On the final day of Black History Month in the US, we’re reflecting on Black women’s fertility and the disparity in who seeks – and gets – treatment
According to her article in Glamour, medical student Adeiyewunmi Osinubi notes the “glaring racial gap” in who attended her hospital’s fertility clinic.
She found that most of the patients she encountered when doing a medical school elective in reproductive endocrinology and infertility were white, middle class, and had private insurance. This is despite the fact she lives in a diverse area with over 76 different languages spoken. However, despite the ethnic diversity of the area, she saw very few Black patients.
Osinubi’s experience was common. Across the United States, 15% of white women seek medical care for fertility, compared with only 8% of Black women. This is even though Black women actually need these services more than other groups.
According to the Association of Obstetricians and Gynecologists (ACOG), there is a widening fertility gap at play. Up to 12% of Black women will experience infertility health concerns compared with 7% of white women. In addition, Black women experience more fatalities and health problems during pregnancy.
Osinubi points out that, “when it comes to actually getting pregnant, Black women are not safe from disparities in outcomes or care there either.”
Of course, there are complex social and political factors underpinning the issue
According to Shaylene Costa, a Black woman and doula, “A lot of people talk about IVF and going to specialists, but that was not on the table for us because we had no insurance.”
She had to struggle through a five-year journey with infertility before she had her first of two children
“We were paying out of pocket for all of the treatments and blood tests,” Costa says, “which meant that we ate ramen noodles instead of good food.”
Osinubi explains that accessing fertility care can be difficult for Black women even when they have insurance. Lynae Brayboy, M.D., FACOG, is an African American ob-gyn. She says, “there is a higher proportion of women of color who use federal insurance coverage, or Medicaid. Medicaid has absolutely no coverage for infertility.”
In addition to medical costs, there are also deeply ingrained cultural factors surrounding infertility. Dr Ijeoma Kola, Ph.D., a Nigerian American with a doctoral degree in the public health history, explained that she felt silenced when trying to speak to others about her fertility issues.
She says, “Black women are presented as hypersexual—we get pregnant like this; we’re welfare queens. There’s this perception of an African woman having 10 kids and being hyperfertile. That can be difficult to push back against if you are struggling to get pregnant.” She thinks that doctors need to pay more attention to Black women’s fertility, helping them to get pregnant rather than preventing pregnancy.
So, what can we do? To close the fertility gap, Osinubi suggests “public service campaigns, pushing back against harmful stereotypes, and continued lobbying for increased access to fertility services for patients of all backgrounds.”
More IVF grants, more education, and more representation – all of these are crucial
She says, “by creating space for diverse perspectives and experiences in mainstream media, I hope that we can reduce the number of Black women who suffer with infertility in silence.”
We are in awe of Adeiyewunmi Osinubi and her advocacy work on behalf of other Black women.