Kashmir may rejoice over a radical decline in child marriages. But the new trend of late weddings has also brought despair.

Thousands of women are fighting infertility and reproductive disorders across Kashmir, which experts such as Dr Farhat Hameed, a top gynecologist, say is by and large related to late marriages. Over the years, the marital age for Kashmiri women has risen from 18-21 to 27-35. Girls prefer quality education and a good career before marriage.

Studies at the premier Sher-e-Kashmir Institute of Medical Science (SKIMS) indicate 15.7 per cent of women in childbearing age will never have an offspring without clinical intervention. A further 14 per cent of women are unable to conceive because of unknown medical conditions.

Thirty-seven-year-old Ruheela Mushtaq from Ganderbal took every cure for infertility. "I have stopped consulting doctors, I am exhausted," says Ruheela, married for eight years. Her younger sister too is childless.

"We are three sisters," she adds. "Only my youngest sister was able to have a child, that too after months of treatment and two miscarriages."

Conflict-related stress is the second major reason for infertility. Depression, anxiety and post-traumatic stress disorder (PTSD) are common among women. Psychiatrics say eight lakh Kashmiris suffer from PTSD, mainly women.

Polycystic Ovarian Syndrome (PCOS) has surfaced as a new cause of infertility. The disease, unknown in Kashmir, now affects 10 per cent of females, including teenagers.

PCOS is a major endocrine disorder in women of reproductive age. It is one of the leading causes of infertility across the world. Doctors identify stress as one of the main reasons for PCOS prevalence in Kashmir.

A SKIMS study of 112 young and adolescent PCOS women found that 65-70 per cent had psychiatric illnesses, eight patients suffered from obsessive compulsive disorder (OCD), five had PTSD, and 27 were depressed.

In vitro fertilization (IVF) clinics have raised some hopes for childless women. Kashmir had none before 2003. But IVF procedures are expensive, costing between Rs 2-3 lakhs, and unaffordable for the most part.

"My husband is a school teacher and does not earn much," says Ruheela. "We cannot afford IVF or similar treatments. I am reconciled to not having a child." Dr Farhat who has an IVF clinic admits to the high costs but says "we do provide some concession to poor patients".

Infertility has harsh social ramifications. Childless women are stigmatized. Married women face the wrath of in-laws and husbands and unwedded girls fear marriage.

Such fear forces Naseema Begum to take her 23-year-old daughter, Ambreen, to another district for infertility treatment to avoid being "caught". "I don’t want people to know Ambreen suffers from PCOS," says her mother. "Such things are not socially acceptable."

Thirty-five-year-old Masooda Begum who is childless after four married years is regularly abused. "My husband and in-laws taunt me every day for not bearing children," she says. "It is a dual torture for me." The misbehaviour of in-laws hurts her more than childlessness.

"I am receiving treatment but the rest is in the hands of God," adds Masooda. "Why should women be blamed for it?" Many women get divorced for not being able to bear children, a trend common in rural areas.