Black Women and Infertility: Less Assumptions, More Support

Infertility impacts at least 12% (1 in 8) reproductive age women in the United States (1), and black women are twice as likely to have infertility compared to white women (2). Despite this discrepancy, black women are almost 50% less likely to seek the fertility treatment that may help them (1). 

Why Would Black Women Not Seek Infertility Care?

Many factors seem to influence this trend, including both societal and individual assumptions. In 2018, Womenshealthmag.com, OprahMag.com, Black Women’s Health Imperative, and Celmatix teamed up to survey women and delve into the disparity between the numbers of black women suffering from infertility and seeking evaluation and treatment. The survey of over 1,000 women found cost was an obstacle to care but also that black women were twice as likely to express not feeling comfortable talking about infertility with their health providers (3). The survey highlighted a mistrust of the medical system and racial profiling experiences in the medical space that left black women feeling unsupported and nervous about being shamed for seeking infertility care. Unfortunately, this fear can be a reality according to a survey of 50 black women seeking fertility care by Dr. Rebecca Cabello, who found that 25% of black women in her study felt mistreated (4). The mistreatment examples varied, but many black women felt dismissed by medical providers when seeking care for infertility. This dismissal may in part be due to society’s assumption that black women do not suffer from infertility despite statistics that show this is not true. Increasing awareness of infertility and treatment for black women includes shattering stigma and assumptions that lead to barriers to care. 

Is the movement for increasing awareness of infertility leaving black women behind?

Infertility has long been surrounded by shame and guilt. In recent years, more women are opening up about infertility in social media and in pop culture, but this is true for some groups of women more than others. Women can watch characters in TV shows like ‘Friends’ and movies like Netflix’s ‘Private Life’ explore fertility issues, find support groups on social media, or participate in fertility walks during National Infertility Awareness Week in April or infertility Advocacy Day in May. This awareness is shattering stigma, but it has predominantly featured white women. Fortunately, this seems to be changing. 

Celebrities can be a reflection of society as a whole. The number of famous women sharing their infertility struggles has broken down some barriers and allowed an open conversation about infertility. Amy Schumer shared her IVF cycle on social media, Giuliana Rancic filmed her infertility journey and treatments for her reality TV show, and Nicole Kidman discussed her family building options, including adoption, infertility, and surrogacy. As more black celebrities share their infertility struggles, more black women may start to feel less isolated in their own journey. Michelle Obama conceived her daughters after miscarriage and infertility with in vitro fertilization (IVF), Beyoncé has openly discussed her multiple miscarriages, and Gabrielle Union tried treatments for years and suffered several miscarriages before having a child with a surrogate. Black celebrities sharing their infertility stories helps get this issue out of the shadows for black women. 

Connecting with a celebrity with a similar struggle is one step towards shattering stigma while seeing characters in film and TV is another. In TV’s ‘Being Mary Jane,’ Gabrielle Union’s character is a broadcast journalist who at 38 decides to freeze her eggs. When treatments don’t go as planned, we watch Mary Jane ask her doctor questions that many women do every day, like “What went wrong” and “What did I do wrong?” In one scene from the 2017 comedy ‘Girls Trip’ staring Regina Hall, Queen Latifah, Jada Pinkett Smith, and Tiffany Haddish, the women discuss the difficulty of infertility on a marriage. In the 2019 ‘Black Girls Guide to Fertility,’ a TV series created by Sonhara Eastman, Ava, a 37-year-old romance novelist, struggles to come to terms with her own infertility while balancing a book promotion and her own new romance. 

Documentaries of black women discussing infertility are powerful. In her documentary series ‘Should I Freeze My Eggs?’ for the Washington Post, Nicole Ellis explores the possibility of egg freezing and discusses fertility, fibroids, and assumptions with her family for the first time. ‘Eggs Over Easy,’ by Chiquita Lockley, is a documentary telling the stories of black women from around the United States about their fertility journeys. Chiquita turned 40 and knew what vacations she had planned and her next steps in her career, but she did not know the answer to the question from her OBGYN, ‘What are your family planning goals?’ She started talking to friends and family about fertility, fibroids, egg freezing, and more and found that they were all whispering. Chiquita found a need to get these conversations out of the shadows and at the forefront of women’s thoughts. Knowledge is power, and Chiquita wants black women to be a part of the conversation. The film is planned for release in summer 2020.

Dr. Tiffanny Jones, reproductive endocrinologist at Dallas IVF, believes another important step towards helping black women get fertility help is having more black reproductive endocrinologists like her. In reference to this blog post, Dr. Jones states, “As infertility becomes less of a taboo for the mainstream there are still underlying systemic issues such as socioeconomic constructs that will have to be addressed to assure health equity for black and brown women.” 

Dr. Temeka Zore, reproductive endocrinologist at Spring Fertility, agrees with Dr. Jones that representation and diversity in doctors and healthcare providers is essential. “Less that 5% of all American physicians are black and representation in my own field is even less. More black fertility care providers would help a much needed increase in diversity in medicine in general. With increased diversity there is increased representation of unique backgrounds, experiences, and care that elevates healthcare for all.”

The long-standing norm to keep infertility in the shadows has allowed it to become wrapped in guilt and shame for all women, but for some groups of women more than others. The assumption that black women do not have infertility is not only untrue, it acts as a barrier to care. As more black celebrities discuss their struggles and as more black characters in film and TV are shown dealing with miscarriage and fertility issues, more black women with infertility and miscarriage may start to feel less isolated. With awareness and open discussion, the hope is that all women can find the care and support they want and need.

Learn more about infertility and miscarriage with more blog posts at drlorashahine.com.

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