Go ahead and begin. This is I'm Mary Martin. I'm the Associate Dean in the Graduate College and it's my great pleasure today to introduce to you Jamail helix than to welcome all of you to her presentation. We're very happy that she does come forward and wants to share with us her research on her topic in a little bit about her personal life and her bowls. And so she's going to introduce herself and take it from there. So once again, thank you all. Now if you have questions that you want to ask or within the presentation, just use the chat and I'll try to read those questions to her once she has she has finished. So to Mel, Take it away. Thank you, Mary, I'm it can everyone see my screen? Yes. All right. Great. I got a baby in a backroom. Good afternoon. Thank you everyone for showing up. Today is a beautiful day. I know because the outbreak to have lunch outside or do the readings the end of his time. But I really appreciate everyone joining today as Dr. Marissa. My name is HTML Higgs. I'm a master's student in Human Development and Family Science. This is my third year. I'm a part-time students. So those things take a little bit longer when you're gone part-time. So this is my final semester in this program. And my thesis, my research focus is concerning black women and in fertility. And I'm excited to share some of the preliminary findings today before I do get far as Natalie. Thank you. I'd like to thank my department for being just such a supportive department. And also my thesis committee, Dr. Anna Villa, dr. Roger carry, and Dr. Shaw. So just getting started, how did I get to this research topic and just how did we get here? So there are three major things. One thing is that this is my personal lived experience. And for those of you who do research in social sciences or sometimes an experience that you've lived, you begin to wonder, Am I the only 01:00? Am I an anomaly? What's really going on? Is there a larger phenomenon? And so with that, from some, has some faculty. And to look deeper into this, this is one of the catalysts. The other part of that for me is there has been a recent focus in the past few years with black women's health, specifically around black maternal mortality and morbidity. We know the United States, generally speaking as a quote, unquote developed country had abysmal maternal mortality rates. In black women suffer higher rates. And the research shows that there is no, It's not related to economics or social standing. It's just, it's a systemic issue. And I started to kind of connect the dots looking at some of the Dann I'm going to present later about black women at other reproductive and gynecological help. And just generally speaking, the infertility experience is somewhat of a unique experience. We'll get into statistics of how many couples experienced this, but just there is a uniqueness to it is not something that thankfully everyone does an experience that so just digging into that experience like what is that experience like and looking at how that, how that affects women and families. So for you started, obviously you have to define some, some things before we get really deep into it. So the first thing of course, will be what is infertility? And this is the medical definition. It is a disease. That is the buyback, failure to achieve a successful pregnancy after 12 months or more appropriate intercourse or therapies. And for women over 35, the period is short to six months. There are some additional medical definitions and restrictions that are put on by Athens and larger agencies like the CDC when they're looking at fertility rates, things about marriage and ever being pregnant and being pregnant and keeping a child. But the blanket term for now in fertility, if you're able to get pregnant, being able to carry to term all those difficulties. And going forward about just a little bit of statistical information and just a little bit just some numbers that they're out there. One in eight couples in the United States struggle with infertility. So that's about 12 percent in their worldwide. It's 48 million couples, 186 million, one hundred and eighty six million individuals. Treatment for infertility can be rather costly in the United States, starting with a round by 1000, going up to 330 thousand and above. Oftentimes it does not include medication. This is just doctors visits, treatment, all those other things. Oftentimes medication is a separate cost. Most insurance plans do not cover or do not cover fully any of the costs for infertility. There are usually lifetime caps on the money that can be spent. There are some states that have passed mandates for an insurance mandates that the infertility is covered. There are 19 states currently including Delaware. Delaware recently joined the ranks of those states that do require that. I'm not sure. I don't use our herd the UV and store it. So I'm not sure when that has kick them, but I know about a year or two ago, very pre-pandemic, like right before pandemic that pass a Delaware is among those 19 states that does have an insurance coverage mandate for infertility coverage. The other operational kind of thing we need to discuss is what's called ART assisted reproductive technology. And those are things like, most commonly is IVF in vitro fertilization. So if anything, we're eggs or embryos are handled outside of the body. So anything going into putting things together in, in lab and then replanting back into a woman. So doesn't have to be the host. Mothers who just could also include surrogacy. And IVF, again, is the most common ART. In IVF, is the process in which eggs are removed from a female's ovaries, fertilize with sperm outside in a sterile lab condition, in a sterile lab situation, and then transfer back into the uterus. Again, it can be from the host woman or it can be to another woman. Little bit of fun facts. The world's first baby, cosine the IVF with Louise Brown in the UK. And she was born in July of 1978 and the first baby conceived in the United States. The idea is Elizabeth Carr and she was born in December of 1981. So the science has been around for many, many years. Some scientists that go take out back to the 1800s were things that they were trying to work on. But around 195859 is when the work really began on this technology, medical technology. There are less invasive ways to treat or two, to work with. Difficulty. Conceiving