Even for those who have some form of insurance, accessing fertility services can still pose a disproportionate challenge for Black women. “There is a higher proportion of women of color who use federal insurance coverage, or Medicaid. Medicaid has absolutely no coverage for infertility,” says Lynae Brayboy, MD, FACOG, an African American OB/GYN specializing in reproductive endocrinology and infertility.
Cost is not the only thing keeping Black women from fertility clinic waiting rooms. It’s impossible to ignore the role of social factors and cultural perceptions surrounding infertility. Dr. Ijeoma Kola, a Nigerian-American entrepreneur who holds a doctoral degree in the history of public health, was just twenty-eight when she experienced fertility struggles. After a disheartening trip to the doctor, she was told she would need IVF in order to conceive. But she suffered in silence for many months, feeling like she couldn’t talk to others about what she was going through—she even struggled to talk to her own mother about it. “Black women are presented as hypersexual—we get pregnant like this, we’re welfare queens. There’s this perception of an African woman having ten kids and being hyper-fertile,” says Kola. “That can be difficult to push back against if you are struggling to get pregnant.”
These harmful stereotypes not only make it difficult for Black women to talk about their infertility but may also have implications for their care. “When a Black woman comes in for her annual visit, infertility may be the last thing that is discussed,” Dr. Brayboy says. This can have implications that extend past the inability to conceive—fertility is a vital sign, Dr. Brayboy says, and loss of fertility can be an indication of underlying health issues.
Closing the Fertility Gap
Public service campaigns, pushing back against harmful stereotypes, and continued lobbying for increased access to fertility services for patients of all backgrounds are just some of the ways to eliminate these disparities. And many stakeholders are advocating for making fertility services such as IVF more accessible. Some states have made great strides in this effort, enacting legislation mandating private insurance to cover a bulk of the cost of these services. However, patients who are uninsured or on Medicaid are still out of luck.
There are fertility centers and organizations that provide a handful of IVF grants to patients each year. For example, Fertility for Colored Girls is an organization that provides three grants to support those seeking IVF, intrauterine insemination (IUI), embryo adoption, egg freezing, and other fertility procedures. But the number of people who need financial assistance often exceeds the number of grants available.
Thankfully, the social stigma surrounding infertility is starting to erode—photography, film, and social media can help speed that along and raise awareness of the racial gap. Over the years, I have indulged in many medically related television shows and documentaries—a handful of them even showcasing people’s experiences with infertility. However, these bodies of work often leave out the voices of those impacted by the fertility gap the most: Black women. In response to this glaring lack of representation, I filmed and produced a documentary series, Black Motherhood Through the Lens, which highlights four Black women navigating the reproductive healthcare system. One segment focuses on fertility, featuring Shaylene Costa and Dr. Ijeoma Kola’s experiences in accessing in vitro fertilization and grappling with the social stigma associated with infertility in various communities.
Creating this series as a full-time medical student was nothing short of challenging, balancing production days with busy clinical rotations for two years. However, watching Shaylene and Ijeoma share some of their most vulnerable moments, opening their hearts to my camera lens, reminds me that this is all for a greater purpose.
I have many goals for Black Motherhood Through the Lens—film festival screenings, facilitating nuanced conversations, and maybe even fostering change in the medical system. And I also have many goals for Black motherhood. 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.
Adeiyewunmi (Ade) Osinubi is a medical student, documentary filmmaker, photographer, and freelance writer based in Rhode Island. She is passionate about women’s health, digital storytelling, and traveling.