ANDREW COUTTS,  MA (Ed), BA (Law),BSc (Econ) Hons

Look Who’s Talking Fertility:

Andrew Coutts, International Fertility Company

Michelle Obama’s recent revelation about her IVF history has started a much-needed debate in the United States about the relationship between race and fertility. 

From being the first African-American First Lady of The United States to her meteoric rise as Mother of the Nation Michelle Obama’s has emerged as one of the world’s great influencers.

When Michelle Obama speaks, people tend to listen.

Her announcement on a recent Good Morning America show

therefore that both her daughters were conceived through IVF

procedures has done much to reopen the debate about how race

impacts fertility in the United States.

So how does it?

According to the National Centre for Health Statistics, married black women are twice as likely to experience infertility as white women in a similar position across all ages.

The incidence however is not reflected in the ethnic composition of those accessing fertility treatment. Research suggests that 15% of white women aged between 25 and 44 in the U.S. have sought medical help to get pregnant compared to 8% of Black women.

A recent study by the Shady Grove Fertility Centre in the U.S. illustrates how these stark differences are replicated even when possible variables (such as different laboratory protocols and the reporting of success results) are controlled.

Kate Devine M.D. who led the research confirmed that disparity between races existed even when compiling data from a single fertility practice using identical lab techniques. Devine’s figures show the rate of clinical pregnancy was 9% lower, clinical pregnancy loss was 24% higher, and live birth was 14% lower for black women relative to comparable white women.

So, why is Michelle Obama’s proclamation so important? Well, she has stepped out of the presidential shadow to become somewhat of a leader and role model for young girls and women of colour. In her own assured and charismatic way, she has been addressing and tearing down racial stereotypes and promoting equality of access across education and healthcare services since emerging as the other half of Team Obama in 2009. Now it’s time to look infertility square in the face.

Michelle Obama has come of age.

In contemporary American society her intervention, interpretation and involvement has become more significant than ever. The fact she has spoken publicly and vividly about how IVF has impacted so positively on her life can potentially have a dramatic effect on how black women view infertility; how they react to it and how they address it.

It is clear that any inequality is multi-faceted and is shaped by a complex web of factors; generated by individuals, community and wider society and I would not assume we could address each of these with the merit they deserve in this article. Some of these factors include;


  • A lack of a body of substantive research into why black women in particular have higher rates of fertility but receive less treatment


  • Economic research has demonstrated how significant income gaps have marginalised black women, denying them the opportunity to access treatment which unaffordable


  • Anecdotal responses from patients suggest women of colour also experience deep rooted misconceptions about race and fertility summed up succinctly by this fertility patient;


“In families of colour, there’s an assumption that when you want to get pregnant, you get pregnant.

There’s a lot of finger pointing that women of colour feel when we’ve gotten to a certain age and we haven’t had children”

So, let’s return to Michelle Obama. Why is her involvement so important again?

It’s important because she has spoken - for so long the black community have suffered in silence about an issue which seems to effect so many.

Obama’s latest intervention may well help those who continue to suffer silently find a voice of their own. Her own personal experience shared and delivered as a black woman with a distinctly influential voice may well encourage others to challenge the obvious disparities which exist in modern day America.

The Future

In the United States at least it would appear that historically middle-class white women tend to have the confidence to navigate the health care system better than less affluent minority women. It would appear from anecdotal and formal research that they also more inclined ‘talk fertility’ with their families, friends, peers and health professionals.; they have the financial means to access more expensive treatment and do not, generally face the same level of institutional racism which is seemingly inherent in some of America’s public services.

On a final note, we hope Michelle Obama continues to talk, intervene, influence and shout about fertility so that the many women of colour who come after her can access successful treatment when they need it, or at the very least, start talking fertility.

Andrew Coutts is a regular speaker, writer and commentator on fertility issues and has been involved in developing numerous patient engagement events throughout Europe.


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