what's called AUI, intrauterine insemination. Sperm or prepare you to like Washington, they are reinserted medically into the woman says a procedure done in an office. Things like hormones and supplements. Oftentimes a weight loss because that may affect for hormones and timed intercourse. So those are kind of like the baby steps. Ivf is like the the big the big momma of it on are usually depending on the current condition of the woman and what they are with the couple was already tried. These are some of the first steps. So just to get those, this is not a medical obviously I'm not a medical student or a nursing student, but just the operationalize them of those things and get those things out of the way. And speaking specifically about black women in this space in terms of infertility, black women struggle with infertility at two to three times the rate of their white counterparts, but they are less likely to seek treatment. There is, some sites have found there is some stigma there. And there's also just a knowledge base difference. So this is where we get into and through these things where we are suffering higher but seeking treatment at lower rate. Black women also tend to suffer at higher rates from other gynecological and hormonal conditions such as polycystic ovarian syndrome, uterine fibroids. So those things can affect fertility. And blue and black women experience these types of things. They, I'm experience an earlier onset and they tend to have more severe symptoms than their white counterparts when they experienced these things. And again, similar to black maternal health and mortality, mortality and other health measures. Socio-economic status and access does not mediate these concerns. So it doesn't matter if you are on public assistance or if you are a tenured professor, it doesn't matter. You are just as likely, sometimes more likely to have some of these conditions. And you are just as likely or more likely to have fertility issues. It does not matter your socioeconomic standing. So I was interested in learning more about how black women navigate this experience, giving their culture, the cultural importance of family, and the black community in navigating position motherhood, as we'll talk about a bit later, motherhood and family is very key to key culturally. So how are Black women navigating his experience when it comes to family outside of their partner, their broader family, their siblings, their parents, even their friend groups. What this family began to look like, what does woman who begins to look like? How are they making meaning of family when they're faced with these sorts of challenges? One of the reasons I wanted to look into this is to normalize the conversations and increase awareness about black women in fertility, it's pluses. And also just add to the discourse around black families, black middle-class families. Specifically, I am, I did look at black middle-class women for several reasons. One being obviously access to treatment, having assurance, or possibly having money on hand or savings on here to experience these treatments. Obviously, if you do not have the money, the funds, this cannot even be a conversation or thought for you. If you don't even have insurance coverage or money to go this route. Also, a lot of the research in the past when it's come to black family has focused on impoverished families, clinical inner city family. And that is limiting the view of black families. While there are definitely black families who are at the poverty line or beneath, there are also black families who live in a diverse, in a wide range of socioeconomic statuses. And that's often overlooked. And it puts black families in a box. And it kind of perpetuates that cycle of saying that black people are this and we are here, we're only in the projects were only are these urban spaces. And this is not to be elitist or classes, but it's just to expand the view of the black experience in America and what black family is. And it's important to look at systemic issues, how they affect the culture across the board. So then you have a broader picture to say this is, you can kind of start to separate out. Is this socio-economic? Is this a cultural like? Where is it coming from when you're able to look at a broader sample and kind of expand the lives of what the experience is. And just very quickly just to talk about where we are with the literature or the majority of infertility research misconduct that using white upper-class women with the sample, whether it's quantitative or qualitative, that is usually the sample that's being used. There are some that may have small numbers of Asian, Latino, or black participants, but the vast majority of the sample are white women. Many studies example the psychosocial responses to fertility treatments and process it and not so much the experience of B up involuntary child looseness or what that means within a family context. And there are some things that I've looked at the partner a dyadic relationship, but not the broader family. The most notable study peer reviewed a published study to date that looks specifically and exclusively add black women is a 2015 study. Violent and infertile and intersectional analysis of the experience of a socioeconomically diverse women, African-American women with fertility, long title. But that is the most significant to date peer reviewed article regarding that, I personally habits and know that there are, I've met several people the past few years who are masters and PhD students who are looking at this issue. And I've met nursing students, public health, medical students, nursing students. So I think this is a brewing issue and I think in several years there's going to be much more research available. I'm looking at this, but everyone's kind of in that. We're all baby academic that this coin or students so weird that it's in the pipeline. But those things I believe are coming because I have seen some other folks research out there. But in this study, there were a lot of several findings and one of the key findings with a sense of finally, it's black woman usual or silence. Theory. There are a lot of culturally, they usually tend to keep the experience to themselves. There is a cultural expectation of motherhood they found, and we'll talk a little bit into that later. An impaired sense of self and gender