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Commentary Family Planning

Hysterectomies Are Not the Only Option for Black Women With Fibroids. We Have Choices.

Kimberly Fain

Black women are two to three times more likely to get fibroids than our white female counterparts. We are also more likely to experience implicit bias and be disempowered by our health-care system.

For more anti-racism resources, check out our guide, Racial Justice Is Reproductive Justice.

As a Black woman who has fibroids, I wish I had more information on the alternatives to getting a hysterectomy from my health-care providers. Unfortunately, the health-care system constantly overlooks and dismisses us, so we have to do our own research and advocate for ourselves.

Uterine fibroids are noncancerous growths, and sometimes the solution is to get a hysterectomy. I was devastated when my OB/GYN recommended that I get a robotic hysterectomy. She explained the process quickly: A surgeon will create small incisions in the stomach with a laparoscope and navigate the procedure with a computer. I was surprised by the casual nature of my doctor’s recommendation despite being under her care for decades. She had a matter-of-fact expression on her face. It was almost dismissive of any fears I might have.

Every year, my gynecologist would ask, “Are you ready to have children?” Like many young women, I dreamt of becoming a mother. Yet, I still prioritized my career and education over having a family. Even after I met my husband and married him at the age of 33, I still wasn’t ready to bring a new life into this world. As both an educator and writer, I had so much more I wanted to contribute.

Sex. Abortion. Parenthood. Power.

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Truthfully, my husband and I knew that once I had a child, I might give up my career to ensure that they have all the attention they deserve. After discussing my feelings with my husband, he assured me that having a child together did not define our relationship. More so, after teaching for 18 years, I felt complete in knowing that I had been a “mother” to thousands.

I’m now 45, and I recently expressed to my doctor that I no longer wished to give birth to a child but didn’t communicate my reasons. With that announcement, she thrust her hands high into the air and said, “Let’s just take the whole uterus out.”

Nervous, I asked if any serious harm could occur to my body if I chose to hold off the surgery. She responded by saying that the procedure would reduce my pain—besides, the fibroids would only get bigger. Like the average person who has this condition, I have little to no symptoms, which may include heavy bleeding, anemia, painful intercourse, miscarriages, and infertility.

Still, according to the National Institutes of Health, there are less invasive medical procedures for fibroids such as a myomectomy or endometrial ablation. A myomectomy involves removing only the fibroids, leaving the rest of the (healthy) uterus intact, so the patient can still get pregnant. Endometrial ablation treats small fibroids by using electric currents and freezing that destroy the lining of the uterus. You may still be able to give birth afterward, but it would be a high-risk pregnancy.

There are nonsurgical treatments for fibroids. “Women without symptoms do not need treatment,” according to the Icahn School of Medicine at Mount Sinai. “Fibroids usually shrink after menopause, so many women close to menopause (average age 51 to 52) choose to defer treatment.” This information further drew me to the conclusion that an elective hysterectomy was not my first option. Even with this available information, I shouldn’t have been surprised by my doctor’s recommendation, despite the risks associated with having the uterus removed during an abdominal hysterectomy: infection, blood clots, or injury to other organs.

As a doctoral candidate specializing in Black feminist rhetoric, I have researched the unconscious racial bias of medical providers. In 2015, the American Journal of Public Health published an article analyzing the implicit racial bias among health-care professionals and found that due to the “attitudes and behaviors of health-care providers,” unconscious bias results in disparities in the “quality of care received” that impact the health and well-being of minorities.

Black women are two to three times more likely to get fibroids than our white female counterparts, and nearly 80 percent of Black women will get fibroids before entering menopause, according to Black Women’s Health Imperative. They are more also likely to “develop them at younger ages, to have bigger fibroids, to have more fibroids, and to have more symptoms.”

If a Black woman is not at risk of death or experiencing severe pain due to her fibroids, prior to getting a hysterectomy, she should do her research, consider various treatmentsmedication, and information from organizations that center our reproductive wellness. Lifestyle changes like diet and stress management can also ease the symptoms of fibroids.

Before making a life-altering medical decision, Black women should be aware of the unconscious bias of doctors. After all, Black women are receiving advice that is influenced by doctors’ misperceptions of Black women. Regardless of wealth, education, or celebrity status, medical doctors and nurses stereotype Black women and spend less time communicating with us. Oftentimes, Black women feel dismissed and even condescended to in health-care settings. As a result of this bias, Black women are learning to advocate for themselves.

At the intersection of racial bias from health-care providers and hostile laws obstructing access to reproductive health care, Black women are dying. Black women are disempowered by our health-care system, further restricting their access to abortion care. When we have coverage, we are still more likely to be denied an abortion. Not to mention, Black women have a higher chance than white women to die due to pregnancy complications.

Whether we choose to have a child or not, our lives are in danger. At the end of the day, information is one way to ensure that—regardless of legislators and medical providers that don’t recognize our humanity—we have choices. We don’t have to accept the first—or even the second—medical recommendation given to us.

Like I tell the Black women I teach every day: Our lives have meaning. We are valuable, too.

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