Changing the Narrative, Starting With Us

Infertility can affect anyone, including Black women who, contrary to popular belief, are most likely to suffer from infertility, less likely to seek fertility care, and more likely to delay or completely forgo fertility treatment (Chin et al Paediatr Perinat Epidemiol 29(5):416-25, 5 ). These trends are likely fueled by deep-rooted stigma generated from a multitude of origins. Some black women may feel uncomfortable discussing their experience with infertility due to the pervasive stereotype that Black women are hyper-fertile (Ceballo et al Psychol Women Q 39(4):497–511, 20 ). This stereotype also has important implications within the medical field, in which provider implicit bias may affect referrals and treatment plans, further contributing to stratified reproduction (Chapman et al J Gen Intern Med 28(11):1504-10, 15 , FitzGerald and Hurst BMC Med Ethics 18(1):19, 16 ). It is time for the medical community to shift our focus to what we can change, starting with how we perceive the narrative. In order to effect change, providers should first become and remain aware of racial/ethnic disparities within reproduction. We can make a concerted effort to effectively counsel Black women about their fertility and future childbearing goals, as well as strive to debunk false racial/ethnic fertility stereotypes with medical evidence. We should actively work to understand our biases, where they stem from, and how to resolve them. We must aim to always provide respectful, equitable, and consistent care, especially when deciding how to counsel someone regarding fertility preservation and infertility treatment options. In sum, we can approach solving this complicated racial-ethnic gap in health equity by taking small intentional and parallel steps, starting now.