Let's be clear, the medical profession is in no way exempt from the issues of systemic racism that plague American society. A quick Google search on the topic of medical racism can reveal the many ways in which Black individuals in America suffer in the process of pursuing medical attention.
At Binto, we believe in supporting the health and wellbeing of all women. In the name of doing the work to bring these issues into the light and work towards a better future, it’s important to take a closer look at the ways in which race affects a woman’s experience of healthcare. Today, we’re looking specifically at fertility.
First, let’s get some things straight.
Infertility as a medical condition does not discriminate based on race, socioeconomic status, or any other factor. It affects women of all backgrounds. Remember, about 1 in 10 women in America have a hard time getting or staying pregnant.
That being said, racial and ethnic disparities reveal themselves in every field of medicine. It is critical to acknowledge the varying factors that contribute to differing experiences of infertility for women of different races.
So How Does Being Black Influence Fertility?
Of all racial groups, Black women are the most likely to face infertility. In studies, this holds true even when researchers adjust for common risk factors like smoking, obesity, or uterine fibroids.
One study reported that 48% of the Black women participating had experienced infertility, compared to 31% of the white women. Another study found the odds of infertility were twice as high for Black women compared to white women, again after adjusting for socioeconomic status, marital status, and other risk factors.
Why Is This The Case?
Research has not revealed a particular factor that directly causes these results. As with many other domains of American life, race interacts with fertility in confounding and complicated ways.
Many of the factors that contribute to infertility are compounded for Black women, such as:
According to the APA, racial and ethnic minorities have worse overall health than white Americans. These disparities are rooted in factors like access to care, neighborhood, socioeconomic status, and education. It goes without saying that a mother’s overall health is a key component of a healthy pregnancy and to the success of an infertility treatment.
In the US, the obesity epidemic is on the rise. In fact, the percentage of people who are overweight has almost doubled in the last 20 years. The link between obesity and infertility is well documented. Obesity can lead to problems with ovulation, lower conception rates and higher miscarriage rates. A woman’s weight can also influence her outcomes when undergoing fertility treatments.
The rate of obesity among Black women remains the highest for all racial or ethnic groups in America. Researchers believe this is because they are exposed to a larger number of social determinants that influence their weight.
One study examined obesity in the context of the identity of Black women, finding that it is the environment Black women live in and the internalization of negative stereotypes that produces these negative effects on physical health. They are more likely to have low levels of self-esteem and high stress levels, both of which are linked to higher rates of obesity.
Long story short, obesity can be a contributing factor to infertility, and Black women are more likely to be overweight or obese. But, even in studies where researchers control for levels of obesity, Black women are still more likely to have experienced infertility than their white counterparts, meaning that this cannot be the only factor.
Black women are more likely to have uterine fibroids. Even in equal access-to-care settings, Black women had more fibroids than any other racial group. In addition, fibroids are more likely to develop earlier in a Black woman’s life, to be larger in size, and to have more severe symptoms.
Fibroids can interfere with fertility by physically blocking sperm from reaching your eggs. Depending on their location, they can sometimes distort your uterus and even interfere with fertility treatment results. For more information on fibroids and how they can be treated, click here.
Let’s be quite frank. IVF, or other assisted reproductive technologies and fertility treatments can be incredibly expensive and the distribution of wealth in America is highly racialized. In 2017, the median household income for Black Americans was half of that for white Americans. In 2016, the net worth of a white family ($171,000) was nearly ten times that of a Black family ($17,150). Research connects higher socioeconomic status with greater use of fertility treatments for all racial groups. Why? Because fertility treatment is expensive and to use it you must be able to afford it.
But, this does not explain the whole story either. Studies have linked socioeconomic status with increased or decreased infertility in black women, but not white women. What does this mean? Wealthier Black women struggle less with infertility than poorer Black women do, but this trend does not hold true for white women. This implies differences in other risk factors like access to quality gynecological healthcare, neighborhood or physical environment, and education.
Usage of Fertility Treatments
Black and white women are the largest racial groups receiving infertility treatment in the United States. That being said, studies have revealed a lower use of fertility treatments among Black women.
Why is this? First, Black women tend to wait much longer before pursuing fertility treatment. Black women and Hispanic women report high “infertility stigma” scores, indicating a social component that contributes to the underuse of fertility treatments. Infertility stigma refers to feelings of shame or embarrassment surrounding an infertility diagnosis or the idea of pursuing treatment.
Access to care is still an issue for minority women experiencing infertility, but increasing access isn't the solution to the problem. Factors like cost and social stigma surrounding treatment prevent many Black women and other women of color from using technologies like IVF.
How Do We Move Forward?
At Binto, we are lucky to be a part of an incredibly diverse community. We stand by, with, and for our Black, Indigenous, and community members of color. In doing so, we believe it is important to recognize that the experience of Black women with infertility is uniquely influenced by a number of systemic factors that are outside of their control.
As part of our mission to make quality women's healthcare accessible to all, we work to be a resource to women and answer questions about what can be difficult experiences. If you are a Black woman struggling with infertility, we are here to help.
Talking about struggles with infertility can be uncomfortable, but it can be healing to find a space to connect with women who are sharing similar experiences. Here is a list of infertility support groups specifically for Black women:
And, Binto has your back! We are here to answer any questions you may have, and to walk with you on your fertility journey.
For more resources, you can check out our Knowledge Center, or schedule a consultation with one of our fertility specialists here. To learn more about how Binto supplements can help your fertility, click here.
If you have any more questions, you can reach out to our team of medical professionals any time using our chat feature!