study was to determine the effect of social support with resilience in women
experiencing infertility. The research method uses a quantitative non-experimental. The sampling technique
is nonprobability sampling with purposive sampling. The samples are 100 women who experienced infertility.
The social support measure uses a theory Uchino with reliability 0.952, and resilience uses a theory of
Grotberg with reliability 0.947. The results showed there was a positive and significant effect between social
support and resilience (Y = 39,4 +0,995 X, Sig 0,00 and r 0,855). The dimensions of social support that have
an influence on resilience are the emotional dimension, the instrumental dimension, and the friendship
dimension, where the emotional dimension has the greatest relationship with resilience (r=0,815). Resilience
among women experiencing infertility tends to be lower (53%) means they need social support especially on
her emotions.
1 INTRODUCTION
Infertility is the failure of a partner to get pregnant
after having sexual intercourse regularly for at least
one year without using contraception (HIFERI,
2013). Infertility disorders can inhibit married
couples who crave the presence of a baby. (Amalia,
2017). Hoose and Worth (in Grace, 2008) say social
criticism is a result of women experiencing infertility.
Couples who do not have children must be ready to
face social criticism from child-oriented societies. In
addition, there is also a group of people who
encourage husbands to remarry with other women
who can’t provide children and even encourage
divorce (Majidi in Grace, 2008).
Infertility has three types, namely primary
infertility, secondary infertility, and idiopathic
infertility. Primary infertility is a condition in which
a partner fails to get pregnant at least within 12
months after routine sexual intercourse, without
protective equipment for pregnancy. Secondary
infertility is a condition when a person is unable to
have children or maintain his pregnancy, and
infertility with no known cause or so-called idiopathic
infertility. (HIFERI, 2013). The efforts that can be
done by women to overcome infertility problems such
as taking drugs, hormone therapy, surgery or surgery,
handling sexual problems through counseling,
utilizing IVF techniques or Fertilization In Vitro
(FIV), and so on (Adrian, 2018).
Married couples generally crave the presence of a
child. The presence of a child in a marriage contains
three elements of value, namely the value of benefits,
psychological value, and social value the value of the
benefits basically views the child as a provider of
benefits, both economic or material benefits to
parents, especially when parents have reached old
age. Psychological values as a form of satisfaction
include pleasure, pride, love, and friendship with
children. And on social values, social acceptance is
generally obtained when married couples have
children. In addition, lineage sustainability is also
seen as a social value (Hoffman in Kagitcibasi, 2009).
In a married couple whose child is not blessed, a
woman is often positioned as the party most
responsible, because normal women have two
tendencies, namely the tendency to be a true mother
and become pregnant (Kartono, 2007). This opinion
is supported by Demartoto's research (2008) which
revealed that due to strong gender biases in infertility
cases, women tend to be blamed. A woman who
experiences infertility is seen as an abnormality or
M., S., Mariyanti, S. and Sasongko, B.
Social Support and Resilience in Women Who Have Infertility.
DOI: 10.5220/0009568701330139
In Proceedings of the 1st International Conference on Health (ICOH 2019), pages 133-139
ISBN: 978-989-758-454-1
Copyright
c
 2020 by SCITEPRESS – Science and Technology Publications, Lda. All rights reserved
133

weakness of that person because it is closely related
to her deterministic nature to conceive and give birth.
Although a woman has a psychological life with true
maternal qualities, for some reason women can
become infertile or experience fertility problems
(Kartono, 2007).
According to Grotberg (in Fave, 2006) said that
the ability possessed to face, overcome, and become
someone who is stronger over the difficulties faced is
called resilience. People with high resilience look for
new and challenging experiences because they learn
that it can be passed through struggle, by pushing
yourself to the limits of the ability to expand their
horizons (Reivich & Shatte, 2002).
Septiani and Fitria (2016) in their study showed
that low levels of stress in a person are influenced by
high levels of resilience. On the other hand, when a
person's level of resilience is low, the degree of stress
in a person is high.
One factor that is thought to influence resilience
is social support. Social relations appear vital for
health and well-being (Cohen in Papalia et al, 2009).
