By: Erika Takeda Eastham
We are keeping the discussion on Infertility going!
National Infertility Awareness Week in the US is recognized April 18th-24th. We love to normalize having difficult and important conversations. Even some of our country’s leaders and known celebrities have talked openly about the difficulty of expanding their families. Former First lady Michele Obama talked about the shame and emotional toll of miscarriages, and her journey of in vitro fertilization in her book “Becoming”. According to the CDC, infertility can affect about 7% of married women aged 15 to 45 and in about 8% of couples with infertility, a male factor is the only cause found. BIPOC women can experience even higher rates of infertility when socioeconomic factors or undiagnosed medical factors are factored into account. Yet, infertility is rarely talked about in everyday conversations; it is a topic of discussion that is left in the dark and only brought up when it happens to you.
In this post, we will break the barriers of infertility by discussing possible causes of infertility and when to seek treatment as well as education and recommendations from OBGYN, Dr. Ashlee Green, and fertility nurse, Nicole Antonio, RN. We hope that education and freely talking about infertility can empower you with awareness and preparedness.
Ashlee N. Green MD, MS is a PGY4 Resident Physician Department of Obstetrics and Gynecology at Rutgers Robert Wood Johnson Medical School.
Infertility is a disease that affects millions of both men and women of reproductive age worldwide. It is defined as the inability to achieve pregnancy within 12 months of regular unprotected intercourse. It is estimated that between 48-186 million individuals live with infertility worldwide.
Despite infertility being a global problem affecting all ethnic, racial, and religious groups with many social and cultural constructs surrounding it, only a minority of the US population has access to treatment. For instance, Assisted Reproductive Therapy (ART) is often sought by women dealing with infertility, however these services are disproportionately accessed by non-Hispanic white women with higher educational training and socioeconomic statuses. A potential cause for this disparity may be that women do not seek the care they need when facing infertility. Population survey studies have noted that the myths and stereotypes surrounding women of color being “more fertile” has caused women to feel shame, loss of gender identity, and sense of self. They, in turn, are uncomfortable discussing and seeking medical attention when facing infertility. Many couples also fail to take into consideration that male factor infertility accounts for 40-50% of infertile couples. So, while there are numerous causes of infertility, for both men and women, the stigma surrounding women of color needs to change so that care can be sought in a timely manner.
Facts of Infertility:
As a fertility nurse at one of the largest IVF centers in the United States, Nicole Antonio, RN, has spent the last five years helping men and women build families and navigate the journey through fertility treatment.
3 Things A Fertility Nurse Wants You to Know
In light of National Infertility Awareness Week, a fertility nurse shares three things that are helpful for everyone to know regardless of race, ethnicity, sexual orientation, religion, or socioeconomic status.
1. Start With Your AMH
Women are born with all the eggs we will have in our lifetime. Each menstrual cycle, our bodies work to mature several ovarian follicles – think immature eggs – with usually only one egg reaching maturity. The mature egg is ultimately ovulated with the hope of creating a pregnancy. The eggs that did not reach maturity disintegrate, reducing the number of available eggs for future pregnancies.
Ladies, if you are curious about your fertility status, an easy first step to take is to ask your OB/GYN to check your Antimüllerian hormone (AMH) level via blood test. AMH is a hormone secreted by the ovarian follicles. In theory, the higher the number of available ovarian follicles, the higher the AMH level. Low AMH levels could indicate decreased ovarian reserve. AMH testing is a useful preliminary tool that can assist in identifying potential reproductive challenges and in determining if further fertility screening is needed.
2. Reproductive Struggles: Causes
Many are unaware that 1 in 8 couples have difficulty achieving or sustaining a pregnancy. Additionally there is an incorrect assumption that fertility is usually a female problem. Reproductive struggles can be due to challenges faced by one person or both partners.
Examples of common reproductive challenges include but are not limited to:
3. Financial Tips
Fertility struggles are not only emotionally draining, but added financial expenses associated with treatment can prevent many patients to proceed with treatment. Here are some of the best financial tips I share with my patients:
There are many reasons why men or women are infertile or have sterility issues; genetic, medical, stress can all be contributing factors for why a person or couple cannot reproduce. At Urban Health Group, we want our readers to stay informed and seek help when they need to by staying informed and staying prepared. We hope that access to information and advice from our medical professionals can help build your knowledge base so that infertility does not have to be taboo. The more you know, the more prepared we can all be and at Urban Health Group, we Plan Well for Care.
