Infertility challenges can arise for anyone, but recent research has suggested a disparity between Black and White birthing women when it comes to access to information, testing, and care. The National Institute of Health (NIH) defines infertility as the inability to get pregnant before the age of 35, after at least one year of actively trying to conceive. Infertility is often silent, but sometimes, your body does provide signs behind why you may have trouble conceiving.
Women put off starting a family for a variety of reasons, including educational and career opportunities, delayed marriage, and increased access to contraception. The rates of women experiencing infertility and/or utilizing reproductive technology to become pregnant will continue to rise as women and couples wait to have children and start a family.
What causes infertility?
There are many factors that affect fertility, including difficulties surrounding ovulation, which can prevent eggs from being fertilized. Many different medical conditions and other factors can contribute to fertility problems, and an individual case may have a single cause, several causes, or no identifiable cause.
Hormonal imbalance, polycystic ovary syndrome (PCOS), or primary ovarian insufficiency (POI) could be root causes if a patient is not ovulating and struggling to conceive. Other common causes of infertility are blocked fallopian tubes due to pelvic inflammatory disease (PID), endometriosis, ectopic pregnancy, and/or uterine fibroids. Of course, fertility declines with age in all birthing women, while the risks of pregnancy complications arise over time.
Primary ovarian insufficiency (POI) is another cause of ovulation problems. POI occurs when a woman’s ovaries stop working normally before she is 40. POI is not the same as early menopause
Infertility causes unique psychological stresses and anxieties, as well as affecting relationships.
How are Black women affected differently?
There are many factors that contribute to these disparities, including health conditions that disproportionately impact Black women. Black women of fertile age are also more likely to have chronic comorbidities—such as diabetes, or obesity—which are linked to lack of access to healthcare, and other social determinants of health, including education level and socioeconomic status. Factors like hormonal imbalances or irregular ovulation tend to affect Black women more.
One common cause of infertility is fibroids, and although they can be completely harmless, they can have an effect on fertility and cause complications when giving birth. Black women are three times as likely to have fibroids than White women. Age is a significant factor for anyone with ovaries—as we age, fertility declines at a faster rate. Black women often seek fertility treatment later than women of other races.
Image: the IVF (in vitro fertilization) process. Source: Freepik.
What about IVF and other fertility treatments?
Low fertility can sometimes be treated by assisted reproductive technologies like in vitro fertilization (IVF). The use of such treatments has increased significantly in recent decades, particularly in states which have mandated their inclusion as part of healthcare coverage. The statistics on the racial disparities of women seeking IVF treatment are stark.
According to CDC data, White women between the ages of 25 and 44 were almost twice as likely (15%) as Black women (8%) or Hispanic women (7.6%) to have used fertility services to get pregnant. Black women experience longer periods of infertility by the time they see their doctor (4 years) when compared with White women (3 years).
Research shows that it’s common for Black women to start fertility treatment after experiencing infertility for multiple years, whereas their
White counterparts usually seek care sooner. Black women are often in their late 30s or early 40s when they start, older on average than White women. Michelle Obama started IVF when she was 37, and Tyra Banks, Kandi Burruss, Angela Bassett and Gabrielle Union started treatments when they were in their 40s.
The delay in fertility treatment may cause higher rates of death in Black newborns conceived with fertility treatment versus White newborns. An October 2022 study in the journal Pediatrics found the neonatal mortality rate in Black moms using fertility treatments was four times higher than in White moms.
Infertility can be an isolating experience so it’s especially important to find a community of women with whom you can share. Numerous support groups and organizations, like Oshun Fertility Services, Black Women and Infertility, Black Mamas Matter Alliance, Fertility for Colored Girls, Broken Brown Egg, and the Cade Foundation, can help families access infertility treatments by providing grants and other valuable information.
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Boitumelo Masihleho is a South African digital content creator. She graduated with a Bachelor of Arts from Rhodes University in Journalism and Media Studies and Politics and International Studies.
She’s an experienced multimedia journalist who is committed to writing balanced, informative and interesting stories on a number of topics. Boitumelo has her own YouTube channel where she shares her love for affordable beauty and lifestyle content.