Marni and Yuniawati (2015) in their research
revealed that there was a significant positive
relationship between social support and self-
acceptance in the elderly at the Dharma Budhi
Dharma Nursing Home in Yogyakarta. The higher
social support given and felt by the elderly will
contribute to the high level of self-acceptance ability
of the elderly at the Dharma Budhi Dharma Nursing
Home in Yogyakarta. And the lower the social
support that is felt or does not get social support will
cause the elderly who are registered at the Wredha
Budhi Dharma Yogyakarta Institution to have
difficulty in living their lives so that they have low
self-acceptance abilities. This is also in line with
research Sargolzaei et al (2018) which shows that the
higher social support felt by patients with HIV / AIDS
in Southeast Iran will affect the high level of
perceived psychological well-being. Uchino (in
Sarafino and Smith, 2011) says social support is
related to feeling comfortable, caring, appreciation, or
assistance received from other people or groups.
Furthermore, Smet (1994) adds that the negative
consequences of stress are protected by interpersonal
relationships as a result of social support.
Women who do not have children and have high
social support will feel comfortable, loved, valued,
and cared for, giving emotionally psychological
strength to women to be able to rise to find solutions
to the burden they face as infertile women. On the
other hand, women who do not have children and feel
low social support feel uneasy, no one loves, is
ignored, feels there is no bond, so they do not have
the emotional strength that makes women rise to find
solutions to the burden they face as infertile women.
This paper will discuss how the influence of social
support on resilience and how the picture of resilience
in women experiencing infertility.
2 RESEARCH METHOD
This research uses non-experimental quantitative
methods. Determination of the sample using a non-
probability sampling method with a purposive
sampling technique, with a total sample of 100
respondents in the DKI Jakarta area.
The measurement of social support refers to the
theory of Cutrona, Gardner, and Uchino (in Sarafino
and Smith, 2011), with dimensions of emotional
support, esteem support, instrumental support,
informational support, and companionship support.
Consists of 42 valid items with a reliability
coefficient of 0.952. While resilience measurement
refers to the theory of Grotberg (1995), with the
dimensions of I Am, I Have, and I Can. Consists of
55 valid items with a reliability coefficient of 0, 947.
3 RESULT AND DISCUSSION
The description of 100 respondents is as follows:
a. Age:
Early adults 87% and middle adults 13%.
b. Education:
Basic education (elementary and junior high)
11%, secondary (high school) 53% and high
(D3, S1 and S3) 36%.
c. Pregnancy history:
Never been pregnant 69 %, ever pregnant and
miscarriage 31%.
d. Length of married:
Early marriage (<10 years) 80 %, middle (10-
30 years) 20%.
e. Occupation:
Working and not working 50% each.
The results of the normality test showed that
social support and resilience variables were normal,
with sig p each 0.200 (> 0.05).
The results of the linear regression calculations
can be seen in table 1.
Table 1: Results of Linear Regression Equations for Social
Support and Resilience.
Model
B
Beta
Sig.
ICOH 2019 - 1st International Conference on Health
134

(constant)
39,386
0,000
Social support
0,995
0,855
0,000
Table 1 shows that there is a positive and
significant effect between social support and
resilience (sig p 0.00 and regression coefficient +
0.995). The regression equation is
Y = 39.39 + 0.99 X.
(1)
Correlation coefficient r-value of 0.855 then r2 of
0.731, meaning that social support has a contribution
of 73.1% of resilience. And the remaining 26.9% is
influenced by other factors not revealed in this study.
To describe social support and resilience,
categorization is done as in tables 2 and 3.
Table 2: Social support categorization.
Categorization
Score
Total
High
X ≥ 134,53
48 (48 %)
low
X < 134,53
52 (52 %)
Total
100 (100 %)
Based on table 2 above, the results show that
social support for infertile women is lower (52%)
than high (48%).
Table 3: Resilience categorization.
Categorization
Score Range
Total
High
X ≥ 173,30
47 (47 %)
Low
X < 173,30
53(53%)
Total
100 (100 %)
Based on table 3 above, the results show that the
resilience of infertile women is lower (53%) than high
(47%).
The effect of social support and resilience is
positive, meaning that the higher the social support
felt by women who experience infertility, the higher
the resilience they have. Conversely, the lower the
social support perceived by women experiencing
infertility, the lower the resilience they have. The
results of categorization show that infertile women
are more likely to have low social support and
resilience.
