Why we need to talk about racial inequality in *reproductive* healthcare.

Why we need to talk about racial inequality in *reproductive* healthcare.

The differences in health outcomes experienced by marginalised communities/non-white groups has needed attention for decades. 

We’ve spoken to Senior Scientific Research Associate and the project lead of Hertility’s Black Women’s Health Initiative, Ruby Ross Relton (BSc, MSc), to explore the findings of their recent Inequality Report and talk about why this conversation is vital for everyone in the reproductive health space. 

The context: 

Examining the medical history of Black women, there are many examples of moments where their reproductive rights have been abused by a healthcare system meant to protect them. Take James Marion Sims, known often as the “Father of Modern Gynaecology”, and the experiments he performed on enslaved Black women or the use of contraceptives such as hormonal IUDs and sterilisations as a means to control the reproductive potential of women from low socioeconomic and minority ethnic backgrounds. 

Today, there continues to be a lack of representation in medical textbooks training future doctors and in clinical trials for life-saving medications, perpetuating systemic disparities. Additionally, reports of experiences of harmful racial profiling and other manifestations of explicit, structural and institutional racism continue to persist, resulting in significant disparities in health outcomes, particularly affecting Black women. 

The report: 

Across the reproductive life course, research has shown that Black women are more likely to experience worse health outcomes than White women. For example, Black patients in the United Kingdom access fertility treatment later than any other patient group and have the lowest success rates. Black mothers are also 3.7 times more likely to die in childbirth or in the six weeks after than White women.

To achieve health equity, there is a huge need to discuss and highlight the impact of racial inequalities on Black women’s health and how this plays a role in their outcomes and experiences. We wrote The Inequality Report to bring this conversation to our community, taking into account current published literature (where it is available), the first-hand experiences of Black women and our own Hertility data to provide a snapshot into what the current state of reproductive healthcare is for Black women in the United Kingdom today. 

What we found: 

Looking at our Hertility community of over 8,000 Black women, we continuously saw differences between Black and White women at various stages of reproductive life. For example, women who self-identified as Black who approached Hertility were more likely to have a pre-existing reproductive health condition than White women (31% vs 18%) and were 6 times more likely to report a previous diagnosis of uterine fibroids. Black women trying to conceive approached Hertility at an older age (1.5 - 3.6 years older) and were more likely to have been trying to conceive for 5+ years compared to White women (14.4% vs 8.9%). We also saw that sexually transmitted infections were more commonly reported by Black women than White women. Black women were also 8x more likely to report a previous Trichomoniasis (Trichomas Vaginalis) infection than White women (4.2% vs 0.5%). 

Recent published literature and our Hertility data show that there is an urgent need for improvement in reproductive health screening, symptom management, sexual health education, preconception counselling and fertility awareness by professionals delivering healthcare across the UK in order to improve the health outcomes and well-being of Black women. 

What now? 

Whilst collecting the data to help close the gaps that exist is vital, it is only part of the equation. It is important that research which explores the experiences, thoughts and perceptions of Black women is prioritised and involving Black women in conversations on policy and social change is essential. From this, we can create tangible next steps and drive collective action from organisations to enable the creation of a more equitable system and ensure that everyone receives the quality care they deserve. 

Download The Inequality Report and read more about Hertility’s Black Women’s Health Initiative here.

About Hertility’s Black Women’s Health Initiative

Hertility’s Black Women’s Health Initiative is led by an all-female group of scientists and advocates passionate about driving equality for Black women’s reproductive health, both in the UK and globally. The Black Women’s Health Initiative aims to not only spotlight the crucial need for more diversity in research, in both the fields of women’s health and, more generally, but to tackle the devastating healthcare inequalities that Black women face through dedication to education, continued scientific research, and by leveraging the comprehensive dataset and platform developed by Hertility to make change.