‘I just think it’s weird’: the nature of ethical and substantive non-ethical concerns about infertility treatments among Black and White women in U.S. graduate programmes

Abstract

In the United States, Black women’s use of infertility treatments is relatively low, despite elevated or similar rates of infertility compared with White women. Ethical concerns about infertility treatments have been identified as a potential sociocultural factor contributing to these treatment-seeking disparities. Despite documented differences, the substance of these ethical concerns is unclear. Clarifying the nature of these concerns contributes to our understanding of the social forces that shape the contexts of infertility care. Using an intersectional and comparative analysis of semi-structured interviews with Black or African American and White women enrolled in U.S. graduate programmes, this paper investigates the nature and substance of ethical concerns about medicalized infertility treatments. Three central themes emerged: (i) ethical concerns were not binary; (ii) ethical concerns varied by modality, but not by race, and focussed primarily on infertility treatments involving third parties; and (iii) substantive non-ethical concerns were concentrated among Black women and were driven by discomfort with or preferences against treatments involving third-parties. The paper concludes with a discussion of the implications of these findings for researchers, providers, and policymakers.

Keywords:

• Infertility
• racial disparities
• ethics
• treatment-seeking
• ARTs
• qualitative

Acknowledgements

The authors are thankful to Arthur L. Greil for his helpful feedback in the preparation of this manuscript.

Consent to publish

Participants were informed and consented to the publications of de-identified data in the written consent forms required for participation.

Disclosure statement

The authors have no conflict of interest to declare. The first author received pilot project funds from the Department of Sociology at the University of North Carolina at Chapel Hill that provided support for the collection of these data.

Data availability statement

The data underlying this article cannot be shared publicly to protect the privacy and identity of individuals in the study. Codebook of codes used for analysis in QSR Nvivo are available upon request.

Additional information

Funding

This material is based upon work supported financially by the first author’s National Science Foundation Graduate Research Fellowship [DGE-1650116] and pilot project funds from the Department of Sociology at the University of North Carolina at Chapel Hill.