#blacklivesmatter – prejudice in fertility, IVF & maternity care

At TRB, we’ve been listening closely to our community and to Black voices, and we recognise the racial disparities that exist within health and fertility, and racism in maternity care more broadly. These aren’t always spoken about openly, and they have dire impact.

As part of our commitment to allyship and learning, we’re opening up more space for these conversations and amplifying the voices of those with lived experience. To begin, we spoke with blogger @kstew222 to learn more about the differences and challenges that exist.

The Black Lives Matter Movement isn’t asking for change. We are creating and demanding it.

“Even the term “minority” can take a long, segregated trip to the trash can. I’ve never been half of a whole human being or less than majorly deserving of every human right under the sun, including access to the best available healthcare. There is an inherent mistrust of the healthcare system for Black people in the United States, particularly Black women, that dates back to slavery,” Kellee writes, bringing harrowing truth supporting the evidence up before us.

The stats

Women are less likely to have their pain taken seriously, are less likely to be tested and treated for chronic pain and seven times more likely to be sent home in the middle of a heart attack. Women are less likely than men to be prescribed pain medication. Black women receive lower quality care and have higher mortality rates than any other patient according to American studies on medical treatment.

In addition, some Black women are known to simply ‘suffer’ through painful menstrual cycles because they are deemed ‘normal,’ instead of being examined for complications such as fibroids, which again, Black women are 2 to 3 times more likely to have.

This trend is consistent with the world of fertility. Women of color have unequal access to fertility help and assisted reproductive technologies in the first place. Those that gain access also tend to seek fertility help and advice later on in life than White women, according to findings presented at the Health Disparities in Infertility Conference in Maryland.

As if these findings aren’t disturbing enough, Kellee explains: “It has been recorded that J. Marion Sims, an American physician, also referred to as ‘The Father of Gynaecology’, perfected his surgical techniques by performing them on Black enslaved women without the use of anaesthesia. There’s also the more commonly known historical reference to Henrietta Lacks, a Black woman dying of cervical cancer in 1951, whose cells were harvested for research without her knowledge or permission. This is the history of health, but certainly not care, for Black women in the United States”.

Fertility treatment

So why is there a discrepancy between White women and women of color and the care they’re given throughout the healthcare system? Is this due to reduced household income? Or society as a whole?

InStyle magazine reported that the difference was far deeper. “There are few spaces for marginalised individuals to discuss their fertility experiences, and this could be impacting their success getting pregnant,” A. Rochaun Meadows-Fernandez writes, “Historical narratives and income gaps leave Black women particularly marginalised in the reproductive choice conversation. As a result, Black women are forced to deal with infertility in isolation.

Though 400 years have passed, Black women are still experiencing a great divide from White women in healthcare practices such as fertility.

“Black women are three to four times more likely to die from pregnancy-related complications than their White counterparts. This ratio holds true for Black women that struggle from a severe disability as a result of childbirth. It is a myth that Black women are highly fertile, an idea also beginning in captivity, as women who bore more children for slave labor were worth more in trade.

However, this myth is a false narrative that is often passed down through generations of Black families, and therefore results in fewer Black women seeking adequate fertility testing, followed by fertility treatments as a means to conceive,” Kellee explains.

Miscarriage

There are higher spontaneous rates of miscarriage amongst Black women than White women of the same age range, higher by 43%. Black women are also significantly less likely to have a live birth following IVF, compared with White women.

So why is that? Meadows-Fernandez suggests that this is due to both media portrayals and cultural myths of expectation that Black women and men are hyper-fertile. The longer this myth is perpetuated, the less likely Black women are to reach out to their friends and colleagues and seek medical intervention.

And when they do, they may receive poorer care.

“Continuous exposure to racism dramatically impacts how Black women experience the world and contributes to a wide range of racial health disparities,” says Meadows-Fernandez.

This can impact not only experience and emotion, but medical condition. “In a study conducted in the DC area, “Black women had a lower pregnancy rate and were more likely to suffer from a pregnancy loss”, says Kate Devine, M.D.

What next?

So, how do we change this? How do we ensure Black women are getting the best possible care out there? How do we seek equality in the medical system? How do we bring #blacklivesmatter into every aspect of our reality? Team TRB has started by looking into their own accountability mirror and reaching out to women of color, to combine resources, continue this conversation and bring awareness to the table.

Kellee has this to say,

“So, here we are, at a time in history when the world has our ear. And, though all may not be listening, we must take this opportunity to move the needle forward for the health and wellbeing of all Black women.

Socio-economic status, internal racial bias amongst professionals, and structural inequality have infiltrated the care of Black women forever. The solutions must start from within the system, one that was never broken, but was always designed to keep Black women under-valued, underpaid, and under-insured.

Eradicating racism is not just about eliminating a thought process of prejudice, but rather dismantling the policies that fortify the unlawful denial of civil and human rights for people of colour. Insufficient healthcare is amongst the countless examples of how systematic racism has negatively and fatally affected Black women at large.

We have always fought against this, but now there’s a global impact joining in on a collective resistance.

Being a Black woman is the greatest gift that God ever gave me. I intend to use every single ounce of my magic to speak truth to justice, manifest change, and encourage everyone to vote as if their life depends on it. Because it does.”

Kellee Stewart