Are you taking the first step to possibly begin fertility treatments and feeling a little overwhelmed? Don’t worry, it’s rare that you’ll ever find anyone starting this process who’s not feeling that way. Maybe you’ve been trying to conceive for a while, or you’ve known that fertility treatments would be the only option for you when it comes to family planning. No matter what, there can be a lot of stress and anxiety present as you start this journey. To add, if the importance of diversity and inclusivity are a requirement in your decision-making process, there’s some additional factors to consider as you prepare for your first appointment to ensure that the clinic you choose is in alignment with your specific needs.
There’s been some progress made when it comes to providing more culturally competent care at fertility clinics, but there’s still room to grow in reducing barriers and limitations to improve quality, inclusive care. The emotional toll tends to already be difficult when it’s time to move forward with fertility treatments, but for Black and Brown communities, as well as LGBTQIA+ individuals, the experience can be isolating because of race-related disparities, stigma, limited accessibility, and barriers to treatment.
A few things to note about your first appointment. This is generally a time where there will be a lot of discussion around your lifestyle, medical history, and going over what options might be best for you and your partner (if applicable). Information gathering is the overall theme for the first appointment. It’s best to have your medical records with you or sent over to the clinic for their review prior to your first visit, if possible. The appointment is typically lengthy; say maybe an hour or hour and a half, so be prepared and make sure you have that time set aside so you don’t feel rushed.
If you haven’t chosen a clinic just yet, here’s a few tips for you as you begin to explore clinics that are culturally competent and inclusive:
- Get Referrals: Whether it’s a friend, family member, neighbor, or colleague, getting a referral from someone who has had a positive experience at a fertility clinic, particularly from someone with a similar background or family planning journey, this is going to be your best bet. Searching online is of course a great tool, but someone who has firsthand experience is key in getting detailed information about how things are done at your clinic of interest. Ask them questions about how they were treated, supported, as well as their comfort level throughout their experience there.
- Research Fertility Clinics: Go to the clinic’s website and see if there’s people displayed who look like you. Pay attention to the language being used throughout – is it inclusive? Read their mission statement and note whether they emphasize diversity, equity, and inclusion. If you are on social media, say Facebook for example, there are often private groups you can join that are specific to your location, where you can see other peoples’ experiences at the clinics you’re interested in. You can share anonymously, read through people’s reviews, or search for whatever information you’re looking for. Also, many of the fertility clinic websites have patient stories – see if any speak to you or feel familiar with your experience. There should be a sense of belonging that you begin to feel through your search.
- If using insurance, check benefits: Typically, the staff at the clinic will verify your benefits if you are using insurance. To reduce any stress or anxiety that is coming up around the coverage of fertility treatments, it’s best to investigate this before moving forward with making your first appointment. Unfortunately, the definition of infertility is still not an inclusive definition, as it is defined by not being able to get pregnant after a year of trying to conceive with no pregnancy, or six months if you’re 35 or older. This is a barrier in family planning that does not allow room for LGBTQIA+ couples, nor does it allow for single-intending parents. The definition only speaks to heterosexual, cis-gender individuals. Find out what options you have through your insurance before getting started. This might also be a time to speak to your employer about the benefits offered at your company. Sometime this is exactly what is needed – employees speaking up and advocating for fertility benefits, or more inclusive ones
- Prepare Questions & Continue to Ask Questions: Prepare questions before your first appointment and throughout your treatment process. Be sure to include questions about treatment options, costs, success rates, and risks. If you choose to move forward with fertility treatments, there will be questions that continue to arise. Do not be afraid to ask at your appointments, send an email, or make a phone call. It’s ok to ask questions and learn more before making decisions. When creating your list of questions, think about questions related to you. Here’s a few suggestions:
- Are you familiar with medical conditions Black and Brown people experience that affect infertility? Black women are 3x’s more likely to have fibroids and are at least twice as likely to have their uterus removed through a hysterectomy. Uterine fibroids, preeclampsia, and PCOS are also other common medical conditions in the BIPOC community. Black people are twice as likely to experience infertility than White people, but less likely to receive care. It’s important for your doctor and the team to understand medical conditions that are common for various cultural backgrounds, and for you to feel that you’re receiving quality culturally competent care.
- Does anyone here speak another language fluently other than English? Individuals who speak other languages often find that their doctors lack cultural sensitivity, which can lead to increased stress and anxiety stemming from communication challenges.
- Do you have experience using third-party reproduction? Third-party reproduction is when there’s assistance building families with a gestational carrier, donor sperm, donated embryos, or donor eggs. This is commonly used for family planning with the LGBTQIA+ communities.
- Does your clinic have recommendations/relationships with attorneys to help navigate the legal process, if necessary? When using egg, sperm, or embryo donors, as well as gestational carriers or surrogates, there are often, legal contracts involved, so for peace of mind, working with a clinic to assist with this process or who already has those connections may be helpful to you and one less barrier in your treatment proces
- Self-Advocacy: Asking questions leads to number 5., self-advocacy. I will say this now and I don’t want you to forget this important tip: Self-Advocacy is extremely important and will be necessary throughout. The earlier you learn and understand how to communicate your needs, feelings, limits, and speak up for yourself, you will feel empowered, which will allow you to take an active role in your treatment process. You want to make sure that your unique needs are being met and that there’s effective communication with the team so that you can continue to ask questions and maintain an open dialogue. It’s ok to speak up. It’s ok to advocate for your own health and wellbeing. It’s your right and responsibility, so continue to be involved.
- Seek therapy or counseling: Taking this step in your family planning process can bring on a variety of emotions, which can be overwhelming to manage. Consider seeking therapy or counseling to help you cope with the emotional aspects of this part in your journey. There are many specialists who work with clients utilizing Assisted Reproductive Technologies (ART), which is the category that fertility treatments fall under. It may be helpful to speak with someone who is familiar with the process and has experience working with your population. If you are part of an underrepresented or marginalized group, having mental health support can be helpful for you to have a safe space to process all that you’re experiencing.
Go to that first fertility appointment prepared so that you can feel empowered and play an active role in your fertility treatment journey. If it doesn’t feel right to you, trust that feeling. It’s ok to get second, third, or fourth opinions. Prioritize your needs and only move forward with a clinic that feels right for you. There will be anticipation and fear around that first appointment. That’s all normal. Taking the first step to make the appointment is huge, even if it feels scary. There are many fertility clinics out there who are providing culturally competent and inclusive care, so keep searching until you find the right fit.
Author Bio: Kendra A. Vargas (she/her), LCPC, PMH-C, is a culturally responsive and inclusive psychotherapist, clinical supervisor, consultant, and infertility trainer. She has 10 years of experience in the field of mental health and has practiced in a variety of settings, including community mental health and private practice.
Kendra specializes in perinatal mental health and holds a Perinatal Mental Health Certificate through Postpartum Support International. Kendra is the founder of Authentically You Psychotherapy, a solo practice where she provides individual therapy and group therapy services. She runs an ongoing Fertility Skills and Support Group for women utilizing Assisted Reproductive Technologies such as IUI and IVF, which is an area she has a deep, personal connection and compassion.