Thursday, May 23, 2002

The Real Baby Mama Drama

The Real Baby Mama Drama
By Pamela Appea

As a newlywed back in 1994, Sandra Taylor decided to try and have a child right away. After all, she was already in her early forties, and had some concern about whether she could get pregnant again at her age (she already had one grown son). Looking back, Taylor said she was optimistic at first.

If she’d read Sylvia Hewlett’s Creating a Life, this year’s contender for scariest book aimed at women who want to “have it all,” she’d have kept her enthusiasm in check. Describing a biological clock more ruthlessly fast than most American women had previously worried about, Hewlett’s controversial book cautions that women who put off motherhood until their forties—or even thirties—may find themselves too late to conceive without costly intervention (and even then, she writes, it’s a crapshoot.)

True to form, Taylor and her husband ran into a wall of infertility problems on both her end and his. Taylor discovered that the abdominal pain she’d suffered for years was courtesy of fibroid tumors in her uterus, and her husband found he had a lower sperm count. It seemed unlikely that the two would conceive a child of their own.

Taylor began looking into in vitro fertilization (IVF), in which a fertilized egg—the women’s or a donor’s—is implanted into the prospective mother’s womb.

“I was told infertility treatments would be expensive,” Taylor recalls. “They told me the costs would be $4,000 and up. And automatically, I just said, forget it.”

It’s a story known to many in the black community, yet seldom discussed. Worse, infertility among black women is often underdiagnosed, undertreated or ignored by a medical establishment that tenders unequal care to patients of different backgrounds.

The first damaging stereotype is that women of color are naturally fertile, sometimes too much so—either earth mothers or baby mamas.

“How many times have you heard someone say, ‘If I just look at a man too hard, I’ll get pregnant?” asks Lori-Burns Simms, a 36-year-old non-profit administrator living in Philadelphia who experienced four ectopic pregnancies and gave up trying to have a biological child a few years ago. “There are the inappropriate comments that may seem unassuming but cut to the core of our issues.”

While the comment may seem funny to most, for black women who cannot conceive or carry a pregnancy to full term, it can feel like a slap in the face. “We start wondering what’s wrong with us,” she says.

Social stereotypes of black women have minimized the significance of what Tina Pilgrim of the Ferre Institute of Color initiative, calls the “hidden problem of infertility” in the African American community. Black women are seen as “fertile Myrtles,” according to a recent paper issued the Institute, a non-profit organization working to promote awareness of fertility issues.

Infertility is not uncommon among black women, though. About 10.5% of black women are infertile, according to data from a 1995 US Department of Health and Human Services survey. An additional 13.6% of women who identify as multi-racial or who are Latinas of African descent push the numbers up significantly. In the US, about 6.2 million women between the ages of 15 and 44 are diagnosed as being infertile and unable to bear a child to term.

While some forms of infertility can be treated, Pilgrim says, “only one-third of women of African descent who face the issue seek treatment.”

One reason is that healthcare practitioners may bring their own racial issues to the treatment of black infertility. Adding to the problem, many women don’t even tell their friends or family, fearing stigma within the community.

“No one comes out and says I’m infertile,” says Burns-Simms, who adds that only recently has she realized how many other black women are in the same situation.

My problem is that I had four ectopic pregnancies,” said Burns-Simms. “I didn’t think of it as infertility, but whether it’s ectopic pregnancies, multiple miscarriages or black male sterility, the issue is not talked about.”

Shame can also come into play, especially if the reason for infertility is a sexually transmitted disease. One of the main causes of infertility among African American women is Pelvic Inflammatory Disease (PID), which can invade the fallopian tubes when left untreated and can cause significant scarring there, enough to block the normal passage of eggs into the uterus. Untreated STDs are one of the main causes of PID (another is the practice of douching, which is more common among black women than other population groups.)

According to the National Institute of Allergy and Infectious Diseases, PID has been classified as the leading cause of pregnancy loss among black women.

The painful fibroid tumors Taylor had removed are also one of the more common complications affecting black women, especially as they grow older. Pilgrim cites a 1995 Essence article that claims 50% to 75% of all African American women are affected by fibroid tumors.

Dr. Jennifer Thie, MD, program director for the Bethesda Center for Reproductive Health and Fertility in Cincinnati, said that she has worked with several black women in her practice who have experienced infertility.

“Infertility for black women is often complicated by a higher rate of uterine fibroids that require surgery because of size or heavy bleeding,” Thie said.

Some black women battling infertility fight racism at the same time. At the first clinic she sought treatment at Burns-Simms felt that, while the staff was professional, they may have looked at her and her husband differently because of race.

Even those black women who seek treatment, and find it, often don’t benefit from it as much as other women.

In a University of Maryland study published in the trade journal Fertility and Sterility, researchers reported African American women were less likely to become pregnant from IVF than white women.

“For two years, I was on a baby-making mission, complete with hormonal medications, hypodermic needles … and disappointments,” Burns-Simms wrote in an online essay. Despite their adequate health insurance, Burns-Simms and her husband spent a significant amount of time, money and energy on getting complicated infertility treatments. “I guess I would tell another women going through the same thing that the process is very costly. We sort of embarked on the project blindly—it was emotionally driven.”

In 1997, Burns-Simms and her husband decided to adopt a baby boy, whom they named Austin. “We took stock of our blessings we had and turned my infertility into an opportunity to provide a home for a loving little boy.”

Burns-Simms says that the issue of infertility—among herself and other black women—is still on her mind, even though her days and nights are full with Austin, who will turn five in July.

Originally published May 23, 2002