Urban Health Group LLC is a boutique-style, concierge for healthcare navigation and mental health support based in Oakland, California. We empower Black Indigenous People of Color (B.I.P.O.C.) with tools and support to effectively navigate their health and mental health needs for better wellness. We are eliminating healthcare disparities and reducing healthcare biases head on through strategic partnerships.
Social workers, clinicians, and community-based providers are experiencing the mental health impacts of COVID-19 right alongside our clients and communities. We ourselves are navigating our own decisions about whether or not we receive the vaccine, if our loved ones should, and if we should encourage our colleagues or staff members to do so, or our clients. In order to better equip ourselves with stronger clinical tools in our toolbox to address questions about the medical science behind vaccines and the trauma-informed conversations we engage our clients in, this Vaccine Forum featuring Guest Speakers Leticia Vaca, LCSW and CEO of Urban Health Group LLC and Dr. Marcus Williams, MD and Emergency Department Physician at Sutter Health and Medical Advisor at Urban Health Group LLC will elucidate up-to-date information about the vaccine and deeper considerations about how to effectively support ourselves as providers AND communities of color. Through this event, we will create space for recognizing the history of harms marginalized communities have experienced at the hands of healthcare and government institutions, and work to demystify some of the theories and conceptions that have spread throughout our communities about the vaccine.
VIDEO FROM MARCH 23, 2021
By: Dominique Boyette, edited by Leticia Vaca
I’m going to ask you to take a moment and just acknowledge whatever pressure you may be currently under. Just let your mind gather it all, take a metal tally.
Large or small, stress can have a powerful ongoing effect on your day-to-day life. Sometimes stress can feel so heavy and persistent--at this point--simply being validated in your emotions and physical struggles can bring relief from a stressful moment.
That’s a depressing thought.
It boggles my mind. The notion that you can get relief from not actually providing concrete assistance to the problems means many are not taking the time to disconnect from their burdens. It can become commonplace to live with stress that is accumulated in the body: being in physical pain, getting sick, or breaking out in acne.
Many of us are living our everyday lives in fight or flight response and don’t even know it. This is an unintended consequence of the constant bombardment of the “Information Age”, i.e. social media, ads, email and phone notifications.
In some B.I.P.O.C. communities, stress can result from a generational circumstances, like systemic racism, or behaviors we pass onto our children, like alcoholism. “Disparities and stresses flow from political and economic depression from social exclusion” says Sherman James, an epidemiologist, “and not having the resources to live life in a healthy way.” Sherman James, Black Health & Wellness Pioneer, developed the theory of John Henryism. He explains the persistence of health gaps is due to the struggle of dealing with the endemic forces of marginalization that create conditions so oppressive they make populations more susceptible to a variety of diseases, ultimately leaving all of their physiological systems compromised.
For myself, sometimes it doesn’t even seem like I have a chance to breathe, let alone take care of oneself fruitfully. Sherman James cites John Cassel and defines “human vulnerability to disease is a function of the social conditions at which people live.” B.I.P.O.C. communities have an overall increased generational susceptibility to chronic disease and socio-economic stress because we are “subjected to rapid social cultural change without being given the resources to cope adequately.” Access and treatment to health care is not a universal right or positively shared experience. This is why highlighting and developing Urban Health is so important as we discuss stress.
Members of racial and ethnic minorities are less likely to receive preventive health services, often receive lower-quality care, and also have worse health outcomes for certain conditions.
While cities can bring opportunities, they can also bring challenges for better health. It is known that many societal issues like unemployment, traumatic experiences, drugs, and other factors can negatively impact health. Populations in urban areas who are at risk for disease, disability, and premature death make cities special places for focusing on the promotion of health and total wellness. Urban Health Group was formed with the core value that everyone deserves quality care. We provide a bridge between healthcare navigation and mental health support.
Stress is not just a term we use to describe tough days or how we feel about fast approaching deadlines. Stress can be a very serious, visceral experience that can negatively impact your health.
Here is how we are helping reduce the stress of coordinating care:
Read more here: https://www.healthline.com/nutrition/16-ways-relieve-stress-anxiety#16.-Spend-time-with-your-pet
For me, my highest periods of stress come from isolated times of pressure. The times I feel unsupported, unheard, invisible, and alone. That accumulation is overwhelming. But learning about resources like the Plan Well For Care Course create light in these storms.
