Minority stress adds an additional layer to fear of childbirth in lesbian and bisexual women, and transgender people

The views and experiences of LGBTQ+ people regarding midwifery care: A systematic review of the international evidence

“…This is viewed as important by LGBTQ+ people as the constellation of family have now evolved beyond the traditionally accepted and understood conceptualisation of 'family' (Röndahl et al, 2009). Often however, LGBGTQ+ people continue to receive care that is delivered within a dominant heteronormative culture with the distinct needs and concerns of lesbian, bisexual and transgender people remaining hidden, ignored and poorly understood (Dibley 2009;Klittmark et al, 2019;Larsson and Dykes, 2009;Lee et al, 2011;Malmquist, 2019;Renaud, 2007;Röndahl et al, 2009;Wilton & Kaufmann, 2001). It was seen as crucial for some that they identify a 'lesbian friendly' health provider to be involved from the outset.…”

“…Other LGBTQ+ study participants had concerns around surrogacy, trust and legal issues such as parental rights (Renaud, 2007). In some studies, the LGBTQ+ participants had negative past healthcare experiences and were reluctant to divulge their sexual identity for fear of discrimination and the threat of the provision of appropriate care and supports (Dibley 2009;Malmquist, 2019;Röndahl et al 2009;Spidsberg 2007;Wilton and Kaufmann 2001). The importance of recognising, valuing and fully involving co-mothers in the ant-natal process and beyond was stressed by some lesbian participants (Erlandsson et al, 2010;Larsson and Dykes, 2009;Renaud, 2007).…”

“…LGBTQ+ people viewed it as necessary for midwives to recognise and respond appropriately to the support needs of different families with diverse experiences and requirements. This was viewed as necessary by LGBTQ+ people to enable midwives to address their own preconceptions and assumptions of appropriate healthcare delivery regarding nongender conforming individuals, thereby proactively addressing issues related to heteronormativity, minority stress and discrimination (Dibley et al, 2009l Ellis et al, 2015Lee et al, 2011;Larsson and Dykes, 2009;Malmquist 2019, Renaud 2007Röndahl et al, 2009). It was highlighted by some lesbian, bisexual and trans participants that midwives need to demonstrate sensitivity, diplomacy and understanding of their unique needs throughout the entire care journey from pre-pregnancy, antenatal care, labour, postnatal care and parenting and on-going care and support (Röndahl et al, 2009;Spidsberg 2007).…”

“…A concern experienced by some study participants during pregnancy and labour related to fear of discrimination and prejudice from midwives that would negatively impact on the care and support received (Dibley 2009;Klittmark et al, 2019;Lee et al, 2011;Larsson and Dykes, 2009;Malmquist, 2019). The concerns led to minority stress and hypervigilance, with some participants in one study highlighting issues related to homophobia and transphobia (Malmquist, 2019).…”

Assessing the Mental Health of Fathers, Other Co-parents, and Partners in the Perinatal Period: Mixed Methods Evidence Synthesis

“…Prevalence of perinatal mental health disorders in step-parents (i.e., new partners), co-mothers, trans and gender-diverse parents is unknown. However, emerging evidence suggests higher depression symptoms in step-fathers and in lesbian co-parents (8,9) as well as potential challenges concerning fear of childbirth where both partners have childbearing potential (10). In addition, there may be some distinct challenges for LGBT+ parents, linked to heteronormative systems, stigma, marginalization, assisted reproduction, and invisibility/social and legal recognition as parents (11)(12)(13)(14).…”