identity. And that is also a good segue to say that this issue of infertility is very intersectional and very has a lot of, it kind of has a lot of tentacles. It can go into a lot of different places talking about stratified reproduction and in insurance coverage generally and insurance in the United States and LGBTQIA, family building. So there are a lot of kind of like touching and overlapping issues, but we're not going to get too much into those. I don't get too much into those just because they're outside of the scope. But they are very much so related and interrelated to what's going on. So just talking briefly about black family and mothering in the past by families had been portrayed as non-existent fragments it, or deficient. However, recent study found that many African Americans routinely interact with members of their family and display high degree of family closeness and exchange support. So again. Now people are kind of re-examining what's been out there. A lot of deficit framing of black families and look, taking a more broad view of what family looks like, a wet that family context is and legitimize the black family. Again is also there's been a pass heavy emphasis on low SES family and not taking abroad abroad, look. Black families are often noted to have characteristics that include gender role flexibility, resiliency, adaptivity, and some structures that are remnants of West African family traditions such as strong kinship bond, collective parenting, high value on children. Continue on with that going out mothering specifically black women and mothers again have been framed and negative live characterized with Mami trolls, welfare, queen, sapphire. Those are tropes that have been around since slavery or before ways of framing black women. And there's actually, I was reading some things and there's like a twist on what we've caught now we call the strong black woman, which is supposed to be like this empowering notion. But there are kind of some negative connotations that come with that as well. So that's usually how black women are framed and not in abroad and more nuanced way. But within the culture or mothers and motherhood are highly revered. Becoming a mother is one of the most significant personal and social identities many black women take on. And it is see, motherhood is seen as a significant marker of womanhood within black culture. It's something that scholars Shirley, he'll have called the black cultural ethos of motherhood. And it is again, a significant marker and cultural, culturally significant in black culture. The existing research does show, of course, that there are across the board. Psycho-social impacts of infertility and stress, shame, guilt, low self-esteem, feeling worthless, unattractive, or different or defective. The stress of actually going through there, since I found that just the going through a protocol in and of itself increases stress. And it can be related to the specific diagnosis, the age of diagnosis and a so all those factors play in on, they're also very real feelings of grief and loss that accompany an experience. Infertility. There are also some stigma related to infertility, social stigma, the disapproval of an individual based on social characteristics that are perceived as undesirable and that person is disqualified from full social acceptance. It is, it's been referred to in fertility, had they referred to as a universally stigmatizing condition. And so then there's a decision to make about this closing and talking and sharing information about what you're going through. Literature regarding Black American and African cultures note that child free women may not be fully recognized in their community as a woman. So these are the types of thing that Our of interests and what happens when I'm a grown woman but I don't have children. So how am I how am I being perceived, Tom, I'm navigating my family when I have a job, have degree, I go to work. I'm fully a fully functional adult. But by not being a mother hat, does that disqualify me or does that like bluff me down the pecking order of family? So these are the type of things that I was interested in learning more about. And there are there again, there's research, some of the research that has taken place in their path in African countries binding that women in that cultural, it's stigmatizing and that those women did not achieve adulthood status. Button, they were not a mother. And so there are two specific ideas that are important to this as the motherhood mandate in the black fertility mandate. And these are based off of pronator list ideas about social someone's value, social value linked to parenting mothering, specifically. The motherhood mandate was created by, as a term coined by Nancy Rousseau in a paper in 1976, characterizing the form of a mandate which requires women to have at least two children and to raise them well. And the expectations to fertility are obviously based in biology, but there are enforced through our social cultural norms. And there's also the black fertility mandate. This is something that came out of that avail study in 2015 about that exclusively looked at black women's experiences in fertility. And that is the belief that it is a theme that they found and immerse going through their interview data. And it is anchored in stereotypes around black, hyper fertility and sexuality myths, as well as the cultural messages, again, the societal messages about mothering and what makes of the mother. So it is the expectation that black women are fertile. If women don't hat and this is something that is believe in culture and outside of black culture. So this is a kind of universal, but it is the belief that black women are naturally fertile. They're naturally fertile and they don't have fertility issues. So it is something that is internalized within Black culture and it's something that also bleed outside of black culture. And we'll get into that a bit as well as particularly going into a medical setting. So those are two key points to think about. Just this two kind of two key main ideas when it comes to women's experiences with infertility, in general, specifically to the motherhood mandate. Because that is something that comes up in any pro nameless society. You anywhere, there's an expectation that mostly Western societies that a mother, a woman equals mother. And it is expected