Fertility and Pregnancy Complications in Black Women

By Chris D. Meletis, N.D.

We are glad to see more and more attention focused on the serious issue of fertility and pregnancy complications in Black women.  Black women in the United States experience an increased rate of miscarriages and pregnancy deaths and they are disproportionately affected by fertility problems.¹

Impaired Fertility in Black Women

There are often ethnic disparities in the ability to get pregnant, but likely due to a variety of systemic factors within our health and economic systems, Black women tend to have a higher rate of fertility problems. According to one study, Black women have double the risk of being infertile compared to white women.² The researchers concluded, “This disparity is not explained by common risk factors for infertility such as smoking and obesity, and among non-surgically sterile women, it is not explained by gynecologic risk factors such as fibroids and ovarian volume.”

Increased Rate of Miscarriage and Preterm Birth

Black women also have an increased rate of early pregnancy loss and preterm births. One study found that Black women have double the risk of miscarriage compared with white women during 10 to 20 weeks’ gestation.³ Black women also have twice the risk of depression after a miscarriage compared with non-Black women.⁴

In addition, Black women are at higher risk of preterm birth. A study found a significantly increased prevalence of cervical insufficiency in pregnant Black women compared to pregnant white women.⁵ Cervical insufficiency, a condition where the cervical tissue is weak and the cervix opens too soon during pregnancy, contributes to preterm births. The Black women in this study also had a higher rate of preterm births.⁵

Increased Rate of Death During Pregnancy

According to the Centers for Disease Control and Prevention (CDC), Black women have two to three times the risk of dying from pregnancy-related complications compared with white women.⁶ For Black women older than 30, the risk of death during pregnancy was four to five times higher among Black women as it was for white women. ⁶

Furthermore, the pregnancy-related mortality rate among Black women with at least a college degree was 5.2 times higher compared with white women. American Indian and Alaskan Native women also were more likely to die during pregnancy compared with white women.⁶

Why Is this Happening?

Experts fear that one of the main reasons for these disturbing pregnancy statistics among Black women is racism. A report from Harvard T.H. Chan School of Public Health came to that conclusion, stating that Black women may be undervalued and when they have symptoms they’re dismissed.  For example, when tennis star Serena Williams suffered from a pulmonary embolism after giving birth through C-section, the medical staff at first ignored her concerns.

Other reasons for the disparity? Some health conditions could come into play. For example, U.S. born Black women have higher rates of preeclampsia.⁸

What Can Be Done About It?

Hospitals and healthcare providers will need to address bias in healthcare settings. It would also help to encourage women of color, as well as all women, to seek mental health support after a miscarriage or while experiencing postpartum depression. In addition, helping all pregnant women understand the ways they and their unborn can remain healthy—avoiding processed carbs and sugar, exercising, taking a good prenatal vitamin, etc.—should be a top priority.

About Dr. Meletis

Dr. Meletis is an internationally recognized naturopathic physician, an accomplished author, and respected educator in the field of natural medicine. Dr. Meletis was honored as a ‘Naturopathic Physician of the Year’ by the American Association of Naturopathic Physicians for his commitment to education and helping those in need. His mission is simply, “changing the world’s health, one person at a time”.

He has authored 14 books on subjects ranging from natural medicine interactions to fertility enhancement and has published over 80 articles in publications such as Natural Health and Natural Pharmacy. Dr. Meletis has served as the Dean of Naturopathic Medicine and Chief Medical Officer for the National College of Naturopathic Medicine (NCNM) for seven years and later as the school’s Senior Science Officer. He sits on several medical advisory boards and has worked with Oregon Health and Science University on a grant from the National Institute of Health to further educate MD graduates on natural medicine.

References:

1. Kelly-Weeder S. Impaired fertility in African-American women: an investigation of behavioral risks. J Natl Black Nurses Assoc. 2010;21(2):9-15.
2. Wellons MF, Lewis CE, Schwartz SM, et al. Racial differences in self-reported infertility and risk factors for infertility in a cohort of black and white women: the CARDIA Women’s Study. Fertil Steril. 2008;90(5):1640-1648.
3. Mukherjee S, Velez Edwards DR, Baird DD, Savitz DA, Hartmann KE. Risk of miscarriage among black women and white women in a U.S. Prospective Cohort Study. Am J Epidemiol. 2013;177(11):1271-1278.
4. Shorter JM, Koelper N, Sonalkar S, Oquendo MA, Sammel MD, Schreiber CA. Racial Disparities in Mental Health Outcomes Among Women With Early Pregnancy Loss. Obstet Gynecol. 2021;137(1):156-163.
5. Tanner LD, Tucker LY, Postlethwaite D, Greenberg M. Maternal race/ethnicity as a risk factor for cervical insufficiency. Eur J Obstet Gynecol Reprod Biol. 2018;221:156-159.
6. Petersen EE. Racial/Ethnic Disparities in Pregnancy-Related Deaths — United States, 2007–2016. Centers for Disease Control and Prevention. https://www.cdc.gov/mmwr/volumes/68/wr/mm6835a3.htm?s_cid=mm6835a3_w. Published 2019. Accessed March 30, 2022.
7. Why black women face a high risk of pregnancy complications. Harvard T.H. Chan School of Public Health. https://www.hsph.harvard.edu/news/hsph-in-the-news/black-women-pregnancy-complications/. Published 2019. Accessed March 30, 2022.
8. Boakye E, Kwapong YA, Obisesan O, et al. Nativity-Related Disparities in Preeclampsia and Cardiovascular Disease Risk Among a Racially Diverse Cohort of US Women. JAMA Netw Open. 2021;4(12):e2139564.