My Mind, My Body, My Journey™ 

Reproductive health is a trending topic, due to constant political conflict regarding women’s access to reproductive health care. Reproductive health includes a variety of concerns and is important for a woman’s overall wellness and for maternal health. Reproductive health includes the health factors that relate to pregnancy, childbirth, and factors such as access to birth control and fertility treatments. Reproductive health involves preventing infections, illnesses, and other diseases that can impact the reproductive system or contribute to chronic diseases or death. It also includes aspects of sexual health such as the experience of pain and pleasure during intercourse.  

For Black women, reproductive health care is more complex. The experience of racism contributed to a variety of stereotypes about Black women’s sexuality and fertility. Information highlighted about reproductive health in the Black community is often negative, such as statistics about the number of Black women who contract STIs and HIV. Additionally, there are statistics that perpetuate and reinforce stereotypes about Black women being single mothers, due to perceptions about Black fertility and hyper-sexuality. In reality, Black women’s reproductive health needs are often neglected in topics such as pregnancy related complications, pregnancy related deaths, infertility, and cervical cancer.  

Pregnancy related complications 

• Black women are more likely to experience pregnancy related complications when compared to women of other races. These are the top pregnancy complications that impact Black women¹: 

• Gestational Diabetes 

• This condition occurs during pregnancy in women who have never had diabetes prior to their pregnancy. Insulin levels are affected, which can cause serious health problems to the mother and the infant¹. Sometimes symptoms are not present with gestational diabetes, therefore, it is important to be tested during pregnancy¹. Current recommendations suggest testing for diabetes between the 24^th and 28^th week of pregnancy; however, women who are high-risk (i.e., older mothers, Black women, women with a history of diabetes, and overweight/obese women) should be tested sooner¹. 

• Pre-eclampsia and eclampsia  

• Pre-eclampsia can be very dangerous as it can become fatal for the mother and the child. It can contribute to a sudden spike in blood pressure¹. If untreated it can lead to eclampsia which can cause extremely high blood pressure, seizures, or even a coma¹. Pre-eclampsia, like gestational diabetes often does not cause any symptoms; however, when symptoms are present they include high blood pressure, sudden weight gain, severe headaches, swelling in the face and extremities, vision problems, and dark urine¹.  

• High blood pressure 

• This condition is common during pregnancy and should be monitored with your physician or at home with a blood pressure machine.  

• Preterm labor 

• When contractions occur between the 20^th and 37^th week of pregnancy, a woman experiences preterm labor¹. Preterm babies are at risk of developing serious health concerns, which are also more common among Black infants. Preterm labor is a medical emergency, so please seek immediate care if you experience stomach cramps, chronic backache, water breaking, pressure on your pelvis, contractions regardless of pain, and changes in vaginal discharge (i.e., watery, mucus, blood).  

Pregnancy related deaths 

• Black women are more likely to die during pregnancy or within a year after giving birth. Health conditions such as postpartum hemorrhage (PPH) which is excessive bleeding after birth. Usually, PPH occurs within 24 hours of giving birth, but can occur up to 12 weeks after having a baby¹. Warning signs for PPH include heavy vaginal bleeding that does not stop or slow down, weakness, nausea, blurred vision, changes in heartrate, and lower blood pressure. If you experience any of those symptoms along with PPH, seek medical attention immediately.  

It is important to explore family medical history to determine if pregnancy related complications have occurred and to advocate for yourself. Use your support system, which can include your partner, family, and friends to advocate for yourself during your pregnancy and after birth. Explore resources in your community which can include home visiting programs or other postpartum support groups. The majority of those programs are designed to support low income or at-risk mothers; however, some programs will support all mothers regardless of income status and support system. Those programs, in my opinion, are crucial to improving reproductive health and maternal health needs of all women.  

Prevention is also important as lifestyle choices and health behaviors can reduce the likelihood of complications. Last fall, I discussed preconception health such as nutrition in a previous blog. Some of those recommendations included maintaining a healthy pre-pregnancy weight, eating healthy, and avoiding tobacco. Proper hydration is also important, so please visit my blog about consuming more water. Stress management is also important, but may be challenging depending on your support system during your pregnancy and your work environment. Obtaining regular prenatal care, including taking vitamins and other recommended medications is also important.  