of you as a woman to become a mother and be a successful key also to be a successful mother. That your children are raised well, they do what? They'd been rates. Do they go to college or they go to the army and they are become productive members of society. It's not enough just to mother that you are a quote, unquote, good mother as well. Also looking at this through what is called life course theory that looks at how chronological age relationships and life transitions a bit kind of impacts one's life. There are several broad concepts, cohorts, which you could also think of as like a generation. Not necessarily, but that's a good example. Transitions your life trajectory, life events at turning points and looking at motherhood or not becoming a mother as a turning point and in fertility, a fuzzy at the life of a life event is as a significant occurrence. The evolving rather abruptly and changes your life course. In a turning point is a major lipid. They are transition, so it comes, so mothering AND OR NOT mothering could be a turning point and definitely an fertility diagnosis could be a life events. And there are some other sub, sub themes to life course theory, the interplay of human lives and historical time, meaning how our lives are connected, what's happening, what you experience, I'm experiencing today it by fears that 20 years ago, what does that experience like and whether it's somebody having this experience 40 years from now, what is that like? The uninterrupted agency. So your ability to make your own choices and take control of your, your situation as much as possible, the timing of live linked lives. So how what you do is linked to those around you. And there are some other newer theme, diversity in life course trajectory and developmental risk and protection. Also, using a bit of black feminist theory. Black feminist thought or consciousness is the recognition that black women are status deprived because they faced discrimination as race and gender. So again, that's a big bazaar right now, intersectionality and all of these things. But as a woman and then if a black person in America, you're kind of doubly oppressed if you want to say or you're experiencing multiple, multiple realities at once and looking at that and the idea that black women are valuable, period that their experiences are valuable, their experiences their existed, but they are valuable. And enforcing that in a culture that tries to devalue them. Agree, our own beer crate, creating our own ideas about the meaning of black womanhood through collective and lived experiences. And this is where this work is kind of intersection of the point of being a black, what being black and being a woman and being in fertile, which is, you could, if it's something I shared that is a marginalized place because fertility and being able to naturally get pregnant is kind of the quote, unquote Depot. And what does expect, there's something you kind of become a bit marginalized by having those difficulties. But just wanted to lay the foundation to talk a bit about that. Think it a bit into my research. So I'm still analyzing, it's still going through a lot of the findings that I've that I have. I did. So what I did was I conducted to semi-structure focus groups. Each group have five to six women. The idea sample size was 15. Of course we have a tracing. You have people who just didn't show up or didn't respond to things. So I ended up with 12 women who volunteered a were excellent conversations. Some of the criteria that was that they needed to meet was that they identified as heterosexual, cis, Black woman that united resided in the United States. Again, there are a whole nother thing to talk about LGBTQIA, family building and using ART and all that, which is rich and FC some information on that as well. But I want to keep it focused on women for this particular venture. Living within the United States and also expanding the idea of black. So the reason I use black and not specifically African-American, is that I want the experience of different cultures through the African Diaspora living in America. So those who are born and raised here who are the descendants, most unlikely, of enslaved people. Those who may be immigrants recently or within the past 24 year, they may be first generation. So that also includes people from Africa, from Latin America who Afro Latina, Caribbeans. So expanding that ideas are not just those who we consider black Americans, that all those who reside in the United States who are, who are of the African diaspora, who are residents of the United States. The ages between 25 and 45. They or their partner are medically diagnosed with infertility and not medically sterile. And that's something that being medically steroids also standard from like CDC mean they do not have a hysterectomy. It has been had the head of the second mean that those can be reversed, but there's no medical intervention that causes the infertility, such as ovary removal, uterus removal, things of that nature. Again, focusing on economics, the annual income between forty two thousand and a hundred thousand per year for more, but those were the parameters, at least within that. And so those interviews, the information is still being analyzed, coded and looking for existing things such as the mother had mandate, like fertility mandate. One of the things I did forget to mention within Black Feminist Thought is the idea other mothers and asked us is the idea of black women mothering children with people in the community that are not their own. So nieces, nephews, but also fictive kin, your best friend's child or the neighbor down the street so that you have mothering to those who are not your biological or legal innocence of adoption. So not including biological children are children talking about community children are again like fictive kin, those who are close to you. That idea. So I'm looking for those existing things, but also looking for what, what themes come up with anything new or interesting that came of all of this because the sensitivity of the topic, all other participants were given an alias that we want, participate it anonymously. We of course, in the Zoom age, did these interviews over Zoom though that was actually a benefit because I was able to get women, not just in the Delaware Valley area, but I was able to get women across the country, which