Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, New York University Langone Fertility Center, 660 1st Ave, New York City, NY, 10016, USA.
Department of Gynecology and Reproductive Health, Kindbody Fertility Center- Silicon Valley, 4756 El Camino Real, Los Altos, CA, 94022, USA.
Reprod Sci. 2022 Jul;29(7):2067-2070. doi: 10.1007/s43032-022-00915-0. Epub 2022 Mar 29.
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.
不孕症可能影响任何人,包括黑人女性,与普遍看法相反,她们最有可能患有不孕症,不太可能寻求生育护理,而且更有可能延迟或完全放弃生育治疗 (Chin 等人,《儿科与围产期流行病学》29(5):416-25, 5)。这些趋势可能是由多种来源产生的根深蒂固的耻辱感所推动的。一些黑人女性可能因为普遍存在的黑人女性生育能力极强的刻板印象而感到不舒服讨论她们的不孕经历 (Ceballo 等人,《女性心理学杂志》39(4):497-511, 20)。这种刻板印象在医疗领域也有重要影响,其中提供者的隐性偏见可能会影响转诊和治疗计划,进一步导致分层生殖 (Chapman 等人,《普通内科医学杂志》28(11):1504-10, 15, FitzGerald 和 Hurst,《BMC 医学伦理学》18(1):19, 16)。现在是医疗界将我们的注意力转移到我们可以改变的事情上的时候了,从我们如何看待叙述开始。为了实现变革,提供者首先应该并且始终意识到生殖领域的种族/族裔差异。我们可以共同努力,有效地向黑人女性提供关于她们的生育能力和未来生育目标的咨询,并努力用医学证据来驳斥关于种族/族裔生育能力的错误刻板印象。我们应该积极努力了解我们的偏见,了解它们的根源,以及如何解决这些偏见。我们必须始终努力提供尊重、公平和一致的护理,尤其是在决定如何就生育保护和不孕治疗方案向某人提供咨询时。总之,我们可以通过现在就采取小而有意的平行步骤来解决健康公平方面这个复杂的种族/族裔差距问题。