Having a physician that you can relate to is important in fertility treatment. However, physicians of color are underrepresented in medicine and especially in the infertility specialty.
There are very few studies that directly compare ethnicity and pregnancy rates with IVF. This makes it difficult to draw conclusions about how ethnicity affects IVF outcomes.
Black women are 1.5 times more likely to experience infertility than white women.
The causes of infertility vary widely, including untreated sexually transmitted diseases such as chlamydia and gonorrhoea; uterine fibroids; nutritional deficiency; environmental and workplace factors; and more. While many of these conditions can be treated or managed through healthcare, the overall rate of access to medical care varies across racial lines.
Research shows that Black patients are less likely to seek out early health care treatment in general—including for reproductive health issues like uterine fibroids that affect them at higher rates—due to historic distrust of a healthcare system that has historically mistreated people of color. Those same barriers can also contribute to poor outcomes when they do receive treatment. For example, one study found that Black patients had lower clinical pregnancy and ongoing pregnancy/delivery rates after in vitro fertilization (IVF) than Whites.
Another factor is that Black women are twice as likely to have had tubal ligation (BTL), which is surgical sterilization. Often, this is done in young adulthood when it’s a “resolution” to previous fertility problems. But BTL can lead to infertility, because it cuts off the fallopian tubes that connect to the uterus, which would be necessary for sperm and eggs to meet up. Several studies have shown that women with BTL are more likely to struggle with infertility than those who never had it. This is a common concern among Black women who are trying to conceive.
BIPOC communities report more chronic stress than Caucasians.
While the use of BIPOC may seem like a great idea for political solidarity, it can be harmful to communities of color. The acronym centers two specific racial groups, Black and Indigenous people, over the rest of People of Color, while also furthering the systemic oppression that affects all those communities. It can also lead to the erasure of other marginalized identities, such as those of Lesbian, Gay, Bisexual, and Transgender (LGBT) people, who have experienced similar forms of oppression but are not always included in conversations about BIPOC.
Chronic stress can cause physical, mental and behavioral health issues, such as depression, anxiety and hypertension. The causes of chronic stress vary from person to person, but common factors include socioeconomic status, family and environmental stressors, acculturative stress, and feelings of hopelessness. People of color are more likely to experience these types of stresses, which can lead to higher rates of mental health issues such as depression.
Individuals in BIPOC communities often face multiple challenges that prevent them from being able to access the health care they need. These barriers include language or cultural differences, different medical interactions, and a lack of cultural awareness among health care providers. In addition, women of color are more likely to experience complications during pregnancy and childbirth due to social determinants of health, such as discrimination, violence, poverty, and housing insecurity. These barriers can also make it more difficult for individuals to navigate the infertility treatment process.
BIPOC communities are more likely to have health problems.
BIPOC communities are often more likely to experience health problems than white populations. In many cases, they are also less likely to receive adequate healthcare and treatment for these conditions. This is due to a number of factors including poverty rates, physician shortages in historically Black and Latinx neighborhoods, greater distrust of the medical system (due to historical traumas), and more.
Even when doctors are not explicitly discriminating against patients, it is important to remember that medicine has a long history of racist practices. The exploitation of enslaved Black women to advance gynecological science is just one example of the racial bias that continues to impact health outcomes today. Health conditions like fibroids, which disproportionately affect Black women, can cause pregnancy-related deaths if not addressed and treated properly.
While it is sometimes useful to use the term BIPOC when referencing all people of color, it’s important for allies and academics to think critically about the issue at hand and what the data or arguments they are using show. It is more accurate to disaggregate the data and use terms that accurately represent the communities they are discussing. In some instances, this will mean using the terms African-American and Latinx rather than BIPOC. In other cases, it will involve recognizing that some community groups have specific preferences for their own names.
BIPOC communities are more likely to be older.
Although genetics define a person’s race, people also have distinct ethnicities that are formed by culture. Ethnicity refers to shared practices like language, religion, ancestry, and beliefs. The US is a very diverse country, and research has shown that a person’s race and ethnicity can play an important role in their health outcomes, including fertility.
The term BIPOC (Black, Indigenous, People of Color) has been gaining popularity over the last few years as a way to be more inclusive and bring attention to groups that are often harmed by white supremacy. While the intention is good, we must be careful to avoid using new terms that don’t necessarily advance real progress.
Many critics of the use of this term argue that it excludes other nonwhite communities. They say it equates all people of color together, when in reality, there are many unique and distinct experiences that Black and Indigenous communities have endured in this country.
It can be easy to fall into the trap of assuming that just because a term is trendy or popular it must be a positive change. This is why it’s so important to consider the impact of your words and how they could be interpreted by others. Educating yourself on the history and context behind a term is a great start. You can also upskill and credential your clinicians on cultural competence to begin making a difference in the health of BIPOC patients.