gives a diversity of experiences as well. So all women were given an alias and the use of cameras was by consent of the group. So they didn't have to turn on their cameras, but I always say it made the conversation a little richer. We could look at faces. In both sessions. Majority of women did choose to have their cameras on so they can participate in the conversation. A bit about the demographics of the sample. Again, there was 12 total participants. Most of them over 30, 32 percent of them were over 40. Almost 60 percent of them had done one to three protocols. Meaning they've done some type of treatment, IVF, IY, some type of fertility treatment. And the majority of the sample, 75 percent were married. So these are all the demographics, but these are just some of the key demographics here. As you see, most of the salaries pretty well split. But the average was between 70 and 130 thousand dollars, excuse me, as an annual income for the women in this sample. So some of the emerging themes that I've found kind of a Mac birth path and a half had to be at the interview data is that there is a sense of guilt or sets of disappointing their family, specifically their partner or their parents allowed the women express apologizing a lot to their husbands. One of the things that I neglected to say that one of the criteria is that it's either the wife, woman only, or it is male and female factor. It could not be exclusively male factor. Research has shown there's a different dynamic that comes into play when the infertility is solely the man. And I should mention that up front. This is not solely a knee issue. I mean, a woman's issue, excuse me. Men do also suffer in fertility. They have sperm count issues, sperm motility, things of that nature. So this is not to put the onus on the woman because there is a male factor involved as well. But there was a sense of guilt. A lot of women express, like I said, apologizing often to their husband's feeling like, Oh, I've dragged and I kind of dragged him into the sampled them into this. Situation though, oftentimes the husband with aware before marrying or is it something that conversation that they had and the husbands didn't per the report of the participants, didn't have any guilt. I mean, didn't have any resentment or anger or if they did, it was like something they worked through and it was resolved with more talky. So that was very heavy also with parents. So not this was not something that was brought reaching to extended family. But with parents, particularly those I had some who were only children who had parents who were very sterile, who are elderly, sick, who had passed away. And there was a sense of guilt or if a sense of disappointing them. Because usually those situations being an only child and kind of having a legacy stop with if they do not have children, that they will be the less of that legacy. Something else was being the rich auntie or the fund IT. And that is just the expectation that the child free women would step in and step up for their actual kids or nieces or nephews or fictive kin my God. Children or just, you know, that you're on team when you call your auntie though you're not really related. And that was both voluntary and involuntary. So it's the expectation at 0 in town. You need to get over here and you need to come hang out with your nieces and nephews. Kinda like a drop everything. We're here. Your nieces and nephews are here, Get over here right away, get involved right now. So there's that expectation. There was also a financial expectation of you. It's kind of, you know, we expect you were does birthday party you why don't you get this big give all I want this. You know, even sometimes the children themselves would come to the participant or sometimes a with the children spirit expecting or kind of asking or requesting something financially, a little huge. Some women did take this role on voluntarily to do extra kinda go above and beyond. So there were instances where it was voluntary and there were some where was kind of forced upon them. And that's kind of that sense of other mothers is taking care of particularly when it's voluntary. Like taking care of some said like, oh, I'd like to call the bubble the new movies. I knew new Disney movies alders, that cool exhibit at the Children's Museum. And they call up and say, all can come pick up so-and-so and let's spend the day. There were some who had one participant say it's hard for her to see herself. They look wonderful on t because she thinks that she's eat all her aunties had like these older women. But then she realizes like, well, I'm in my 40s, maybe I am an older woman to the children, but in her mind, she's like, I don't think I'm in IT. I'm young and find new. But you know, that it's more of not so much the age, but more of the role that the woman takes on. A new finding out of this group was that their relationship, their partnership was strengthened. By going through this adversity. They were able to kind of come together and talk more a kind of force, better communication between the partners and it strengthens their relationship. There are also women who express their frustration at clinical doing things the right way, meaning you follow that prescribed method of you go to school, stay away from boys, will keep your legs closed. And this is also something black culture there is that we want to succeed. We have to try extra hard. You have to push on all these distracting, especially at the black woman. We know black women are high, you know, some of the high, most high as highly educated population in the United States. So there's a focus on goals to school, live your life, do all these things. Then you meet somebody and then you get married and then you have children. And their width, there was a bit of frustration where now I'm at this point I did all these things that I was told to do. Now I'm at this point where I'm shelling out money on doctors and I'm having difficulty and I'm doing all these things. So there was a bit of frustration. However, not many expressed regret like many women express that I would not change, that. It's worse, it's frustrating that I'm here, but I've been able to travel as enablers to get degrees. I've been able to buy a whole. I've been able to do these things because I didn't have a child at 20 or I didn't I didn't have a child younger. I was