We hope you are able to take time to invest in your mental and physical well being. It is our goal to create a space where you can explore and access the care you deserve.
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By: Leticia Vaca
You may have noticed that every month there is a National Something Month here in the U.S.. My personal favorites are “ National Donut Day'' and “ National Taco Day” celebrating some of the tastiest foods and desserts. It’s fun...and encourages me to go out for a donut or a few tacos.
On the other hand, National days and months of recognition are designed to bring awareness to a serious concern.
April is National Minority Health Month.
It is not our goal to try to capture as many health related days of recognition as possible to fill our social media feeds, but rather highlight how Urban Health Group is actively involved in these concerns year around.
There is a frequent debate on how to label groups of people that are not white: “ minorities”, “poc”, and now “ bipoc” in academia and professional arenas. Rule of thumb, It is always best to ask people directly how they identify. I personally do not use the word minorities. I prefer to use "Black, Indigenous, People of Color (B.I.P.O.C.)" when referring to non-white groups of people; unless otherwise, I am referring to a specific group.
Urban Health Group celebrates and champions the unique health and mental health needs
of Black, Indigenous, People of Color EVERY month.
How did National Minority Health Month come about?
CDC's Office of Minority Health & Health Equity (OMHHE) explains that “health equity” is when everyone has the opportunity to be as healthy as possible. It also forces us to explore the differences in health outcomes and their causes among groups of people. For example, African American children are more likely to die from asthma compared to non-Hispanic white children. Reducing health disparities creates better health for all Americans.
Why is Health Equity Important?
Your health includes our physical health, emotional health, and social support within your community. Health equity is closely tied to your quality life and most visible in where you can live, learn, work, and play.
Urban Health Group was formed with the core value that everyone deserves quality care. We provide a bridge between healthcare navigation and mental health support.
Who we are:
Urban Health Group (UHG) is a boutique-style, concierge for healthcare navigation and mental health support based in Oakland, California. We empower Black Indigenous People of Color (B.I.P.O.C.) with tools and support to effectively navigate their health and mental health needs for better wellness. We are eliminating healthcare disparities and reducing healthcare biases head on through strategic partnerships.
Who is the Founder?
I am the Founder and CEO of Urban Health Group LLC and Bay Area Native. I am multicultural: Black, Mexican, 1st Generation America (family by way of Michoacán, Mexico) , and with Southern lineage ( family by way of Marietta, Georgia). Like a growing number of families across the United States, I have personal experience with my family confronting the challenges of mental illness, substance abuse and physical ailments. Witnessing the disconnect and experience the stress of the entire hospital experience, and ultimately their untimely passing; I became a Medical Social Worker in a Trauma Center--where I’ve helped over 6000 people in a crisis. I am also a Trauma Therapist, Co-Owner of Urban Catalyst Psychotherapy.
Why I care about B.I.P.O.C. Health?
During my ER, ICU, acute care days of medical social working, I recognized there was a salient difference in the delivery of treatment for care and preparedness of families to assert their needs for non-white families vs whites families. I spent a lot of time brokering with patients and their families and medical providers for care for non-white patients and families; while I noticed that whites patients and families rarely needed this level of brokering; and the delivery of care from medical providers was different, more pleasant. Well I know through my education and from first hand experience, how healthcare biases negatively impact the care experience for Black, Indigenous, People of Color. Admittedly, I am impatient about the changes within healthcare systems towards providing equitable care for all. I want folks to be the center of their health and care needs RIGHT NOW; not systems and providers. More work is needed outside of the hospital walls. As a medical social worker and therapist, I have made it my mission to educate and empower people to plan for medical emergencies.
Urban Health Group differentiates itself within the industry as it is designed specifically to service B.I.P.O.C. by highly trained B.I.P.O.C. professionals in a preventive and proactive manner. It is a small, boutique company that has the capacity to address the unique needs of B.I.P.O.C.. Our approach includes a social justice awareness around issues of intergenerational and racial trauma impact on health; and an awareness of historical and current experience of oppression when interfacing healthcare systems.
Our Mission is to Empower Black, Indigenous, People of Color ( B.I.P.O.C.) with tools and support to effectively navigate their health and mental health needs for better wellness.
Our Vision is to eliminate healthcare disparities and reduce healthcare biases for Black, Indigenous, People of Color. We address healthcare biases head on through strategic partnerships.
What can you do for National Minority Health Month?
“Without health and long life, all else fails.”
– Dr. Booker T. Washington