LITTLE ROCK, Ark. — Infertility is a common problem for people looking to expand their families. It's also a topic that doesn't always get a lot of attention.
This is also true in the Black community specifically, as infertility is a big issue that's often not talked about— it’s also often misunderstood and surrounded by a negative stigma that usually includes deep shame.
This is something that many like Charissa Jackson understands, as she’s battling infertility, more specifically stage four endometriosis.
She’s become accustomed to the dozens of shots and multiple medications, which have become the norm.
"We had multiple miscarriages in multiple months of not being able to get pregnant at all," Charissa Jackson said. "It doesn't matter when the miscarriages happen, it's completely devastating, it takes a huge emotional toll on me."
According to a 2013 report from the National Center for Health Statistics, Black women are roughly twice as likely to experience infertility than Hispanic or non-Hispanic women.
"Reproductive issues like fibroids, which are very, very common in Black women, add to infertility," Dr. Gloria Richard-Davis with UAMS said. "Endometriosis is probably underdiagnosed in Black women."
Another issue comes in the form of delaying pregnancy, which Richard-Davis said only makes infertility in Black women worse.
“Not just Black women, but women in general," Richard-Davis said. "That adds to the difficulty of conceiving."
So, if infertility rates are so high for Black women, are they in turn receiving infertility treatment at a high rate too?
Doctors that we spoke with actually said otherwise.
"Black women tend to delay seeking care by as much as a year beyond what we see in white communities," Richard-Davis said.
But, why is this the case? Well, many like Vanderbilt University’s Dr. Michael Eric Dyson attribute it to history.
"It's not just the Tuskegee experiment," Dyson said. "The father of gynecology, Dr. Sims, is a person who practiced on Black women without anesthesia, so Black men and women are highly skeptical, and rightfully so, of some of the procedures that have been placed on them."
According to many, Sims helped pioneer tools and surgical techniques that center around women’s reproductive health, but has since been heavily criticized.
Dyson believes it’s one of the many contributing factors as to why Black men and women are now resistant to seeking out infertility treatment.
This resistance is also something that therapists, like Beatrice Klokpah, are also seeing within the African American community.
Klokpah said she serves clients in Texas and Arkansas and has noticed many of them are only interested in finding healthcare workers that look like them, which helps them feel more at ease.
When they can’t, a lot of her patients are less inclined to seek help or speak out about their issues.
"Wanting to find providers that look like them and identify with them and they can feel safe to take that journey with," Klokpah said. "Those are the two main things I'm hearing from clients."
It's not just a history of distrust with health professionals causing infertility to go unaddressed, there's also a cultural reliance on religion.
So, how does this tether to religion cause infertility to get swept under the rug exactly? Well, many experts attribute it to it simply being in God's plan for them.
"I guess it's kind of like a Drake lyric. God's plan," Dyson said. "If God wants me to have a baby, I'll have a baby. Some people think that's what it is."
Dyson said this mentality can prevent us from confronting the root of the issue and figuring out how to deal with the potential cause of infertility.
"So religion can work in a counterproductive way for us seeking out the best remedies and solutions, which is why it's important for religious preachers and teachers in our churches to begin to reach out and talk about these issues," Dyson said.
Charissa Jackson said she leaned on faith enormously on her journey to have kids. However, she also leaned into medicine.
“Me and my husband believe faith without works is dead," Charissa Jackson said. "Therefore it was important to us to seek help from an endocrinologist because having infertility is just as much of a medical condition as any other condition."
Jackson shared that she experienced three miscarriages before deciding to reach out to a fertility specialist who finally revealed her diagnosis and suggested she start IVF, also known as In Vitro Fertilization.
“I was ashamed," Charissa Jackson said. "I felt like everyone in my family is getting pregnant, why is this happening to me?”
This shame, regardless of race, is something many families deal with when battling infertility. However, experts say there are numerous factors at play that could make the shame seem worse for African Americans.
Richard-Davis said stereotypes lead many African Americans to believe they have to live up to false misconceptions.
"There is this history that we can't control our reproduction,” Richard-Davis said.
Dyson agreed that there's a stereotype.
“We're supposed to be this hypervigilant, hyper-fertile community," Dyson said. "We're hypersexual, it's said as a stereotype."
Dyson added that these stereotypes are often perpetuated through pop culture like music, television and social media.
“No disrespect, but when you look out there and you look at Nick Cannon and he has 10, 11 kids, you look at Future the rapper, he has 10 kids, Eddie Murphy has 10 kids, you feel ashamed," Dyson said. "Can I not have one?"
Richard-Davis said that given these stereotypes, and popular depictions of African American reproduction, there are often conversations about contraception in the African American community, but limited conversations about reproductive health.
It’s something Charissa Jackson also agrees with.
“Everything we're taught, and when we're growing up is, ‘you're going to be a mother one day,'" Charissa Jackson said. "When it doesn't happen in the way it's supposed to happen, and the way society has taught us it's going to happen, it's completely devastating."
