Fertility care is essential reproductive health care, yet Black women face disproportionate barriers to accessing it, with consequences that extend beyond family building to broader health outcomes. A new fact sheet from the National Women’s Law Center and the Partnership for Southern Equity details how structural inequities in cost, coverage, and geography deepen racial health disparities in fertility and pregnancy care.
Non-Hispanic Black women in the United States are almost twice as likely as White or Hispanic women to experience infertility. Higher rates of conditions linked to infertility, including uterine fibroids and tubal factor infertility, contribute to that burden. Black women are also more likely to be exposed to environmental toxins that harm fertility, such as lead-contaminated water and endocrine-disrupting chemicals. Misdiagnosis and delayed treatment of conditions like endometriosis further reduce treatment options over time.
Cost remains a central barrier. A single cycle of in vitro fertilization typically costs between $15,000 and $30,000, with additional expenses for medications, genetic testing, donor materials, transportation, and storage. Fertility preservation services, such as egg freezing, can cost as much as $15,000 upfront, plus annual storage fees. Because Black women face persistent wage and wealth gaps, these prices put care out of reach for many.
Geography compounds the problem. Fertility clinics are often concentrated in metropolitan areas, leaving Black women in the rural South with few or no local options. Southern states also have higher rates of uninsurance and limited access to pregnancy-related care, intensifying risk in a region where Black women already face the nation’s highest maternal mortality rates.
The fact sheet emphasizes that comprehensive insurance coverage for fertility care could reduce financial barriers and help prevent adverse pregnancy outcomes, including miscarriage, preterm birth, and severe maternal morbidity. Without policy action to expand coverage and address structural inequities, fertility care remains another pathway through which racial health disparities persist.
See: “The Importance of Equitable Access to Fertility Care for Black Women” (April 25, 2025)
