Black History Month: The Infertility Issue
While discussions of infertility are slowly coming out of the shadows; research heavily centered around Caucasian patients, a lack of representation in media, as well as lingering stigma and discrimination, has meant that many people within the Black community struggle with infertility in silence and alone.
Mega star couples like Beyoncé & Jay-Z, as well as Gabrielle Union & Dwayne Wade are starting to shed light on infertility within the African-American population, by sharing their struggles with conception, surrogacy and stories of miscarriage. There is still, however, a long journey until equal attention and support is reached.
Although most causes of infertility are not exclusive to the African-American/Canadian population, here are some more common causes of infertility for those with African heritage. (Note: sadly, most of the research I can find is American and thus, not all of the economic and social factors will directly translate to Canadians)
1. Fibroids: Black women are up to 3 times more likely to have fibroids than White women. Not only was it noted that Black women were more likely to have larger and more numerous fibroids, their symptoms (like pain and heavy periods) were also likely to be greater.
2. PCOS: While Polycystic Ovarian Syndrome (PCOS) affects all ethnicities, some symptoms are more notable and unique to how they affect women of African heritage.
3. Tubal issues: Some STIs related to fallopian tube damage are more prevalent in African-American women.
4. Male factor: A higher level of stigma and lack of communication around the issue can make seeking diagnosis and treatment for male factor a major hurdle in infertile couples.
Other barriers include:
1. Fertility awareness (which was found to be lower in the African-American community)
2. Representation (most news pieces, research and discussion often centre around Caucasian heterosexual couples)
3. Communication (lingering stigma has meant that open conversations don’t happen as readily)
4. Physician bias and discrimination (still rarely discussed or confronted)
Where do we start?
This is a little bit of a loaded question. I think we each have a role to play here.
1. Families and friends can break the stigma by sharing the journeys of their paths to parenthood, whether it was discovering a diagnosis, seeking treatment, IVF, surrogacy or adoption.
2. Doctors and practitioners, like myself, need to focus more on communicating what to look out for, specifically for different ethnicities, and differentiate what people can do to feel healthier, happier and more fertile. We also need to recognize ethnic biases in research and disease symptomology, so that we can properly educate our patients on how the disease may affect them personally. We need to call out any overt discrimination we see from our colleagues, and look closer at any unintentional discrimination we may be guilty of. While it is easy to claim that there is no overt racism at your workplace, I have personally noticed many little changes that I could make (and I’m sure there are many more changes I can still make moving forward)
- For instance, the Low Level Laser Therapy we use at Acubalance (for pain, improving
egg/sperm quality and endometriosis), needed to have the settings changed for my
patients with darker skin tones, in order to avoid discomfort but remain equally as
- I find that I often take 3 times longer in order to find a stock image for our Acubalance
blogs (like this one), so that it doesn’t just include Caucasian ‘patients’/pregnant
women (yes, Fotolia, I’m talking about you).
- I also made a conscious choice to offer clear tape for the ear seeds I use on my
patients, rather than the beige ‘skin colour’ ones also sold through our supplier.
3. Finally, we also all need to be mindful and hold media accountable, so that coverage takes into consideration that infertility affects all ethnicities.
My contribution in honour of Black History Month this year will be, to post a blog series on conditions and how they apply and differ for those with African heritage, as well as highlight people who have shared their stories.
I challenge more of you to find a way to break the silence, shatter the stigma and support each other.
-Dr. Emilie Salomons
Here is the rest of the Black history month series:
#2. B.H.M: The period pain issue (Fibroids and more)
#3 B.H.M: The PCOS issue
#4 B.H.M: The supplement issue