Barriers to accessing assisted reproduction for diverse and minority groups in Aotearoa New Zealand: Findings from a qualitative study



Aotearoa New Zealand, assisted reproductive technologies, fertility barriers, qualitative research, structural infertility


INTRODUCTION: There is now an extensive body of international research on fertility help-seeking. While this body of work has historically centred the experiences of dominant ethnicities and heterosexual and cisgender couples and families, our study attends to the experiences of individuals and couples from diverse and minority groups in Aotearoa New Zealand, for which, to date, there is little research. In the article, we report delays and disparities accessing assisted reproduction for these groups to advocate for fertility care based on reproductive justice.

METHODS: The article draws on semi-structured interviews and talanoa from a qualitative study conducted during 2020 and 2021 with 39 Māori, Pākehā, and Pacific people residing in Aotearoa New Zealand who have experienced fertility issues for social or medical reasons and have sought reproductive assistance, using a range of procedures and treatments, to create families.

FINDINGS: To better understand the reproductive journeys of people from these groups we report the challenges identified by study participants in the process of decision-making around accessing assisted reproduction and fertility treatment help-seeking. Importantly, we document a range of situational and structural fertility barriers that point to stratified reproduction relating to affordability, delays and long wait times for resources and services, discrimination, and non-inclusive care.

CONCLUSION: To address these issues, we recommend improvement to fertility treatment services and delivery that is culturally accessible, responsive, and equitable. This entails attending to the structural constraints that prevent people from accessing and obtaining the resources needed to realise their family building goals.


Blyth, E. (1999). The social work role in assisted conception. British Journal of Social Work, 29(5), 727–740.

Boddington, B., & Didham, R. (2009). Increases in childlessness in New Zealand. Journal of Population Research, 26(2), 131–151.

Bourke, B. (2014). Positionality: Reflecting on the researcher process. The Qualitative Report, 19(33), 1–9.

Braun, V., & Clarke, V. (2013). Successful qualitative research: A practical guide for beginners. Sage.

Briggs, L. (2018). How all politics became reproductive politics: From welfare reform to foreclosure to Trump. University of California Press.

Colen, S. (1995). “Like a mother to them”: Stratified reproduction and West Indian childcare workers and employers in New York. In F. Ginsburg & R. Rapp (Eds.), Conceiving the new world order: The global politics of reproduction (pp. 78–102). University of California Press.

Connolly, M. P., Hoorens, S., & Chambers, G.M. (2010). The costs and consequences of assisted reproductive technology: An economic perspective. Human Reproduction Update, 16(6), 603–613.

Culley, L., & Hudson, N. (2009). Commonalities, differences and possibilities: Culture and infertility in British South Asian communities. In L. Culley, N. Hudson, & F. van Rooij (Eds.), Marginalized reproduction: Ethnicity, infertility and reproductive technologies (pp. 97–116). Earthscan.

Daniels, K. R., & Douglass, A. (2008). Access to genetic information by donor offspring and donors: Medicine, policy and law in New Zealand. Medicine and Law, 27(1), 131–146.

Fertility Associates .(2023a). Infertility explained. https:// infertility-explained/ accessed January 18, 2023.

Fertility Associates. (2023b). Public funding referral and criteria. public-funding-referral-for-gps/ Accessed January 18, 2023.

Fertility Associates. (2023b). Donor sperm wait time. donor-sperm-wait-time/ Accessed January 21, 2023.

Foaese, A. (2017). Pasifika women’s experiences of infertility in Canterbury and Wellington. [Unpublished master’s thesis]. University of Otago.

Galpern, E. (2007). Assisted reproductive technologies: Overview and perspective using a reproductive justice framework. default/files/ART.pdf

Gillett, W.R. (2017). Infertility. In C. Farquhar & H. Roberts (Eds.), Introduction to obstetrics and gynaecology (pp. 181–189). Nurture Foundation.

Glover, M., McCree, A., & Dyall, L. (2007). Māori attitudes to assisted human reproduction: An exploratory study. Summary report. School of Population Health, University of Auckland.