The results of this study are in line with the
research of Raisa and Ediati (2016) which shows that
there is a positive relationship between social support
and resilience. The higher the social support provided
and felt by inmates contributes to the high level of
resilience ability in overcoming and serving a period
of detention in the Semarang Women's Class IIA
Penitentiary. Conversely, the lower the social support
that is felt or does not get social support will cause
prisoners difficulty in serving a period of detention so
that prisoners have low resilience. In addition,
Febrinabilah and Listiyandini (2016) add in their
research that there is a positive and significant
relationship between self-compassion (self-love) with
resilience in former adult drug addicts. The higher the
score of each dimension of self-compassion, the
higher the resilience of former drug addicts. It was
stated in his research that one of the protective factors
that have a role in strengthening former drug addicts
to become resilient include social support, especially
those from the family. This shows that those who get
affection from the surrounding environment are more
resilient compared to those who are neglected.
Based on the foregoing, it can be said that women
who experience infertility who feel high social
support, will feel comfortable, feel cared for, feel
loved, feel valued, and get help from other people or
a group. So emotionally-psychologically make
infertile women feel strong, confident, optimistic,
able to recognize their emotions, and be able to
overcome the problems at hand. So emotionally-
psychologically make infertile women feel strong,
confident, optimistic, able to recognize their
emotions, and be able to overcome the problems at
hand. Besides, with the social support they feel they
have someone to look to, they feel they have someone
they can trust, they feel they have people who
encourage them to be independent and strong, and
they feel they have a family or community that
supports them.
Taylor (2015) in his research suggested that social
support can help someone think that there is someone
who can help in dealing with stressful events. In
addition, Rohayati (in Jarmitia et al, 2016) added that
one's self-confidence can be influenced by the
environment, other external factors that also increase
individual self-confidence such as motivation and
support from others. In addition, Sarafino and Smith
(2011) add that each person's reaction to stress varies
from one person to another, and from time to time in
the same person, this variation is a modification of
psychological conditions and social factors on the
impact of individual stressors.
On the other hand, women who experience
infertility and feel low social support will feel
discomfort, feel lonely, feel alone, and feel no one
wants to listen to it. So emotionally-psychologically
make infertile women feel pessimistic (hopeless),
inferior, and dependent on others. In addition, low
social support or the absence of social support makes
it difficult for them to establish relationships, solve
problems, and get help when experiencing
difficulties.
Social Support and Resilience in Women Who Have Infertility
135

This is felt because no one motivates them and
cares about the problems they face. Cohen and Wills
(in Elliott and Gramling, 1990) in their research
revealed that individuals who get low social support,
feel more depressed and anxious when experiencing
stress. Then, Dewi (2015) added in her research that
social support has a close relationship with resilience
in mothers who have children with cancer of
retinoblastoma at the Loving Cancer Hospital in
Bandung. The higher the social support, the higher
the degree of resilience the mother has, conversely the
lower the social support the lower the degree of
resilience the mother has.
In addition, the results of this study obtained a
quadratic correlation coefficient (r2) is 0.731. That is,
social support has a contribution of 73.1% of
resilience, and the remaining 26.9% is influenced by
other factors not examined in this study. It shows that
social support has a very large contribution for
women who experience infertility to make them feel
strong when facing feelings of decline due to stigma
obtained from the environment or negative judgments
from others, as seen as women who are not normal,
useless, infertile, or the weakness of the person
because it is closely related to the nature of women
that must be able to contain and give birth.
These results are in line with Primandari's
research (2014) which revealed that subjects who
have high resilience are characterized by people
taking part in their lives so that subjects can carry out
their duties and responsibilities well and believe the
situation they are facing can be passed well. While
subjects who have low resilience are characterized by
the absence of people who can carry out their roles
properly so that subjects cannot see well that they are
important in life. This causes the subject to not be able
to carry out the task properly and is not sure of the
situation at hand.
This can also be explained based on the results of
the multiple regression calculation of the dimensions
of social support for resilience, which can be seen in
table 4.
Based on table 4, it can be seen that the dimension
of social support that has an influence on resilience (p
<0.05) is the instrumental support dimension (sig.
0.001) and companionship support dimension (sig.