Infertility  

• The Centers for Disease Control and Prevention (CDC) defines infertility as being unable to get pregnant after a year of trying for women under age 35². The window changes to six months for women over the age of 35. Women who are able to become pregnant but cannot maintain their  pregnancy can also be considered infertile². Ten percent of women of childbearing age in the United States experience infertility.²    
• Infertility among Black women is often not discussed in the Black community or in society. As mentioned above, due to negative stereotypes about Black women’s sexuality and fertility, this medical condition is often ignored. Studies have found that Black women are more likely to experience infertility when compared to White women³. Black women are less likely to engage in fertility treatment due to financial barriers and stigma³. Research suggests that fertility assisted live birth rates are lower among Black women³.  

• Black women experiencing infertility struggle with the lack of Black sperm and egg donors, in addition to physician biases that delay referrals for treatment, and cultural stigmas about being unable to birth a child⁴. 

If you are a Black woman experiencing infertility these resources can be helpful:  

• The Cade Foundation 

• This nonprofit was founded by a Black physician to provide support, resources, and financial assistance to Black women impacted by infertility. More information can be obtained from this website https://www.cadefoundation.org/.  

• Sister Girl Foundation 

• This nonprofit was founded by a Black woman who was impacted by reproductive health concerns. It provides support and financial assistance to Black women impacted by reproductive cancers and infertility. More information can be obtained from this website. https://www.sister-girl.org/.  

• Broken Brown Egg 

• This nonprofit was founded by a Black woman who experienced infertility and IVF treatments. The site provides resources, books, support, and a toolkit for providers to support Black women experiencing infertility. More information can be obtained from this website. https://thebrokenbrownegg.org/  

• Fertility for Colored Girls  

• This nonprofit was founded by a Black woman and minster who experienced fertility concerns. Information incorporates Christianity and includes resources, books, supports, and financial assistance to Black women who have experienced fertility concerns. This website also supports Black women who have experienced the loss of a pregnancy. More information can be obtained from this website. https://www.fertilityforcoloredgirls.org/.  

Remember the experience of infertility and a miscarriage can be emotional for the woman experiencing it. Society has not been sensitive to this topic, because people have normalized asking women if they have children or plan to have children. We have normalized judging women for not having children, without knowing the circumstances. Some helpful things to say to a woman in this situation include: “It is not your fault” “I am here for you” “Don’t be hard on yourself.” Unhelpful and insensitive things to say include “You can always try again” “It wasn’t meant to be” “Everything happens for a reason” “Trust me kids are a lot of work/expensive” “You still have time to enjoy your freedom.”  

Cervical cancer  

• Any woman with a cervix has a risk of developing cervical cancer, although risks of developing cervical cancer are greater among women over the age of 30⁵. When compared to White women, Black women have higher rates of developing cervical cancer and have the highest death rate from cervical cancer⁵.You can reduce your risk by avoiding smoking, obtaining the HPV vaccine (if under age 26), and having regular PAP screenings.  

Reproductive health care in the Black community can improve, with knowledge and advocacy for the issues that are more likely to impact Black women.  

Wishing you health and happiness  

References:  

1. Five Pregnancy Complications Black Women Should Know About. Beaufort Memorial Hospital website. https://www.bmhsc.org/blog/5-pregnancy-complications-black-women-should-know-about. Published July 16, 2021. Accessed February 11, 2023.  

2. Women’s Reproductive Health. Centers for Disease Control and Prevention Website. https://www.cdc.gov/reproductivehealth/womensrh/index.htm. Updated May 3, 2022. Accessed February 11, 2023.  

3. Infertility and Black, Indigenous, and Women of Color. Fact Sheet from the Committee on Women in Psychology. American Psychological Association Website. https://www.apa.org/pi/women/committee/infertility-bipoc. Accessed February 11, 2023.  

4. What Black Parents Need to Know About Infertility. Very Well Website. https://www.verywellfamily.com/what-black-women-need-to-know-about-infertility-5272521. Published January 3, 2023. Accessed February 11, 2023.  

5. Cervical Cancer. Centers for Disease Control and Prevention Website. https://www.cdc.gov/cancer/cervical/index.htm. Updated December 6, 2022. Accessed February 11, 2023.