Fertility equity in practice: Black women's support needs and recommendations for infertility care.

OBJECTIVE

To identify the specific support needs of Black women navigating infertility care and generate strategies to improve access, patient experience, and outcomes.

DESIGN

Mixed-methods observational study.

SUBJECTS: Black women aged 18-45 years in the United States who were currently seeking or had recently sought infertility care.

EXPOSURE: Online survey and semistructured interviews.

MAIN OUTCOME MEASURES: Quantitative data on demographics and fertility care experiences; qualitative data on perceived support needs and recommended solutions.

RESULTS

One hundred seventy-six women responded to the online survey; of these, 41 women provided consent to participate in semistructured interviews with the study team. Most participants (74.3%) were 35-45 years of age, married or partnered, held an advanced degree, worked full time, and had insurance that covered some or all fertility services. Of them, 25.5% reported feeling undersupported by friends, family, doctors, or others during their infertility journey, with 31.3% identifying this lack of support as a barrier to initiating treatment. Participants described feelings of loneliness and isolation, with few affirming spaces or communities to find resources and connect with other Black women with infertility. They also shared examples of racism, discrimination, and a lack of compassionate care that led to dismissal of health concerns and delays in referral to reproductive endocrinologists that complicated their infertility journeys. Study participants provided several suggestions for clinics and providers to improve the support of Black women seeking infertility care, from enhancing patient-centered care to increasing access to Black reproductive medicine and mental health providers.

CONCLUSION

Understanding the specific support needs of Black women seeking infertility care will inform patient-centered, compassionate, and culturally responsive care that improves the patient's experience and outcomes.