Black women at higher risk of infertility?

By Jasminee Sahoye

African-American women may be more likely to experience infertility than white women, a study finds.
African-American women may be more likely to experience infertility than white women, a study finds.

A University of Michigan (U-M) study has found that African-American women are equally, if not more, likely to experience infertility than their white counterparts.

It also revealed that these women often cope with this traumatic issue in silence and isolation and more often feel that infertility hinders their sense of self and gender identity.

This study is believed to be among the first known to focus exclusively on African-American women and infertility. Most research has been conducted on affluent white couples seeking advanced medical interventions.

“Infertile African-American women are indeed hidden from public view,” said the lead study author Rosario Ceballo, a U-M professor of psychology and women’s studies.

Ceballo and colleagues Erin Graham and Jamie Hart interviewed 50 African-American women of different socioeconomic backgrounds about infertility and relationships with friends, relatives and doctors. Their ages ranged from 21 to 52 and most were married. Many of the women had college degrees and worked full-time.

The respondents at some points in their lives met the medical definition for infertility, a condition in which a woman is unable to conceive after 12 or more months of regular, unprotected sex. The women spent from one to 19 years trying to become pregnant.

Thirty-two percent of the women talked about stereotyped beliefs that equated being a woman with motherhood, as a result of difficulties of getting pregnant. Some responses included: “Emotionally, I felt that I was not complete, because I had not had a child. I didn’t feel like I was a complete woman,” and “It (having no biological children) would label you as a failure.”

Furthermore, infertility was infused with religious significance for some women. They believed God intended women to produce children, which further heightened their sense of shame.

The study states that all of the women dealt with infertility in silence and isolation, even when a friend or relative knew about the woman’s difficulty conceiving. Respondents thought infertility was not as emotionally painful for their husbands and partners.

Researchers indicated that some women, especially those with secondary infertility, stayed silent about being unable to conceive because discussing it did not elicit sympathy or empathy.

“Women may also reason that other people can neither change their infertility status nor understand what they were experiencing,” Ceballo said.

Other reasons for women’s silence about infertility may have to do with cultural expectations about strong, self-reliant Black women who can cope with adversity on their own and with notions about maintaining privacy in African-American communities, she said.

Respondents said, “You don’t want people in your business” and “I never said anything to anyone else because in our culture … it was not something that you shared.”

With their interactions with doctors and medical professionals, about 26% believed that encounters may have been influenced by gender, race and / or class discrimination. These women talked about doctors who made assumptions about their sexual promiscuity and inability to pay for services or support a child.

Researchers said they were surprised to learn that highly educated women with high incomes were equally likely as low-income African-American women to report discrimination in medical settings. In addition, the cost of fertility treatments was prohibitively high for most respondents.

Overall, when Black women could not conceive a child, it negatively affected their self-esteem. They saw themselves as abnormal, in part, because they did not see other people like themselves – African-American, female and infertile – in social images, Ceballo said.

Another study in 2010 showed that almost 50 million couples worldwide were unable to have a child after five years of trying. Infertility rates have hardly changed over the past 20 years, according to a study by international researchers.

The authors found that primary infertility rates among women wanting to have children varied by region, ranging from 1.5% in Latin America and the Caribbean in 2010, to 2.6% in North Africa and the Middle East.