Infertility in the Hispanic community is rarely discussed in the U.S., despite the fact that the birth rate for Hispanic women has plummeted by 31 percent from 2007 to 2017. This steep decline has been driven in part by young, American-born Hispanic women postponing childbirth to prioritize their education and careers. As women wait longer to start a family, the likelihood of experiencing infertility is likely to increase. Infertility may also be more prevalent in the Hispanic community due to certain common medical conditions.
However, due to a variety of cultural and societal factors, including increased stigma surrounding infertility and barriers to accessing care, Hispanic women are less likely to pursue or receive treatment for infertility compared to non-Hispanic White women.
Stigma of Infertility
The belief that Hispanic women are naturally very fertile is a long-held stereotype that contributes to increased stigma regarding infertility. Additionally, certain religious views that emphasize 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 judgement. Additionally, sex, sexuality, and women’s bodies are often considered taboo topics, which compounds the stigma regarding reproductive health and limits awareness of the many options available for family-building.
Diabetes and PCOS
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 a common condition that often causes infertility and is linked to obesity, diabetes, high blood pressure, hormone imbalances, and problems with ovulation. Additionally, Type 2 diabetes is thought to be more prevalent in the Hispanic population and can negatively affect fertility in both men and women. Both of these conditions may be cited for increased prevalence of infertility in the Hispanic community
Disparities in Access to Care
Hispanic women are underrepresented in the population receiving infertility treatment. They are less likely to seek out fertility treatment and, even after an infertility evaluation, are less likely to receive fertility care. Cultural factors, such as the stigma of infertility, are only part of this trend. Economic issues and lack of health insurance combine to create financial obstacles to pursing treatment, while geographic issues and language barriers can make it 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 being very or extremely worried about using reproductive technology to conceive, citing greater ethical concerns and trepidation about the side effects of treatment.
Increasing Access to Fertility Care
A study at a large teaching hospital of low-income Latinx immigrants who sought infertility care found four major barriers to treatment: communication, continuity of providers, bureaucracy, and accessibility. Language was a huge barrier in communication as most of the physicians or other providers were not fluent in Spanish, and there was often a lengthy wait for a translator. Culture and communication style was also a factor, for example patients were likely to describe their symptoms as a lengthy story of their experience, while the doctors were pushing to complete a medical history as quickly as possible to stay on schedule. As a result, patients often felt the physicians were not caring or attentive. Continuity of providers was an issue in the hospital because care was provided by multiple residents and fellows supervised by a reproductive endocrinologist, resulting in patients seeing multiple physicians over time as shifts changed. Bureaucratic barriers involved appointment scheduling and delays, availability of testing, and lengthy waits once they arrived for an appointment. Accessibility included issues related to affordability and availability of care.
Among members of higher socioeconomic status, some of these issues may be less of a barrier to accessing treatment. However, improving communication methods, fostering a better understanding of cultural differences, and facilitating a more simplified path to treatment will continue to be important considerations in making family-building more attainable for all who wish to become a parent.
WINFertility can make access to fertility treatment easier for patients of all backgrounds due to the diversity and expertise of its provider network and on-staff Nurse Care Managers. Patients are paired with a dedicated Nurse Care Manager who is there to provide education, support, and guidance throughout the entire family-building journey. WIN’s vast national provider network allows for convenient access to treatment, including specialists who are specialized in treating PCOS and other health conditions that affect fertility. WIN matches patients with providers that are right for their unique needs, taking into account a variety of factors such as geographical location, LGBTQ+ inclusivity, and language. In fact, many providers in the WIN network speak Spanish or have fluent Spanish speakers on their staff. WIN also provides translation services and communications materials in several languages, including the WIN Companion app which is available in Spanish. Contact us to learn more.