Contrary to the idea that having kids is easy within the Black community, the Jacksons underwent five rounds of IVF to now have one daughter and another child on the way.
De’Andre Jackson, Charissa’s husband, said he’s excited they’re pregnant again.
“Elated that we actually have a child, because we've been on this journey for so long."
De'Andre Jackson said the path to having their rainbow baby journey was all worth it, and that his focus was to be a strong partner for his wife throughout the journey.
"She is our little spirit baby," Charissa Jackson said. "She loves to make everybody happy. She loves to give hugs. She's such a loving kid."
But what if the Jacksons weren’t so lucky? Many families say seeking out egg and sperm donors is a natural next step.
What’s alarming though, African American donor rates are not keeping up with the high rates of infertility seen within the African American community, specifically Black sperm donors.
According to a recent Washington Post article, Black sperm donors make up only 2% of the available supply at the country's four largest sperm banks.
This limited pool is something Casse and Alexandria Vaughn say they experienced first-hand.
“We always knew we wanted to have a family, but you just don't know how it's going to happen," Casse Vaughn said. "Two women, you just don't know how you're going to do that."
As a gay couple, they knew they’d have to rely heavily on a sperm donor to make this dream a reality. However, finding one turned out to be a greater struggle than they realized.
“We wanted a Black donor," Casse Vaughn said. "We're a biracial couple and we knew we wanted our child to be similar to us."
The couple looked into cryobank and found they had a limited supply.
"Of probably 100 donors, probably three or four Black ones," Casse Vaughn said. "These are two different companies."
Alexandria Vaughn expressed the same frustration.
"There was a site that had over 700 donors, and it was probably 25 African American donors," Alexandria Vaughn said.
This shortage of Black donors is not just a problem for LGBTQ couples, but a problem for any individual or couple looking for a Black donor.
"Being in those offices and the clinics, I saw straight women, single women, lesbian women, you name it," Casse Vaughn said. "All types of people trying to complete their families."
According to a spokesperson at the California Cryobank, the waiting list for an in-demand white donor is normally three months. For a black donor, the wait can stretch as long as 18 months.
The Vaughns did find some luck.
“We finally found one that we felt really resembled my wife," Casse Vaughn said. "They both are Scorpios, they both played basketball, he's an entrepreneur and so is she."
Thanks to an anonymous African American sperm donor, the Vaughns were able to conceive and welcomed their son, Landon.
The Vaughns said that their donor makes them thankful for the roughly 2% of Black men who have chosen to donate to all families in need, including those battling infertility.
However, doctors say many Black men and women who are healthy enough to do so may not even know there's a need for donors, much less a shortage.
“I was recently reading an article where the women were saying it's almost like it's a bidding war," Richard-Davis said. "There are so few sperm donors that they try and buy it up, and one woman said she feels guilty because if she bought an additional vial, then that meant one of her sisters was going to go without."
She explained that his "bidding war" could be the result of a lack of knowledge and comfort with the procedure for many Black men.
“It's not like it's an extensive procedure to collect sperm, but you have to be willing to give from the heart,” Richard-Davis said.
Another possible barrier to Black men not donating can also be traced back historically, Richard-Davis shared that it translates to the feeling of lacking self-control.
“There is this amount of distrust with, ‘what are you going to do with my sperm?" Richard-Davis said. "What's going to happen?"
Experts tell us that this lack of control may create a false sense among African American men that their sperm could be used for purposes they didn’t intend.
“I think mentally they feel like, I'll have a kid somewhere that I'm responsible for that I've never met,’' Casse Vaugh said.
With more awareness, more conversations, and more education on infertility, she hopes these statistics will increase for the better.
However, Dyson explained that this mindset is not going to be something the African American community can easily rid itself of. He said slavery is also a contributing factor.
“Black men and women’s bodies were used to procreate in slavery to make certain we had enough people in the fields and to tend to the needs of the dominant white society,” Dyson said.
This caused many Black men today to opt for having full control and autonomy over the way they reproduce.
“We literally weren't allowed to marry," Dyson said. "Our children could be taken from us, they could be sold off, we had no control except the children we produced."
Not considering this history, even when Black men donate there can still be issues.
Some studies show these donations may not work due to male infertility issues, such as lower sperm counts than white and Hispanic or Latino men.
This can put a strain on an already limited donation supply.
Doctors and scholars said the biggest hurdle is getting Black men through the doors and that it starts with recruiting.
"We typically recruit from college campuses and professional schools," Richard-Davis said. "There's a small pool there."
Another way to help is to better educate Black patients about their genetic history, which is a requirement if you want to donate.
"You want people to know their genetic history," Richard-Davis said. "It's like two generations back... so that's been a rate-limiting step."
Experts hope doing all of this will help address black infertility and usher in a new mindset.
“We have to be on the offense," Dyson said. "We have to talk about reproduction... the positive side of reproduction is valuing the Black body.”
Dyson hopes that the additional dialogue and greater acceptance will lead to greater fertility in the Black community.