Glover, M., McKree, A., & Dyall, L. (2009). Assisted reproduction: Issues for takatāpui (New Zealand indigenous non-heterosexuals). Journal of GLBT Family Studies, 5(4), 295–311.

Hudson, M., Milne, M., Reynolds, P., Russell, K., & Smith, B. (2010). Te Ara Tika: Guidelines for Māori Research Ethics: A Framework for Researchers and Ethics Committee Members (Auckland: Health Research Council of New Zealand.

Inhorn, M. C. (2020). Reprint: Where has the quest for conception taken us? Lessons from anthropology and sociology. Reproductive BioMedicine & Society Online, 11, 11–121.

Johnson, K. M., McQuillan, J., Greil, A. L., & Shreffler, K. M. (2014). Towards a more inclusive framework for understanding fertility barriers. In M. Nash (Ed.), Reframing reproduction: Conceiving gendered experiences (pp. 23–38). Palgrave Macmillan.

Ker, A., Shaw, R. M., Byrne, J., & Veale, J. (2022). Access to fertility preservation for trans and non-binary people in Aotearoa New Zealand. Culture, Health & Sexuality, 24(9), 1273–1288.

MacManus, J. (2017). Meet the couple who tried to get sperm on Reddit. The Spinoff. parenting/17-10-2017/meet-the-couple-who-tried-to-get-sperm-on-reddit

Melville, L. (2016). Lesbians making babies: Why research on sperm, space and decisions matters. Te Kura Kete Aronui, 7. file/0008/317429/Lisa-Melville-Lesbians-Making-Babies. pdf (Accessed May 22, 2023).

Mourad, S. M., Curtis, C., Gudex, G., Merrilees, M., Peek, J., & Sadler, L. (2019). Measuring patient-centredness in publicly funded fertility care: A New Zealand validation and international comparison of the patient-centred questionnaire-infertility. Australian and New Zealand Journal of Obstetrics and Gynaecology, 59, 265–271.

Nordqvist, P., & Gilman, L. (2022). Donors: Curious connections in donor conception. Emerald Publishing.

Parker, G., & Le Grice, J. (2022). Sized out: Fatness, fertility care, and reproductive justice in Aotearoa New Zealand. In R. M. Shaw (Ed.), Reproductive citizenship: Techologies, rights and relationships (pp. 153–178). Palgrave Macmillan.

Peterson, M. M. (2005). Assisted reproductive technologies and equity of access issues. Journal of Medical Ethics, 31, 280–285.

Repromed (2023). Your top IVF questions answered. https:// Accessed May 26, 2023.

Reynolds, P., & Smith, C. (2012). The gift of children: Māori and infertility. Huia Publishers.

Shaw, R. M. (2020). The silence around miscarriage. Newsroom. silence-around-miscarriage/. Accessed June 5, 2023

Shaw, R. M. (2022). Reproductive citizenship and meanings of infertility. In R. M. Shaw (Ed.), Reproductive citizenship: Technologies, rights and relationships (pp. 1–15). Palgrave Macmillan.

Shaw, R. M., & Fehoko, E. (2023). Epistemic injustice and body mass index: Examining Māori and Pacific women’s access to fertility treatment in Aotearoa New Zealand, Fat Studies, 12(2), 338–352.

Surtees, N. (2022). Constructing gay fatherhood in known donor-lesbian reproduction: ‘We get to live that life, we get to be parents’. In R. M. Shaw (Ed.), Reproductive citizenship: Techologies, rights and relationships (pp. 253–278). Palgrave Macmillan.

Tam, M. W. (2021). Queering reproductive access: Reproductive justice in assisted reproductive technologies. Reproductive Health, 18(164), 1–6.

Te Whatu Ora. (2023). Public Funding. https://www. public-funding/. Accessed May 26, 2023.

Vaioleti, T. (2006). Talanoa research methodology: A developing position on Pacific research. Waikato Journal of Education, 12, 21–34.

World Health Organization (WHO). (n.d). Infertility.




How to Cite

Shaw, R., & Fehoko, E. (2023). Barriers to accessing assisted reproduction for diverse and minority groups in Aotearoa New Zealand: Findings from a qualitative study. Aotearoa New Zealand Social Work, 35(4), 102–111. Retrieved from