The Real Baby Mama Drama

The Real Baby Mama Drama
Africana.com
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

A Bitter Pill? Black Boys and Ritalin

A Bitter Pill? Black Boys and Ritalin

By Pamela Appea

It’s a common September scenario. A child refuses to stay in his seat or won’t stop acting out in class. He’s restless and fidgety and he likes to talk and talk…and talk. Frustrated teachers quickly think of ADD (Attention Deficit Disorder) and ADHD (Attention Deficit Hyperactivity Disorder), and equally frustrated parents quickly acquiesce to requests that their child be evaluated and possibly medicated.

It’s a difficult decision to make, especially amid growing concern that children are being overdiagnosed and overmedicated, especially with the ADD/ADHD miracle drug, Ritalin. A study from the Journal of the American Medical Association found the use of drugs like Ritalin among children aged two to fourteen tripled in the 1990s.

When this problem child is black, the complications only increase. While many in the black community have decried a rush to medicate minority children, especially boys, with Ritalin and other drugs, others have argued that black boys, while disproportionately diagnosed with learning difficulties, in fact receive far less treatment than other students.

“There are a lot of children suffering,” says Dr. Marilyn Benoit, a child psychiatry expert at George Washington University “Many don’t get the treatment they need.”

What they do often get, Benoit and others agree, is a stigmatizing label, and sometimes a one-way ticket to special education classes. The Civil Rights Project at Harvard University found in a 2001 study that black public school students in the US are three times more likely than whites to be identified as mentally retarded or in need of special education services. In addition, the study said, black students with learning disabilities are often misdiagnosed as being “emotionally disturbed.”

Beyond ADD and ADHD, kids now are tested for a veritable alphabet soup of disorders, including Obsessive Compulsive Disorder (OCD), Oppositional Defiant Disorder (ODD) and Pervasive Development Disorder (PDD). But with symptoms for ODD like “often argues with adults,” “often loses temper” and “often deliberately annoys people,” many parents – and teachers – wonder how to tell the difference between a bona fide medical condition and the behavior of a grumpy, spoiled or bratty child.

Such broad definitions, when combined with studies like Harvard’s that suggest how quickly black children are seen as “trouble,” make for a combustible combination.

“I know that a lot of black boys are labeled as having behavior problems and are placed in Special Ed. Classrooms,” says Xoli Dyasi, a fifth-grade teacher in the New York public schools.

The National Medical Association, a DC-based group promoting the interests of black doctors and patients, has spoken out against the disproportionate placement of African American children into special education programs.
Still, Dyasi says, some children do have learning disabilities and benefit from the diagnosis, when followed by proper treatment. She says she leaves the diagnosing to the school psychiatrist. Therein lies the problem, some minority child advocates say. Most teachers are not like Dyasi — a rush to Ritalin is common, with teachers sending notes home to parents demanding that their children be medicated.

What children do need medication? ADHD experts like Dr. Laurence Greenhill, at Columbia University and the New York State Psychiatric Institute, say some tell-tale signs of ADHD among young children are an “insatiable” curiosity or “excessive” temper tantrums. “A child with ADHD may appear restless, aggressive, demanding, argumentative, or noisy,” Greenhill says. Evelyn Polk Green, president of Children and Adults with Attention Deficit Hyperactivity Disorder (CHADD), a Landover, Maryland-based advocacy group, lists some real life examples – the child who has no friends or playmates, who has been expelled from day care centers, who is no longer welcome at larger family functions – that indicate the potential need for medication.

Polk Green, a Chicago resident, early childhood educator and parent of an ADHD teenager, says she struggled with the idea of medicated her child. “His temper tantrums were long and uncontrollable, yet he could be the sweetest, most loving child in the world,” she said.

And it wasn’t the amount of discipline her son received, she says, recalling how she and her husband tried every trick in the book. “None of the standard behavior modification techniques seemed to work,” she says. “Eventually, my husband and I realized that we could not do this alone.”

She says she initially worried ADHD medications would transform her smart, creative son into a zombie. But the decision paid off. Polk Green said her son is doing well today — still on medication but an active, college-bound high school student.Success stories like Polk Greens combine many factors – concerned, committed parents being the main one – that many kids diagnosed with ADD/ADHD lack. When parents lack health insurance, or the school system is uncooperative or even hostile, the results can be disastrous.

Despite laws like Individuals with Disabilities Education Act or IDEA, an amendment that advocates blended classrooms, (in conjunction with the Education for all Handicapped Children Act of 1975), children diagnosed with learning disabilities are often placed in special ed classrooms, taught a watered-down curriculum, or tracked into nonacademic programs.
And even when an ADHD-diagnosed student stays in a regular class, he or she faces counseling sessions, special group times, break times for medication, and other specialized parent-teacher meetings. The stigma can spread to a student’s peers. It’s not a secret who has ADHD, especially among urban school districts. Just ask the kids who takes medication and who doesn’t – they always know.

“I am actually torn with this topic,” said Dyasi. “I think that some medications do more harm than good for the child who is diagnosed as having ADHD. It may work for some kids and it may not. I think it really depends on the seriousness of the symptoms. It's really up to, I think, the experts – the doctors whose interest are really the children and not the doctors who are willing to only test out medications on children that may not need it.”At the same time, she says, all disruptive children should be evaluated immediately once they get into school—at age five or six – rather than letting problems fester.The topic of black children and medication is so controversial that one staff member at Florida A & M university in Tallahassee asked not to be identified when she said she feels more kids and adolescents within the African American community probably should be on medication. While not a popular opinion, her argument is echoed by recent findings in one Virginia school district that, while 17 percent of white boys are on Ritalin, only 9 percent of black boys are. All agree that parents and teachers must communicate better about ADHD and other learning disabilities, and that parents should inform themselves of their children’s rights and the medical and non-medical options for treatment.

After that, says Polk Green, you just make the best decision for your child. “Taking meds is a huge decision and should not be taken lightly,” Polk Green said, but adds, “if my child needed glasses or a hearing aide, or insulin or even chemotherapy, I wouldn’t hesitate to give him the treatment he needed.”
(Article prepared for www.africana.com in 2002)
Do not repost or redistribute without permission. E-mail me at pjappea@hotmail.com.