able to spend more time with myself, spend more time exploring the world. And so they were grateful for that experience. But there was again at a level of frustration where maybe if I had done this detour, things might have been different, But then I wouldn't have had the resources to tackle this problem. So that was kind of conundrum there. A lot of women also express joy in the success of other women who struggle. So learning that a friend that they made who's been struggling with fertility as well, has gap, successfully pregnant and had a child or even adoption that the friend going into motherhood or someone who also experience difficulty transitioning into motherhood, brought a lot of joy. They didn't have the same amount of joy necessarily what it was just someone who naturally got pregnant, not that they weren't happy, but there's a different level of joy because they understood the struggle and how difficult it had been for them. Um, and there was also someone who mentioned this is our baby. So there's like a joint ownership of this is our baby. This is, you know, we've all work. We've watched each other go through this difficult time. And so this baby belonged to all of us. So there was that too. The key thing that kinda fall outside of the scope of family and relationships that came up. Or lack of education and awareness of reproductive health and disrespect that unequal treatment from medical professionals. This came up over and over again. And this was touched on several things though. Women found it difficult to share because they are met with a lot of pushback or a lot of room questions or comments. And it's not, they understand, it's not purposeful. It's just people don't understand what you're going through. And so there's a bit of hesitancy to share. And as patients themselves, they understand they did it. No. You don't know what you don't know. And it was a lot of I wish that someone had told me that this could with a possibility. I wish someone told me about PCOS before I got diagnosed with PCOS and now I'm here. I wish someone told me these things about fertility, about reproductive health before I got into a sort of crisis mode, I wish I had that information and wishing that those around them generally had that information. And that includes and I had some who were very specific and including black men and this as well because they were also often left in the dark. And you have when there was a dual infertility diagnosis, they're both in the dark about what are we supposed to do. You're trying to process all this information and having to go to libraries or go to Google. But do all this extra, extra legwork to understand what's happening. And there was an emphasis that I shouldn't just focus on women having this education, that men as well needs to have this education. They can make better decisions and then they can understand what's going on. And the second part of that was treatment from medical professionals. And I go again so that black fertility mandate, so which was president and other places here as well. The internal belief that black women just get pregnant, but externally, there is a belief that black women don't have issues getting pregnant. Getting funny looks, where are you Here? There? So that type of situation, um, there's an anecdote shared that there was one participant who had gone and had to go to several doctors before she was listen to and believe and before she got diagnosis for herself and her partner, that was helpful and was able to move them along the track of getting done, what they wanted to get done. And there was a lot of agreements and that it's similar similar experiences. And again, for me, the overlap with that is also with black, the black maternal mortality. That is what's experience as well when black women are not believed in medical settings on their spirit talking about their pain or they're, what they're going through and they're not believe. This is a larger issue with black patients in the medical and medical settings are not believed about pain levels. It's believed that black people can take more pain. That their study with resonance couple years ago. That even there's a belief by some that black people have thicker skin, literally have thicker skin. So there are all these archaic medical beliefs about black people and other, other culture, latino cultures as well. So there are these old stereotypes and things that don't die that are affecting care for patients. So though that will, these two things are not necessary related to family experiences. These were two things that came up a lot about being connected and B, how they're treated in medical settings, as well as being educated and feel like they're not being educated. Had their medical professional like they're not. They're regular annual gynecological Chekhov, no one was telling them about freezing their eggs when they're 27. If that's something they would like, they didn't hear that, but they know that they're white friends heard that. There have conversations and I go, Oh yeah, my God, let me actually remaining for that. I'm not really dating anybody. I don't I don't know what's going to happen. And there are women Gua will not. Doctors never told me that. And on paper they are the same but they're not getting that same information. So there was a concern about that. So those are the preliminary findings that we have seen with these conversations and the implications of this. So Bradley, apply, apply this type of thing clinically in terms of therapy and counseling. Helping therapists have a better idea of what pieces maybe going through. And even in, in fertility clinics, there are some who have therapists on hand or require some sort of counseling while going through that. But that's rare. It's not a requirement. It's not something all clinics do. But this is something having this type of information may cause may be something that is a part of treatment. And having culturally responsive therapy. Rather it's related to the fertility clinic or not to help individuals and couples through this time. Of course, there's also impact on health policy. So talking about insure insurance policy and what should be covered in which shouldn't. Also obviously as I just discuss a medic clinically in a medical setting, properly training medical professionals about other cultures, generally speaking, make