In a week that has seen huge gains for women in the public service, Michelle Obama has just broken another major hurdle.
The former first lady, in an interview for the promotion of her next memoir, shared a painful and personal secret: she and Barack Obama fought against infertility, had a miscarriage and used fertilization in vitro (IVF) to have their two daughters, Malia and Sasha.
What makes her story so remarkable is not that she and her husband have fertility problems, but that she is talking about it now and opening the door to millions of women who have had or are struggling with conceive to share their own stories.
"I think it's the worst thing we do to each other as women, not to share the truth about our bodies, how they work and how they work," Obama said in an interview with " Good Morning America ".
The fact that this woman has touched on this topic could immediately bring attention to how public policy is treating it. Obama's new willingness to discuss his previously secret struggles can shed new light on the prevalence of infertility and the incredible emotional and financial cost of medical care for medical treatment.
While the Affordable Care Act, her husband's legislative asset, mandatory coverage of maternal health care, she did not require coverage of fertility treatments. Medicaid either. And while 15 states have enacted laws that insurers cover or offer coverage for infertility treatments, women in the remaining 35 states often have to pay out of pocket if they hope to conceive. And even when it is covered, it is sometimes only partially, and still requires a massive expenditure of money inaccessible to most people.
In vitro fertilization can cost up to $ 20,000 per cycle, so the opportunity to have children becomes a matter of means. In other words, only infertile couples with this type of disposable income have all the possibilities for pregnancy. This is perhaps the most striking example of disparities in access to health.
In May, Senator Cory Booker (DN.J.) and Representative Rosa L. DeLauro (D-Conn.) Introduced legislation requiring insurers to cover infertility treatments without increasing premiums or co-payments. payers. The bill never went anywhere, but could find a new life in a Democrat-led House with a record number of women.
Just like mental health is an invisible disease that people often fear to talk about, as is infertility. Last year, the American Medical Association decided to follow the example of the World Health Organization and referred to infertility as a disease, in which it was found to be an illness. hope to promote more insurance coverage for treatments and less stigma.
Richard Paulson, former president of the American Society for Reproductive Medicine, compared this to the way people treated breast cancer.
"I remember a time when people were not talking about breast cancer and it was only when celebrities came in to take it out and demystify it," he said. "Infertility is a legitimate disease, there is treatment and we have it."
Infertility rates continue to increase as more and more women wait until later in life to start a family. The Obama's were in their thirties when they underwent IVF.
The least well-kept secret about infertility lies in its frequency – about a couple in eight is struggling to get pregnant or a baby until the end – but women still resist talking about it , often blaming himself and silently conveying shame and anguish.
"Our culture is focused on reproduction and infertility in particular, it touches the very heart of our self-image, who we are and how we see ourselves." Many women still feel that They are sterile "And for men, this reflects their power and masculinity," said Paulson. But it's incredibly common, and it's wonderful to discover it in broad daylight. "
In addition, one in four pregnancies ends in miscarriage – about 4 million pregnancies in the United States in a given year, or up to 1 million women. And yet, since most miscarriages occur during the first trimester when women do not often reveal their pregnancy, they lose it alone.
It's a sad reality to which Obama has spoken directly.
"I felt lost and alone and felt that I had failed, because I did not know how common miscarriages were, because we do not talk about them," she said. declared. "We are sitting in our own pain, thinking we are somehow broken."
Obama is not the first political figure to openly discuss his infertility. Earlier this year, Senator Tammy Duckworth (D-Ill.) Announced that she was pregnant with her second child, making her the first senator to have a baby.
About her pregnancy, Duckworth said, "I have had multiple IVF cycles and a miscarriage trying to conceive again, so we are very grateful."