As heart emojis flooded the comments section beneath this month’s British Vogue cover featuring Naomi Campbell and her baby daughter, the 51-year-old supermodel’s “she’s not adopted, she’s mine” quote increased speculation about donors and surrogates.
It provided an insight into modern motherhood for women undergoing fertility treatment.
Of course, the first-time mother isn’t obliged to share details surrounding her daughter’s birth but should she have undergone fertility treatment, she forms part of a small minority of black women, like myself, who have explored assisted conception. This is despite American research (British studies into black women’s fertility rates are yet to be prioritised) suggesting that we’re twice as likely to experience infertility as white women.
Despite fertility-challenging conditions such as fibroids and PCOS tending to affect more black women, and over 1.3 million IVF cycles performed in the UK since 1991, we are still being left on the reproductive side lines. The UK’s fertility regulator, the Human Fertilisation and Embryology Authority (HFEA), reports that black women are 25 times less likely to access fertility treatment, and when we do it’s roughly two years later than our white counterparts, who are seven per cent more likely to enjoy successful results.
The HFEA has committed to understanding the reasons behind these disparities as a way to promote equity across the fertility sector. They could have gained an insight into the situation through a chat with my mother, whose blasé attitude towards fertility preservation was shaped by the myth of hyper-fertility, a legacy of slavery internalised within the black community.
Her optimism that everything would fall into place led to me putting my faith in finding love on Bumble and the £7,000 cost of freezing my eggs — a substantial amount when research from People Like Us has found black women are paid 84 per cent of what their white colleagues earn — into buying a house .
“Black women are still being told by family members it will happen and to just pray on it,” explains Kezia Ashley Okafor (@iamkeziaokafor), author of Flipping the Script on Infertility and one of a handful of black therapists uniquely placed to support women struggling with stigma in their own community.
She would have been invaluable to me when, as a 40-year-old singleton, my ability to carry a baby was threatened by a neurological autoimmune condition which lead to me freezing my eggs two years later than the age the HFEA finds women most commonly undergo the treatment.
“When infertility isn’t openly discussed within communities it leads to internalisation and the extent of the situation becomes underestimated, meaning not only are people likely to seek treatment later, if at all, they’re less likely to become donors,” explains Okafor.
For black women like me, three per cent of sperm and egg donors share our ethnicity. Once DNA compatibility has been established, that number may dwindle further and it starts to explain why, according to the HFEA, 76 per cent of mixed race and 63 per cent of black sperm donors are likely to be imported from European and American sperm banks where importation charges can cost more.
For black women like me, three per cent of sperm and egg donors share our ethnicity
Should a woman require an egg donor, it means joining a long waiting list for the few donors on the clinics’ books or searching for a different treatment centre attached to a larger database. To find the most diverse database means heading to the US, but American eggs command higher prices and fertility treatments in a country are some of the most expensive in the world.
Then there is surrogacy. High costs affect access, with budgets for UK surrogacy hovering around the £60,000 mark. Considering a recent LSE report found that black women are the least likely to be among the UK’s top earners, this puts treatment out of reach for many average earners.
Black women can struggle to find candidates with a shared cultural background, add to that medical mistrust within the UK’s black community and it means searching beyond British shores - with surrogacy in the US costing from £150,000 to £200,000.
The fertility process is frustrating and financially ruinous. It led me to consider abandoning the process. But could it be that the system simply isn’t designed for me?
“The infertility industry is geared towards the majority and those spending the most money,” explains Dr Christine Ekechi who co-chairs the Race Equality Taskforce at the Royal College of Obstetricians and Gynaecologists.
“A more individualised approach to fertility could mean assessing women more likely to experience health conditions which impact fertility a lot sooner, before they’re even accessing treatment, and may minimise the nuances missed by providers which have limited experience dealing with the barriers faced by black women.”
The fertility process is frustrating and financially ruinous
She believes dismantling economic barriers and extending diversity throughout the fertility space are key to creating equity - something which is starting to be seen amongst forward-thinking businesses and organisations.
These include the British Pregnancy Advisory Service which is making treatment more affordable through the launch of BPAS Fertility. It is the country’s first not-for-profit fertility clinic and charges £3,500 for a full cycle of IVF. According to the NHS, the average cost is about £5,000.
The Ebony Concept, founded by obstetrician and gynaecologist Dr Edmond Edi-Osagie, sources donor eggs and surrogates for British patients from a Nigerian database with treatment taking place at its Lagos fertility clinic.
Black women can also access tailored advice from Fertility Network UK’s support line (0121 323 5025) and connect with women through its Black Women’s Fertility Facebook Group. Members can attend online events as well as share experiences and advice with others going through what can be an isolating experience when you’re not represented within the infertility narrative.
Meanwhile, my mother was right and things did fall into place - eight years later than ideal for my ovaries. I’m now exploring my options alongside my partner.
Fighting to overcome challenges can seem like it is part of my DNA as a black woman, but my experience leads me to believe the onus should be placed on the fertility industry where simply being seen could start to dismantle the barriers standing in the way of more women becoming mothers.
