Why Black Women Face Higher Infertility Rates And What Real, Affordable Options Are Within Reach

For many Black women, the road to fertility can be paved with personal and private struggles. Higher risk of reproductive conditions, delayed diagnosis and unequal access to treatment create a public health gap that disproportionately impacts Black women. According to CDC data, Black women experience infertility at nearly twice the rate of white women. A recent CDC report revealed that Black women are also about half as likely to seek medical help.

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April 19 – 25 is National Infertility Awareness Week. To learn more about the impact of infertility on Black women, The Root spoke with Michelle Alero Adeniyi, LPN, a full-spectrum doula, Black women’s health advocate, and founder of Maven Maternal & Family Care. Adeniyi has dealt with PCOS and fibroids herself and uses her own experience to help support other Black women.

Early Warning Signs

Some of the biggest drivers of infertility risk appear early and are easy to normalize, especially when women learn to live with pain. Black women are more likely to develop uterine fibroid tumors and are three times more likely to be hospitalized for fibroid problems, according to the Mayo Clinic. Adeniyi urges women to treat symptoms like painful cycles, heavy bleeding, irregular periods, fibroids, infections, endometriosis and pregnancy loss as “red flags.” Clinically, trying to conceive for 12 months without success is another sign to consult your healthcare provider, especially if you’re 35 or older.

Barriers to Care

According to Adeniyi, systemic barriers, such as cost, being uninsured or being underinsured, can prevent women from getting the help they need. Limited access to specialists, lack of awareness about care options, and embarrassment can also delay care. CDC data also shows that systemic issues can lead doctors to steer Black women toward hysterectomy as the first option, while other women are offered treatments that preserve fertility.

Cultural pressure is another significant factor. Stereotypes that label Black women as “hyper-fertile” can increase shame and make it harder for women to advocate for themselves.

“It can feel frustrating and isolating when your body is not doing what you want it to do,” Adeniyi said.

Medical bias, dismissive practices or misdiagnosis can leave women to believe that something is wrong with them. But Adeniyi encourages women to know that infertility is not their fault.

“Infertility is a medical condition—it’s not a personal failure,” she said.

Treatment Is Not Limited to IVF

IVF is often seen as the “gold standard,” but it doesn’t have to be the first step. Adeniyi recommends starting with a full evaluation and a plan that includes testing both partners. Earlier, less invasive and more affordable options can help. For example, fibroids can be removed with a myomectomy, which keeps the uterus intact. Ovulation issues like PCOS can be treated with medications like Clomid (clomiphene citrate). A hysteroscopic exam can detect polyps, cysts or small fibroids that regular exams miss.

Small Lifestyle Changes Can Make a Difference

For many couples, making intentional, realistic lifestyle adjustments can make a difference. “Something as simple as losing 5 to 10 pounds can really help,” Adeniyi said, suggesting walking, working out or low-impact activities like yoga. Before conceiving, she reduced carbs and starches, took prenatal vitamins and managed stress triggers. She emphasized that fertility planning is not solely a woman’s responsibility. “Keep the man’s fertility as part of the conversation,” she said, noting that alcohol, smoking, cannabis use and diet all play a role.

Anyone on a family-building journey should start gathering health information early. Adeniyi suggests talking with mothers, sisters, aunts and grandmothers about their reproductive histories, such as fibroids and miscarriages. She stresses that lifestyle changes should be practical, not perfect. Most importantly, she urges choosing a provider who listens, takes pain seriously, and offers clear next steps. “Trust your body. You are the expert on your body, and it’s OK to keep advocating for yourself until you’re heard” she said.