Dominant narratives and excluded voices: Research on ethnic differences in access to assisted conception in more developed societies

Abstract

There is a considerable body of work in the UK, US, Australia, New Zealand and increasingly within Europe which documents inequities in the provision of healthcare to both migrant groups and settled immigrant or minority ethnic communities (Bhopal, 2007).Within the UK, the main emphasis in this field has been on access to primary care, coronary heart disease, diabetes, cancer and mental health services (Nazroo,1997; Smaje and Le Grand, 1997; Atkinson et al, 2001; Atkin, 2004).1 In the area of reproductive health, considerably more emphasis has been placed on ethnic differences in access to sexual health and contraceptive services than infertility treatment (Katbamna, 2000), reflecting perhaps a dominant (racist) view that minority ethnic women are ‘hyperfertile’(Ceballo, 1999). In the US, Nsiah-Jefferson and Hall (1989) and Roberts (1999) have argued that ignoring the infertility problems of ‘women of color’ (and poor women) is consistent with the historical association between eugenics and social policy programmes that have promoted policies to maintain the dominance of the native-born white population, while restricting the reproductive activities of immigrants, blacks and native Americans.