0,000). While the dimensions of social support that
have no effect on resilience (p> 0.05) are the
dimensions of emotional support (sig. 0.070) and the
dimensions of informational support (sig. 0.145).
Since the emotional dimension is closely related to
resilience, the multiple regression equation is
recalculated by only eliminating the informational
support dimension, with the results shown in table 5.
Table 4: Results of Multiple Regression of dimensions
Social Support with Resilience.
Model
B
B
Sig.
(constant)
36,483
0,000
Emotional
0,459
0,222
0,070
Instrumental
2,067
0,282
0,001
Informational
0,935
0,121
0,145
Companionship
1,844
0,346
0,000
Table 5: Results of Multiple Regression of dimensions
Social Support with Resilience after Elimination of the
Informational Support dimension.
Model
B
Beta
Sig.
(constant)
37,438
0,000
Emotional S.
0,630
0,305
0,006
Instrumental S.
2,195
0,300
0,000
Companionship S.
1,829
0,343
0,000
Based on table 5 above, it appears that there is a
change in the value of sig. dimensions of social
support, so that the three dimensions of social support
have an effect on resilience (p <0.05).
According to Pearson product-moment
correlation, the highest emotional dimension
correlation level is 0.815 followed by the level of
companionship correlation 0.790 and instrumental
0.749.
The result above is in accordance with Cutrona,
Gardner, and Uchino's theory (in Sarafino and Smith,
2011) which says emotional support is a form of
support delivered through empathy, care, attention,
appreciation, and positive judgment about a person's
ideas or feelings so that he feels comfortable, feels
loved and feels cared for when dealing with various
pressing problems in life. So, women who experience
infertility and get emotional support from their family
and surrounding environment, they will have high
self-confidence, feel comfortable, feel loved, and
make infertile women can see a positive value in him.
They do not see themselves as someone who is alone
in dealing with problems that arise due to infertility
problems experienced, to feel valued and still be
loved by others. In addition, emotional support from
family and the environment also makes them feel
strong, optimistic, able to think rationally and not
blame themselves or the conditions they experience.
They will be able to overcome the problems faced and
take lessons from each incident experienced. This is
in line with research by Titisari (2017) which shows
that the higher the family social support that is given
and felt, the higher the level of resilience in kidney
failure patients undergoing hemodialysis therapy. In
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136

addition, Arjani (2015) in his research stated that
emotional support from parents had a positive
relationship with students who were working on their
thesis. The higher the emotional support of parents
felt by students, the resilience held by students will be
higher in doing a thesis.
Table 3 shows that more infertile women have low
resilience, which is as much as 53%. It is suspected
that women who experience infertility tend to have
difficulty in controlling emotions when the situation
collapses or are confronted with questions about the
existence of children, difficult to solve problems
faced without the help and motivation of others, as
well as difficulties in understanding the emotions of
themselves and others. This is in line with Mulyati's
research (2015) which revealed that women who have
not been blessed with children and cannot accept
themselves positively in the condition of not having
children tend to keep their distance from their
environment, especially when asked about the
presence of children in their marriages so as to
prevent them from feeling psychological well-being.
To describe high and low resilience, a cross-
tabulation of resilience based on age, education,
length of the marriage, pregnancy experience and
occupation is further made as in the following tables
6 to 10:
Table 6: Results of Resilience Cross Tabulation Test with
Chronological Age.
Age
Resilience
Total
High
Low
Early adults
47 (54 %)
40(46%)
87(100%)
Middle adults
6(46%)
7 (54 %)
13(100%)
Total
53 (53%)
47(47%)
100(100%)
Based on table 6 infertile women in early
adulthood have more high resilience (54%) than in
middle adults (46%). Women who experience
infertility and are in the early adulthood range have
high hopes of being able to get pregnant and give birth
because they are still in the fertile age range. And has
the opportunity for a long time to be able to do
therapy and other treatments. HIFERI (2013)
revealed that women whose age is getting older are
increasingly infertile, making it difficult to get a
pregnancy. In addition, pregnancy at the age of 35
years has a high-risk factor. More difficult and
prolonged labor and stillbirths are problems that can
be found in pregnancy and childbirth at the age of 35
years and above (Sibuea et al, 2013).
Table 7: Cross-tabulation Resilience with Latest Education.
