I write as an urgent matter of public health. I write as a woman with over a decade-long journey trying to conceive my miracle child.  While the dream of holding my baby, after five failed in vitro fertilization (IVF) cycles, is still a dream, a birth did occur: my voice.

I write to every American gynecology and obstetrics department.  I am urging you to hear the cries of Black women yearning to hold their miracle child. 

Their cries matter and must call you to action in the fight for reproductive, racial equity.  Black women undergoing fertility treatment experience worse outcomes than their white women counterparts. Reproductive justice for Black women starts with dispelling the politicized and racist myth that Black bodies are uber fertile and consequently unworthy of full quality access to healthcare. We cannot wait for America to turn the corner from its shameful dark past of devaluing Black bodies and perpetuating harmful stereotypes of Black women being natural breeders. 

The fight for research into the factors causing greater infertility in Black women must happen today.  For example, reproductive justice is researching and understanding why Black people in Chicago make up 32 percent of the state's population but only 5.3 percent of those seeking fertility treatment. All the more alarming, considering fertility treatment has mandated coverage by insurance companies under Illinois law.

I write to every Black woman with an infertility diagnosis who is in her office, behind closed doors, reapplying her makeup before bracing the stare-downs and side-eyes.  I see the composure you keep while trying to look unfazed amidst 7 AM morning monitoring visits, waiting for beta numbers, scarfing down pineapple hearts, brazil nuts, bone marrow soup, and trying acupuncture as the "trick" to make it work, this time. All the while being careful to conceal the bruises from your nine straight days of blood work from coworkers out of fear of how your career might be impacted.  

I see you. 

Battling infertility while in law school at night and working full time during the day, and being a newlywed was equivalent to a trial by fire. The loneliness I felt just being a Black woman associate, let alone was rough and juggling the trauma of infertility all while trying to establish or advance my career, silenced me, as it silences the voices of so many women in the workplace.  

Even when I thought to speak out, I wasn't sure where to turn.  Infertility was never discussed among my family and friends. Though mental health awareness was increasing nationally, neither mental health nor infertility was being widely discussed in the Black community. Even though Black women are almost twice as likely as white women to be diagnosed with infertility, and less likely to seek medical treatment, and are less likely to be classified as infertile. 

We need answers to this evident racial disparity within the healthcare system. When Black women are in fertility clinic waiting rooms flipping through educational and advocacy pamphlets and resources, the lack of representation and diversity is unsettling. Further, our cultural code of "we just don't talk about that" does not help and only adds to the isolation, stigma, shame and is likely discouraging couples to seek treatment sooner.  

Keeping it all bottled up: the increased cortisol levels from stress, the treatments, the fighting for visibility in the firm, AND being a new wife affected my reproductive health.  I had excelled at just about everything else I set my mind on, but this one thing, I couldn't. I felt as if my body failed me, lied to me every month. I was disconnected from it and hated it. Today, I now know my body did not fail, but instead, something bigger was failing me. 

When I chose health law for my career in 2013, I had no idea the critical lens I would develop because of my own health journey when looking at the many racial disparities rife in our healthcare system. Even though I lived in a state with mandated fertility coverage, there were many costs I did not anticipate, like embryo freezing and coverage loopholes. I thought I knew all the right questions to ask, but there were warning signs missed and unanswered questions. 

When my OBGYN showed me the fibroid tumors during a routine check in my late twenties, she linked the fibroids to my heavy and painful menstrual cycles. Two other OBGYNs saw the same uterine fibroid tumors and reassured me they did not pose any serious health risks, but they neglected to discuss my fertility.  After the fibroids and heavy periods were dismissed, my mom and the other Black women in my circle talked of their fibroids and their similar OBGYN experiences. I was lulled into a false security until trying to conceive. 

Even though the causes of infertility can be unexplained and depend on the individual patient, uterine disorder of fibroids may contribute to infertility. Data shows that a quarter of Black women between age 18 and 30 experience fibroids, compared with 7 percent of white women by age 35, and that number will increase to 60 percent. While a definitive link between fibroids and fertility has not been established, the research on the correlation and prevalence is not occurring.  

What are we waiting for?  

It's been a little over a year since the tragic passing of my husband. I have since turned my pain into purpose. At times during our journey, we did not have coverage and had to pay over $100K for fertility care. Coverage and costs remain as barriers to so many other couples. My foundation, the Latoya and Joe Dawkins Miracle Child Foundation has joined the battle for reproductive, racial equity through industry expertise and fundraising for couples without coverage. 

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