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. 2015 Sep;29(5):416-25.
doi: 10.1111/ppe.12210. Epub 2015 Jul 22.

Racial Disparities in Seeking Care for Help Getting Pregnant

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Racial Disparities in Seeking Care for Help Getting Pregnant

Helen B Chin et al. Paediatr Perinat Epidemiol. 2015 Sep.

Abstract

Background: Fertility counselling and treatment can help women achieve their desired family size; however, disparities exist in the utilisation of this care.

Methods: This study examines the persistence of a racial disparity in visiting a doctor for help getting pregnant by estimating the direct effect of this association using data from the Furthering Understanding of Cancer Health and Survivorship in Adult Women's Study, a population-based cohort study. This cohort included 1073 reproductive age women (22-45 years) with 28% reporting infertility. We fit log binomial models to quantify the magnitude of the racial difference in reported care seeking after adjustment for hypothesised mediators using inverse probability weighting.

Results: Compared with white women, black women were less likely to visit a doctor in the total population [adjusted risk ratio (RR) 0.57, 95% confidence interval (CI) 0.41, 0.80] and in the subgroup of women with infertility [RR 0.75, 95% CI 0.56, 0.99]. In addition, black women waited twice as long, on average, before seeking help compared with white women.

Conclusions: There were notable racial differences in visiting a doctor for help getting pregnant in this study although reports of infertility were similar by race. These differences may be mitigated through improved communication about the range of counselling and treatment options available.

Keywords: care seeking; disparities; infertility; race.

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Figures

Figure 1
Figure 1
Unadjusted Survival Curves for Visiting a Doctor for Help Getting Pregnant by Race in the FUCHSIA Women’s Study

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