sure we have a culturally competent bedside manner or we're treating patients and giving information equally and not making assumptions when someone comes in the door about their socioeconomic status or their access, or what their body is able or not able to do without having conversations and having a full medical motto, work up. And of course, public health is again with the education piece, is educating the public about having more information available about reproductive health. Often people talk well, things like reproductive justice, those type of things. But really talking about reproductive health, having those conversations probably as early as mitt, like when we're in school, we're talking about Brigham banana that I'm talking about, sex ed curriculum and talking about not just how you know the basics of sperm and egg and that's how you get pregnant. But let's talk about the deviations of that. What can happen, what can go wrong, and having a more educated populace. So that's where I am, where we are with my research and I will be sympathizing and finishing all death I can turn in my thesis, I can graduate from this program. But that's where I am with that. And I think all of you for your time and again for a 10 day. So if you have any questions, feel free. First of all, first of all, HTML and wanted to thank you for a very excellent presentation and very thoughtful presentation about the issues and the concern that women would have and the importance of mothering to women. And so I do want it to it over to our audience to ask questions. There are a couple in the chat I can bring up, but let's just see if anyone right now would like to ask you a particular question and then I can ask you the questions that are in the chat. And they would like to ask or exchange a conversation with HTML. Okay, go ahead, Alyssa. Hi, do now I actually just join a little bit later. I missed like the first half of your presentation, but I wanted to know what were like, What did you do to analyze your data? Because you mentioned the different themes that you had with the participants. So what kind of method did you use a Beijing use a thematic analysis, like what did you do? Yeah, So if I say right now, I'm kind of like this is just a general call. Those I've done like a thematic analysis. Like I bet you, they like some of the themes that I knew that I expected to come up like the motherhood mandate or so looking for those on my first pass. And so now kind of going back and I'll just from like my first, I will say pass and a half. But Riyadh use Google, I may use Zoom. So there was a transcript, but transcripts on horribles, I had to like go through a Clay's of doing that clean and then actually going through and looking. Those are the first few things that I saw it. So I'll continue to do it in that way and then look for new things that come up. For example, with the dyadic partnership being straight then with that was something that I didn't expect to find and that was a theme that came up. So I'll be like conceiving of it that way. Thank you. Anyone else has something? One of the questions in the chat HTML was, did you collect information on me, race, or ethnicity of the partners and also whether or not the partner's role the partners had in the medical visits in, in terms of influencing the medical professional to to work with a black women? That's actually a great question. I did not collect data on the partner, the race or ethnicity of the partner. I did not do that. I'm actually pretty good. Huh? The topic for the next time. I did not. But from in terms of involvement, just from the conversation, a lot of the partners are very much still evolve even when they are not. Some of the women had male factor, so obviously they weren't ball because they also needs to go to a specialist and take supplements, things of that nature for those who the men were not the causeway was solely on the woman. They were all very supportive and they did go to visits and they were in on the process. So all the partners had those who were partnered. I do see the other question about the the demographics about partnering. Those who are partners so that the breakdown was partnered with partnered I broke that said partnered and married. Partnered and long-term relationship, meaning that they don't live together and partnered long-term relationship, but they live but they cohabitate, but are not married. So that was the the different breakdowns and of course, single. So that was the breakdown of the relationships. Thank you for answering that question. I also have a question regarding just people who were partnered and I'm sorry if you set it and I missed it. But when the infertility was male factored, was there a sense of blame for the woman anyway? Like even though even though the actual cause was the man was a woman, more kind of piled on are looked at as the reason. So it for my study I did. There was no one who was excluded, those who work exclusively male only because the research has shown that, that basically that's what happens, is the woman still take that on and they have take a protecting role of the man. So I wanted to try to factor that out. But even for those where it is dual, whereas both man and woman, the woman still feel most, they express feeling most of the responsibility even though they know it's the both of them, several of them expressed that they still feel the weight, the diagnosis. And it's often because also they're not sharing. So they're not necessarily upfront with oh, yeah, we're having people are just asking like, well, where do you want to have kids and they're not always forthcoming with what's going on. And then when they do they want to like meter it out. They don't want to go like, Oh, Joe had the low sperm count in. I have fibroids like they don't want to put everything out there. So then they're trying to do this dance of trying to protect their, their relationship and trying to protect each other, but also get people off their back, but they also want to educate people. So there's this very like weird dynamic that's going on there. I just want to say that was a really interesting presentation and I'm just curious if you've gotten a cost. The work of a medical anthropologist by the name of Mark shot into along. And she writes about in fertility in the Middle East. She's done various ethnographic studies among