Researchers from the University of Michigan exploring the experiences of African-American women coping with infertility have found that many experience infertility in silence and isolation from friends and family.

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African-American women are equally, if not more, likely to be affected by infertility as white women, yet most infertility research in the US focuses on affluent white couples.

The study, published in Psychology of Women Quarterly, also found that infertility impaired many of the women’s sense of self and gender identity.

According the Centers for Disease Control and Prevention (CDC), there are an estimated 6.7 million women ages 15-44 in the US with an impaired ability to get pregnant or carry a baby to term. Around 1.5 million married women ages 15-44 are diagnosed as infertile.

Infertility is a traumatic condition experienced by many women in the US. The medical definition of infertility for women is when a woman is unable to conceive after 12 months of regular, unprotected sex.

Women from all backgrounds can be affected, yet the majority of research on infertility in the US examines affluent white couples participating in advanced medical interventions. On top of this, the authors of the study state that African-American women are equally, if not more, likely to experience infertility than their white peers.

“Infertile African-American women are indeed hidden from public view,” states lead author Rosario Ceballo, a professor of psychology and women’s studies.

For the new study, the researchers conducted interviews with 50 African-American women who had met the medical definition of infertility at some point in their lives about their experiences with the condition and their relationships with friends, family and doctors.

The participants came from an array of different socioeconomic backgrounds, with many of the women possessing college degrees and working full-time. The women were aged 21-52, and the majority of them were married. They had each spent between 1 and 19 years attempting to become pregnant.

When asked to describe their difficulties with conceiving, 32% of the participants spoke about widely-held beliefs equating women with motherhood. One woman stated that having no biological children “would label you as a failure.” Another woman reported feeling incomplete:

Emotionally, I felt that I was not complete, because I had not had a child. I didn’t feel like I was a complete woman.”

For some, their experience of infertility was influenced by religion, with a sense of shame being heightened by the belief that God intended for women to bear children.

Nearly all of the women interviewed for the study said that they coped with infertility in silence and isolation, even if a friend or family member was aware of their condition. Some women, particularly those with secondary infertility, reportedly remained silent about their condition because mentioning it did not lead to sympathy or empathy.

Ceballo states that this silence about infertility may be associated with cultural expectations among African-American women of strong, self-reliant and stoic women and with notions about upholding privacy in African-American communities.

“Women may also reason that other people can neither change their infertility status nor understand what they were experiencing,” she adds.

Around 26% of the participants believed that their interactions with health care providers may have been influenced by gender, race or class discrimination. Several women mentioned doctors making prejudiced assumptions about their promiscuity and financial status.

To the surprise of the researchers, participants were equally likely to report discrimination in medical settings regardless of their level of education or income.

Ceballo concludes that, overall, infertility has a negative effect on the self-esteem of African-American women, who see themselves as abnormal as they do not see infertile African-American women represented in social images.

In order to address this, the authors recommend interventions such as disseminating a greater range of African-American women’s reproductive experiences to help normalize them and lessen the sense of shame and isolation that many experience.

Previously, Medical News Today reported on a study revealing a new technique that researchers believe could lead to more effective, cheaper in vitro fertilization for couples struggling to conceive.