A sexual time bomb: the declining fertility rate of the black middle class

Ebony, May, 1995 by Monique Burns

WHEN it comes to making babies, nobody does it better than Black folks. In fact, 19 percent of all Black teenagers, aged 15-19, become pregnant each year, compared with only 8 percent of White teens. Because Black teens are giving up educational opportunities and careers to bear babies at an age when they are still "babies themselves," this "baby boom" has caused nationwide concern about the future of Black America. Less well known--but just as critical to the future of Black America--is the "baby bust" occurring among older Black couples, aged 25-44. At a time when they have the maturity and financial means to establish and nurture strong families, many Black couples are finding that they simply cannot have children. The truth is, when it comes to making babies, African-American couples in the 25-44 age group are discovering that the much-vaunted myth of Black fertility is just that--a myth.

The National Center for Health Statistics, a division of the National Centers for Disease Control, notes no difference in fertility rates for White or Black women, aged 25-44. However, according to RESOLVE, a national clearinghouse and support group, infertility is actually 1.5 times higher among African-Americans than Caucasians. Infertility--defined as the inability to conceive after one year or more of intercourse without contraception--usually can be treated and reversed. In fact, of the 5.3 million infertile couples in the U.S. who seek treatment two-thirds are able to have children.

A major problem is that Black couples often fail to get diagnosed and treated for infertility. As Dr. O'Delle M. Owens, a Black doctor who was Cincinnati's very first board-certified fertility specialist and who has been the director of Reproductive Endocrinology at the city's Christ Hospital since 1986, explains, "White couples tend to seek treatment for infertility in greater numbers than Blacks. For White couples, infertility is often the first roadblock they've faced--while Blacks are distracted by such primary roadblocks as food, shelter and clothing." Another problem is failure to get early diagnosis and treatment of diseases that often lead to infertility.

Still another factor is the negative attitude toward infertility among Black men and, to some degree, Black women. About 40 percent of all infertility is caused by a female factor, 40 percent is caused by a male factor, and 20 percent is caused by a joint male-female factor. Yet, even if their wives have no infertility problems, many Black men balk at being tested and treated for sperm abnormalities that keep the couple from having a baby.

Because many Black men equate fertility with potency, they are simply unable to come to grips with the notion that they might be contributing to the couple's infertility. Dr. Elwyn M. Grimes, newly appointed chief of OB/GYN at Meharry Medical Center in Nashville and owner of the Midwest Fertility Center for Reproductive Research (perhaps the country's only Black sperm-bank owner), says, "A major problem is the increased tendency for Black men not to participate in the treatment process. The ego issue gets in the way. I had one patient, an ex-Marine and ex-football player who simply could not handle the idea that his sperm was causing the problem."

These attitudes, of course, can differ depending on socioeconomic standing. "At the clinic where I worked," says Dr. Owens, "Black men often didn't want to provide semen samples." However, Dr. Owens found that among the middle-class Black couples he sees in private practice, the men seemed more willing to submit to tests that could uncover the reason for a couple's infertility and put them on the road to solving the problem. "The greater the understanding and involvement, the greater the participation among Black men," adds Dr. Grimes. Attitudes toward infertility by Black college professors, for example, are probably comparable to those of White college professors, but Black males of lower economic standing tend to avoid diagnosis and treatment. Even so, old attitudes die hard, and a college-educated Black man who has grown up believing that infertility means impotency also may have a hard time submitting to diagnosis and treatment.

Many doctors believe that women cope better with infertility. Linda Villarosa, editor of the newly published and highly readable health book, Body & Soul: The Black Woman's Guide to Physical Health and Emotional Well-Being, says, "For Black men, infertility is like a threat to their masculinity. But infertility also can cause high emotional distress in Black women. Traditionally, we Black women have been thought of as the world's best babymakers. The myth is that pregnancy is so easy for us, that we're so fertile--and we've bought into the myth of our abundant fertility. But the myth that we are hyper-fertile, hyper-sexual, is left over from slavery days and bears no relation to reality."

Indeed, the Black woman's rise from cotton field to corporate boardroom may be a key factor in decreased fertility among African-Americans in the 25-44 age group. Following the lead of White female peers, well-educated, middleclass Black women are delaying childbirth until their 30s and 40s when fertility decreases among all females. Unlike men, who produce sperm on a regular basis throughout most of their lives, women are born with a set number of eggs. As Dr. Owens explains, "Women are born with millions of eggs. But each month, a woman loses 10,000 eggs. The older you get, the fewer eggs you have." In fact, that problem, says Dr. Owens, can affect women as young as 28 years old.