I grew up in a household of women who didn’t talk much about their reproductive health. Period talks were reserved for hushed tones, always behind closed doors. But over the years, stories began to emerge: A relative clocking into work despite her stomach being so swollen with fibroids she appeared pregnant; a childhood friend excelling in school while doctors dismissed her chronic pain and missing periods as “anxiety”; a family member’s miscarriage garnering little sympathy from nurses.

Black women have long been forced to grin and bear reproductive pain until it becomes unbearable—just like the data has been telling us: By age 50, 90 percent of Black people with uteruses in the United States report having fibroids and often have severe symptoms like anemia and intense pain. Black women are not only more likely to have uterine cancer, but twice as likely to die from it than non-Black women. Black women are also three to four times more likely to die in childbirth. It’s a crisis that transcends economic and education boundaries, with celebrities like Beyoncé and Serena Williams experiencing near-fatal pregnancy complications.

I spoke with Dr. Kemi Doll, author of the new book A Terrible Strength: The Hidden Crisis of the Black Womb and Your Survival Guide to Healing, about what Black women can do to educate ourselves about our reproductive health and how we can advocate for ourselves in our gyno offices and beyond.

This interview has been edited for length and clarity.

One of the main points you bring up is how breast cancer, ovarian cancer, and our ongoing maternal mortality crisis are reproductive issues that make headlines. But with uterine cancer, the disparity in Black women doesn’t receive that same attention from the public. Why is that?

I have a lot of ideas about this. Part of it is that all of us, the public included, are so used to not talking about “down there.” So we don’t. We eliminate that world in a woman’s life unless she’s pregnant, unless we can tie it to something like bringing life into this world. But then we see this [lack of care] played out on a larger scale, where you have this cancer disparity.

Uterine cancer is the worst cancer disparity that we have that affects women. We’re getting more cases every year. But the level of dialogue and awareness doesn’t match the gravity of the crisis. It’s an example of what I’m talking about: the power of silencing. It’s why I’m so passionate about talking about the womb in the realm beyond giving birth and beyond being pregnant, because we all spend most of our time not pregnant, and we all deal with these conditions every day. It’s beyond time to stop that silencing and........

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