Problem

Unplanned pregnancies disproportionately affect BIPOC communities. Specifically, Black women face the highest incidence of unintended pregnancies as they are impacted by contraceptive deserts, and a reported 67% of them face discrimination when attempting to use family planning services. This disparity is compounded by the fact that Black women are 3-4 times more likely to die due to childbirth-related causes than white women. Some of these pregnancy and childbirth-related complications can be explained by how Black and American Indian/Alaska Native mothers are at higher risk of cardiomyopathy, gestational hypertension, and pre-eclampsia, all of which can lead to severe maternal health concerns which include morbidities or disabilities.

Key Terms

**Contraceptive deserts:** areas where the number of health centers offering the full range of methods is not enough to meet the needs of the area's number of women eligible for publicly funded contraception
**Doula:** a person, who is not a medical professional, who provides emotional and physical support to mothers-to-be or mothers during pregnancy and childbirth
**Endometriosis:** an often painful disorder in which tissue similar to the tissue that normally lines the inside of a woman's uterus — the endometrium — grows outside the uterus
[**Gestational hypertension](https://americanpregnancy.org/healthy-pregnancy/pregnancy-complications/gestational-hypertension-859/#:~:text=Gestational Hypertension– High blood pressure,and protein in the urine.):** high blood pressure that develops after week 20 in pregnancy and goes away right after delivery
**Human papillomavirus (HPV):** the most common sexually transmitted infection (STI) that sometimes leads to genital warts or even cervical cancer. A HPV vaccine does exist in the U.S., but there are disparities in access both within America and the rest of the world
**Perinatal:** a short time period before and after birth, generally considered as starting 22 weeks into pregnancy and ending 1 week after birth
**Polycystic ovary syndrome (PCOS):** affects the ovaries and ovulation for women of reproductive age - generally involves cysts in the ovaries, higher levels of male hormones (androgen), and/or irregular or skipped periods
**Postpartum:** the period just after birth and a time of tremendous hormonal change for a mother; generally, estrogen and progesterone drop very quickly
**Pre-eclampsia:** a pregnancy complication characterized by high blood pressure and signs of damage to another organ system, most often the liver and kidneys

Solutions

1. Contraceptive Access

19 million women don’t have access to all birth control methods, and 67% of Black womxn face discrimination when obtaining family planning services.

Existing Solutions

NURX, Hers, and Pill Club ****are democratizing access to contraceptive health and sexual wellness resources through direct to consumer delivery in discreet packaging. By enabling anyone to get access to high quality, affordable sexual healthcare, these startups are battling one facet of racial inequality in America.
Everlywell is offering at-home STI/STD, HPV, and general fertility/menopause testing kits that allow womxn to collect samples from the comfort of their homes, mail their samples discreetly to a lab, receive results via personalized reports, and schedule telemedicine consultation followups with specialists if necessary.
Bloomi is a brand and online wellness marketplace that is seeking to destigmatize sexual health products for Latinx womxn.
There is no male birth control pill, and [overall usage of condoms has been falling.](https://www.healthline.com/health-news/why-are-so-many-teens-ditching-condoms#:~:text=The decreasing use of condoms,more often than high schoolers.) Introducing male birth control could help reduce the burden BIPOC womxn face -- a hormonal-based gel called NES/T and a small molecule from YourChoiceTx are two promising candidates.

What needs to be done?

<aside> 🔬 Contraceptive drug development and discovery: Past research into hormonal treatments (e.g., testosterone) have encountered complications with the far-ranging side effects of steroid use. Small molecule drugs for male birth control have been difficult to identify.

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<aside> 👩🏾‍🤝‍👩🏽 Access to quality and discreet contraceptive / sexual health care: Providing online care, community, and education can help womxn more comfortably learn about their bodies and seek preventative care or treatment without shame or stigma.

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