low-income women. And it might just be interesting for you to read some of that if you haven't already, because it's everything that you would describe also the woman taking on all the blame and all that today until I had I had her values books. I hadn't really thought about the issue of one. It's like for women's status. When she cannot enter in a culture where you have to have controlled, you just knocked down and you can't have childhood. And the woman is always blamed, even though we know medically that that's not too. And the women will go to unbelievable lengths to try to have babies like they will do terrible things to themselves. So I just think might be interesting for you to look at that. And in my most recent work has been on men and sort of men's reactions to infertility. So I wrote that down, dr. Kenneth back there that are going to be like No, we're reading back, have a right hand as well. Not my area at all, but I feel that all of her works because this, so she's really an anthropological circles. She is really well known. Work is just, it's, it's very interesting and it really gets you to thinking about what is going on and the whole issue of mothering and motherhood and how it's in truck went did not want it to say that's actually at this point, there's not that much academic work on motherhood at all. So it was popular for a while. I've done it sort of faded out. So I was very interested to hear that this is what I think it's necessary because the world has changed a lot and yet in some ways it hasn't. So thank you. Thank you, Dr. Jonathan. I wrote that down now we'll definitely be looking it it's been, I will say a difficulty with this project is what is there? There's so much great information. So I do kind of get into the psych rabbit hole of bathe and I'm like, I have to pull myself out and like Okay, let's focus. But there I did Rhea study leave of Israeli women and it was very similar how they're expected to have to mother and their status is very much so based on their motherhood and how they are perceived in their culture and in a country like with I'm not being mothers. That's most of the very interesting research had not been in the United States, it's been in Africa and the Middle East. 7 in some studies in India because of the way their cultures are. And here in the United States is still like, such as taboo to talk about. So the things that, that research that seen so far that's come out of the United States is more just very like how does this, what does the stress level and what is the, you know, there's not going kind of the next layer under they're just either it's medical or they're just talking psychologically or psychosocial about like, what is this and not kind of go in a little d, I guess we're still, it's still kind of taboo here. We don't really want dig in to the next layers of it, though. It's been very interesting. I was wondering with the women that you interviewed, did you did you ask them when they when they finally made the decision that they couldn't bear their own child, what kinds of decisions that they make about whether adoption or otherwise and if they did do have the fertility methods are and were successful that way, what were they then accepted in the community in toward motherhood? Even though people in the community may not have known they were the natural birth mother. Did you find anything about that in the literature? Excuse me. So in my in my interview sample, none of the women are biological mothers. So none of them have yeah, Have mother there is wine with an adoptive mother, but she was still pursuing I mean, it's known that she was there. Her husband are adoptive parents, so that's not a secret. But they are still pursuing treatment. So they're so to date, none of them have had birth anyone. And there were varying kind of feelings about going towards adoption or just choosing to live. Ciao three, I think at the, at the point it's at that point in time most are still very invested in triad. They weren't quite ready to make the next set of decisions yet they were still very much making a decision about treatments. What to do, when to take a break, how can we afford it? So there they were still very much so in that mode and not ready to move on to the next set of decision-making is just wrong, worthy, worthy be accepted after they have the child in a different way in their community. Now, that would be interesting to see how that changes. Great. Thank you so much. Anybody else have another question before we close? Just want to thank you so much HTML for our presenting today. I was a very interesting topic, gave us, gives us a lot to think about in relationship to what these individuals faced with the decision of infertility. And I think that we want to recommend that you continue on in your research. And we hope it all goes well and we'll hear more about what you do. Find out that helps this population of individuals. Very good. Thank you so much. Thank you so much. Thank you, everyone. Thank you. Thank you.
Jamel Hicks: Black Women, Family, and Infertility
From Jessica Netta March 22, 2022 Created from Clip of March Graduate Student Seminar Series
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Infertility affects an estimated 12% of women in the United States. Black women experience infertility at higher rates and tend to wait longer to seek treatment. Black women are a population whose experiences are often missing from the literature and research examining family building and infertility in the United States. Jamel Hicks' research aims to highlight the gender, racial/ethnic, cultural and emotional experiences of Black women as they negotiate familial aspirations and challenges, and the lived experiences of middle/upper-income Black women facing fertility challenges.
Hicks is in her third and final year as a master's student in UD’s Department of Human Development and Family Sciences. She holds a BFA in dance with a minor in African American Studies and a nonprofit management master's, both from George Mason University. She is a former dancer and teacher and a current nonprofit professional who is an emerging blogger and advocate for Black reproductive health.
Her research interests include family and community and Black family and community, specifically, mothering and reproductive health.
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