one in eight couples, single parents of choice and a large portion of the LGBTQ+ population in the United States seek fertility services. Studies have shown that women with infertility have experienced depression similar to that of women who receive a cancer or HIV diagnosis.
This is all in line with a much bigger problem: the dire state of maternal and child care in the United States.
In 2018, with 17 maternal deaths per 100,000 live births, the death rate in the US was double that of France and Canada, and nearly triple that of the UK. In addition, the death rate is rising significantly for black women, at 34 per 100,000. According to the US Centers for Disease Control and Prevention, 60% of pregnancy-related deaths in the US are preventable.
Countries like Italy and Hungary offer some of the longest leave periods, with five months providing 80% of wages and 100% of wages for 24 weeks respectively. Twelve weeks is a popular time frame with varying amounts of pay during that time covered by the employer, Social Security or both, but countries like Pakistan, Mexico and India all cover 100% for the period.
Without fertility services, unexpected tests, or NICU visits, it costs between $5,000 and $11,000 on average to have a baby (without a cesarean section) in the US. That’s just before birth. While Rhode Island, Hawaii, New Jersey, California and New York have state-sanctioned paid maternity leave, there is no federal mandate that covers the entire country.
Barbara Collura, president of Resolve, a nonprofit created to bring women with infertility together, says that individuals and couples often come to Resolve with a tremendous lack of understanding about an infertility diagnosis and what happens next. For people on these journeys, seeking answers often only leads to more questions.
“They certainly don’t know that their insurance might not cover things like egg donation or IVF,” she says. “Or they certainly don’t know the cost of surrogacy and everything that comes with it.”
Patients often have to learn about this as they make decisions, without much guidance on where to go for resources beyond an OBGYN.
To have a baby, a sperm, an egg and a uterus are needed. Collura says they don’t just need to figure out what patients are working with in that area, they also need to think about the finances and the route they need to take to have a baby.
“There are a lot of people who can’t afford what they can do best. So the most affordable care may not be enough, but something they can afford. It’s an odd form of medical care where the people need it, but this cost issue plays on a very complicated, non-cookie-cutter path,” she says.
The spillovers of poor education
“It’s notorious across cultures for not talking about women’s health,” said Kindbody’s chief physician and co-founder, Dr. Fahimeh Sasan.
“There is just a lack of information. For example, up to 40% of pregnancies in the first trimester end in miscarriage. When most women miscarry they really think they are the only one, and then they usually come back to me and say they miscarried, and five of their friends have too, and they’ve never talked about it .”
dr. Sasan pointed to Michelle Obama as a glaring example of how women are taught not to talk about infertility. “She was a very popular first lady and throughout her presidency, she never spoke of how she actually miscarried and that her daughters are a product of IVF. This only came out when she released her autobiography.”
In the United States, sex education and/or HIV education is only required in 38 states and the District of Columbia. Of those, only 18 states require the information to be medically correct.
This shows a huge gap in scientifically accurate information not only for those trying to conceive, but also for policy makers, which in turn contributes to the state of reproductive and maternal care in the U.S.
Americans cited medical reasons, their spouse and costs, but they also said the pandemic alleviated the lack of easy access to health care as a caveat to having children. Birth rates in the US hit a record low in 2020, falling 4% from a year earlier, following a steady decline since the 2008 recession. Population growth in 2021 is expected to reach record lows, in addition to how COVID-19 is significantly reducing the death rate. has boosted.
Within the country’s two-party system—Republican and Democrat, Conservative and Liberal—this lack of factual scientific education about reproductive health and all it encompasses leaves a lot of wiggle room for decisions about state sanctions to be based on beliefs rather than biology.
And we’re starting to see the implications of monitoring women’s bodies.