Silencing Stigma
BIPOC females (Black, indigenous and people of color) are 7-18X more likely to be concerned about the social stigma of fertility than White women. The long-held stereotype that Hispanic women are naturally very fertile and the thought of sex, sexuality, and women’s bodies as taboo subjects compound the stigmas regarding fertility and reproductive health within the Hispanic community. Additionally, religious views emphasizing the importance of procreation, while simultaneously imputing the ability to get pregnant to “God’s will,” can discourage many from pursuing fertility treatment. Some women may avoid nontraditional methods of conception to honor their personal beliefs, while others worry about experiencing shame or judgment—many Latinx women even report difficulty accepting the term “infertility,”—all of which limits awareness of the many options available for family-building.Increased Risk for Complex Health Conditions
Across the U.S., members of ethnic minority groups may be more prone to certain health conditions. In fact, women of Hispanic heritage are more at risk for PCOS, or polycystic ovary syndrome. PCOS is one of the most common causes of female fertility challenges and is linked to obesity, diabetes, high blood pressure, hormone imbalances, and problems with ovulation—all conditions that can negatively impact female fertility—and are cited to be more prevalent in the Hispanic community.Disparities in Access to Care
Hispanic women are underrepresented in the population receiving fertility treatment; they are less likely to seek out support, and, even after an evaluation, are less likely to receive fertility care. Beyond the cultural factors above, economic issues and lack of health insurance create financial hurdles to pursuing treatment, while geographic and language barriers make it more difficult to access a provider. Research carried out in Illinois, which mandates insurance coverage for fertility treatment, found that Hispanic women traveled twice as far as White or Black women to seek fertility care. They also reported trepidation about using reproductive technology, citing greater ethical concerns and worries about side effects.A Study of Fertility Care Among the Hispanic Community
A study at a large teaching hospital of low-income Latinx immigrants who sought fertility treatment found four major barriers to treatment: communication, provider continuity, bureaucracy, and accessibility.- Language and communication styles were critical barriers to care, as most physicians or other providers were not fluent in Spanish, and there was often a lengthy wait for a translator. Patients often described their symptoms as a story of their experience, whereas doctors were pushing to complete a medical history as quickly as possible to stay on schedule, often making patients feel the physicians were not caring or attentive.
- Lack of provider continuity was a major challenge in the teaching hospital. Given care was provided by multiple residents and fellows supervised by a reproductive endocrinologist, patients saw multiple physicians over time as shifts changed.
- Bureaucratic barriers involved appointment scheduling and delays, availability of testing, and lengthy waits once patients arrived for their appointments.
- Accessibility issues related to affordability and availability of care.
