Maternal Health — Track B: WOC Advocacy Sanctuary — Pillar 1
Overcoming Delayed Diagnoses: Your Voice Against Fibroids, PCOS, and “Normal Pain”
The WOC Reality Check
Your Pain Is Not “Normal,” and Your Concerns Are Not “Exaggerated.”
In the United States, Black women are two to three times more likely to develop uterine fibroids than white women — often developing them at younger ages and with more severe symptoms. Similarly, Indigenous and Brown women face disproportionately delayed diagnoses for Poly-Cystic Ovary Syndrome (PCOS) and endometriosis.
Why? Because for generations, the healthcare system has dismissed the reproductive pain and heavy bleeding of Women of Color as “just normal cramps” or told women to “just try to get pregnant and see what happens.”
Under Iwosan Journeys, our stance is non-negotiable: You deserve an objective, thorough diagnostic baseline before you try to conceive. We equip you with the exact language to demand imaging, blood work, and early evaluations without being brushed off.
Decoding Your Baseline (The WOC Red-Flag Audit)
Do not let a provider tell you to “just live with it.” Use this non-medical WOC awareness guide to evaluate your reproductive baseline:
| What You Experience at Home | What Providers Frequently Say | Why You Must Demand an Objective Evaluation |
|---|---|---|
| Heavy Bleeding & Clotting | “Some women just have heavier periods.” | Soaking through a pad/tampon in under two hours or passing blood clots larger than a quarter is a primary indicator of uterine fibroids, polyps, or adenomyosis. |
| Severe Menstrual Pain | “Take some ibuprofen; cramps are normal.” | Pain that causes nausea, missed work, or pain during intercourse is never normal. It warrants an immediate pelvic ultrasound to screen for endometriosis or fibroids. |
| Chronic Fatigue & Ice-Chewing | “You're just tired from working hard.” | Unexplained fatigue, dizziness, or craving non-food items (ice, cornstarch) are classic signs of severe iron-deficiency anemia or ferritin depletion, often caused by heavy cycles or Sickle Cell Trait. |
| Irregular Cycles & Facial Hair | “Just take birth control to regulate it.” | Skipping cycles, cystic acne, or chin/facial hair growth are physiological markers of PCOS or metabolic/insulin resistance — which must be optimized before conception. |
What to Tell & Ask Your Doctor (The WOC Preconception Script)
When you book a preconception or gynecology consultation, use this structured script to set a boundary against dismissal and demand objective data.
1. What to Tell the Doctor (Setting the Standard)
“Doctor, I am here for a comprehensive preconception baseline evaluation. I am aware of the reproductive health disparities impacting Women of Color, and I am taking a proactive stance. Over the last year, I have experienced [heavy bleeding / severe cramping / irregular cycles / profound fatigue]. My goal today is to order objective imaging and blood panels so we are not guessing about my reproductive baseline.”
2. What to Ask the Doctor (The 4 Non-Negotiable Questions)
The Pelvic Imaging Question
“Can we order a complete pelvic and transvaginal ultrasound today to map my uterus and ovaries and rule out fibroids, polyps, or structural cysts before conception?”
The Iron & Sickle Cell Baseline Question
“Can we run a complete blood count (CBC), check my ferritin (stored iron) levels, and verify my Sickle Cell Trait status so my blood baseline is optimized?”
The Metabolic & Endocrine Question
“Can we screen my fasting insulin, hemoglobin A1c, and a full thyroid panel (TSH, Free T3/T4) to ensure my endocrine system is ready for pregnancy?”
The Culturally Congruent Care Question
“How does your clinic actively monitor and support Black and Brown maternal health, and what is your protocol when a patient raises a concern about pain or symptoms?”
3. The “Document the Refusal” Script (When an Ultrasound or Lab Is Refused)
If a doctor says, “An ultrasound isn't necessary right now, just try for six months,” use your #1 WOC legal advocacy tool:
“I understand that is your clinical opinion. Please document in my official medical chart today that I explicitly requested a diagnostic pelvic ultrasound for my [heavy bleeding / pelvic pain], and note that you refused to order it. I would like a printed copy of my visit notes before I leave.”
Note: Over 90% of providers will order the test immediately rather than assume the liability of a documented refusal.
A note on this page: The information here is educational and self-reflective in nature. It does not diagnose, treat, or replace a conversation with a licensed healthcare provider.