Latest Education
Resillience
Total
High
Low
Basic (SD, SMP)
3(37%)
8(73%)
11(100%)
Secondary (SMA)
29(55%)
24(45%)
53(100%)
High (D3, S1, S2)
21(58%)
15(42%)
36(100%)
Total
53(53%)
47(47%)
100(100%)
Based on table 7 above, it can be seen that subjects
with primary education have more low resilience
(73%). While subjects with secondary and higher
education have more high resilience (55% and 58%).
Infertile women with basic education have low
cognitive skills, difficult to solve problems because
of the lack of information obtained so that they feel
pessimistic or hopeless. Holaday and Phearson (1997)
revealed that one of the things that have an important
role in individual resilience is cognitive skills. This is
in line with Lestari's (2007) research which revealed
that cognitive skills have a close relationship with
resilience because it involves the ability of
individuals to understand and convey information
appropriately.
Table 8: Cross-tabulation of Resilience with Length of
Marriage.
Length of marriage
Resilience
Total
High
Low
Early marriage
(< 10 years )
46(58%)
34(42%)
80(100%)
Middle marriage (10-
30 years)
7(35%)
1(65%)3
20(100%)
Total
53(53%)
47(47%)
100(100%)
Based on table 8 above, it can be seen that subjects
with the first 10-year marriage period have higher
high resilience (58%). Whereas subjects with a
marriage period of 10-30 years have low resilience
(65%). Infertile women who enter the middle period
in their marriage experience boredom to do therapy,
even their hopes to have children began to diminish.
In addition, married couples who enter the mid-
marriage period begin to enter middle adulthood.
Jackues (in Papalia et al, 2009) revealed that at this
time, they realized that they would not be able to
fulfill their dreams and hopes in their youth. People
with non-resilient characteristics will go through
middle age under stress, frustration, discomfort with
uncertainty and complexity, and have flat emotions
(Papalia et al, 2009).
Table 9: Cross-tabulation Resilience with Pregnancy
experience.
Pregnancy
experience
Resillience
Total
High
Low
Social Support and Resilience in Women Who Have Infertility
137

Never been
pregnant
36(52%)
3(48%)
69(100%)
Ever and
miscarriage
17(55%)
14(45%)
31(100%)
Total
53(53%)
47(47%)
100(100)
Based on table 9 above, it can be seen that subjects
with experience of pregnancy have never and never
had and miscarriages both had higher high resilience
(52.2% and 54.8%). Women who experience
infertility but have never been pregnant have high
hopes of getting pregnant at any time. While women
who experience infertility and have been pregnant but
have miscarriages, still have hope to get pregnant
again. This was stated in Hapsari and Septiani (2015)
in their research that individuals who do not have
children can accept the situation, understand their
shortcomings, and have goals and expectations.
Table 10: Cross-tabulation Resilience with the occupation.
Occupation
Resilience
Total
High
Low
Working
29(58%)
21(42%)
50(100%)
Not working
24(48%)
26(52%)
50(100%)
Total
53(53%)
47(47%)
100(100)
Based on table 10 above, it can be seen that
subjects with a working category have a higher
resilience (58%). Whereas subjects with the category
of not working had lower resilience (52%). Infertile
women who work are more financially independent,
have higher self-esteem, and have wider social
networks making it easier to get help. It was stated by
Cohen, Gottlieb, and Underwood (in Papalia et al,
2009) that people who have extensive social networks
and have social roles are many more comfortable and
happier.
4 CONCLUSIONS
Based on the results of research that has been done, it
can be concluded that there is a positive and
significant effect between social support and
resilience in women experiencing infertility (sig p
0,000 and regression coefficient + 0.995). The
regression equation is Y = 39.39 + 0.99 X. This means
that the higher the social support felt by women
experiencing infertility, the higher the resilience they
have. On the other hand, the lower the social support
felt by women experiencing infertility, the lower the
resilience they have. The correlation coefficient r
0.855 with r2 of 0.731, so social support has a
contribution of 73.1% of resilience, the remaining
26.9% is influenced by other factors not revealed in
this study. This shows that social support is needed
for women who experience infertility.
Resilience among women experiencing infertility
is dominated by the low category (53%), and also low
social support 52%
The dimensions of social support that have
influence with resilience are the dimensions of
emotions, companionship and instrumental.
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