Exploring Infertility in Ethnic Minority Populations

Infertility may be caused by a range of different factors impacting the male and female reproductive systems. Evidence suggests infertility may impact 8-12% of couples (Kumar & Singh, 2015) and at least 186 million people globally (Inhorn and Wentzell, 2011). In many developed countries, approximately one out of five women remain childless.

Research and health care professionals typically define infertility as the inability to get pregnant after approximately one year of unprotected sex. Furthermore, secondary infertility, which focuses on the women’s inability to conceive again after having a child has also been discussed within research and medical consultations (Sormunen et al., 2018). 

Research suggests people managing infertility and secondary infertility may experience a number of consequences, including psychological, physical, mental, and medical detriments. For example, the social identity of a woman when she is considered childless in society, can put her in a position of feeling stigmatized.

Some research suggests that stress can contribute towards cases of infertility, with women being significantly more depressed than their fertile counterparts. Some women have self-reported that infertility is one of the worst crises they have ever experienced in their life, potentially worse than a divorce or even loss of a parent. Fertility is often a stressful subject, whereby there is pressure to conceive and those who potentially fail to do so can feel isolated, ostracized from communities, and often face stigmatization. 

Regardless of the prevalence of infertility as a health condition, it can be perceived as a social concern impacting quality of life as opposed to a disease of the reproductive system

Infertility and ethnic minority populations

Despite the impact and prevalence of research focusing on infertility, research exploring the impact of infertility among minority ethnic populations is limited. In the UK, ethnic minority communities are considered to be where individuals are from diverse backgrounds, with such populations being referred to as the minority, and are not classified as White British. For example, within communities which value the family and parenthood responsibilities, experiences of infertility could be extremely traumatizing and devastating leaving women feeling undermined and worthless in some cultural groups.

Similarly, while motherhood can be deemed as a position of strength, can feel powerful, giving women a sense of identity and fulfilling a role they were “created for”, in actual fact the stance should be taken that there should be a difference when defining women rather than as a homogenous group.

Cross cultural research has explored insight into the differences between different populations and what this means for such women. Women can be made to feel as though they are deficient, irrespective of their efforts spent to try and conceive, or alternatively those women who choose to remain childless and work extensively to build a career.

When considering some diverse cultures and communities such as those from South Asian descent, there is a firm prenatal and patriarchal stance. Studies reveal that embarrassment is a reoccurring overarching theme, which can cause barriers when seeking infertility treatment. There is a stigma attached to seeking such treatment, and some couples utilize assisted conception in secret to avoid shame and gossip within their community (Hampshire et al., 2012).

Furthermore, for some women, there are additional barriers to having English as an additional language, and they therefore struggle to be understood by medical practitioners first hand. There is also the additional apprehension for ethnic minority women having to liaise with professionals who may come across somewhat unaware of diverse backgrounds’ needs. Therefore, it is imperative that practitioners challenge their medical biases and explore ways in which talking therapies could help people manage experiences of infertility.

Moreover, there can also be high levels of stigmatization in Black culture as some research has conveyed that infertility in such communities enforces women to lag in seeking treatment due to the consistent issue of disparities in health care systems leaving women with negative perceptions of clinical environments. 

A facilitator to seeking treatment was psychological distress, as Black women have reported in research that they have high levels of fertility related psychological pain and discomfort. Another perspective is the financial strain that such communities are challenged with as ordinarily the stereotypical viewpoint is that priority is given to wealthy White women who perhaps do not have as many complications as Black women do such as being of advanced age, overweight, or with complex gynecological diagnosis. 

From a biological standpoint, research has highlighted that some Black women held the perception that they are of low risk, as they generally had the belief that they would not be affected by infertility due to family history which did not lead them to suspect they would ever have fertility concerns. More common barriers overall for women include the delays in being able to consult with gynecologists or physicians even after receiving treatment, especially when gynecologists are needed.