The other mother: a narrative analysis of the postpartum experiences of nonbirth lesbian mothers

Family-Centered Care for LGBTQ+ Parents of Infants in the Neonatal Intensive Care Unit: An Integrative Review

BACKGROUND

Having an infant in the Neonatal Intensive Care Unit (NICU) can disrupt parent well-being, the transition to parenthood, and the typical trajectories of infant and child health. For lesbian, gay, bisexual, transgender, queer, or other sexual and gender minority identity (LGBTQ+) parents, this stress may be compounded by health disparities and fear of stigma and discrimination; however, research is lacking about LGBTQ+ parents of infants in the NICU.

OBJECTIVES

The purpose of this integrative review was to better understand the experiences of LGBTQ+ parents of NICU infants, with a focus on experiences of stigma and discrimination, sources of strength and resilience, and provision of family-centered care.

METHOD

We searched EBSCOHost, ProQuest, Web of Science, and Google Scholar between 30 May 2023 and 18 September 2023 for empirical studies published in English in peer-reviewed scholarly journals in which LGBTQ+ parents shared their experiences with having infants admitted to the NICU.

RESULTS

We identified six articles that met inclusion criteria, all of which were qualitative studies that included 12-14 LGBTQ+ parents of NICU infants.

CONCLUSIONS

LGBTQ+ parents in all studies reported instances of perceived stigma and discrimination while their infants were in the NICU, whereas parents in two studies mentioned strength and resilience, and parents in three studies described elements of family-centered care. There is a need for rigorous research on family-centered NICU care that includes questions about sources of strength and resilience in addition to challenges. We propose that future researchers use community engaged methods to center perspectives of LGBTQ+ parents.

Childbearing at the margins: A systematic metasynthesis of sexual and gender diverse childbearing experiences

BACKGROUND

The reproductive and perinatal health of sexual and gender-diverse (SGD) individuals is a research priority area for the National Institutes of Health. Over the past decade, this childbearing population has been the focus of several qualitative studies providing the opportunity to evaluate and synthesize the qualitative literature on SGD childbearing experiences in a metasynthesis.

METHODS

We conducted a literature search of four databases to identify original research published from January 2011 through June 2021. These results were augmented by forward and backward searching strategies. Two authors independently screened studies. All qualitative studies of the childbearing experience were eligible. Data were extracted and inductively coded using conventional content analysis, and studies underwent a quality appraisal by two authors.

RESULTS

From 2396 articles, 127 full-text articles were screened, and 25 were included in this synthesis. Three overarching themes were identified: (a) Systematic Invisibility; (b) Creating Personhood Through Parenthood; and (c) Resilient Narratives of Childbearing.

CONCLUSIONS

Relative to heterosexual and cisgender parents, SGD childbearing parents experience unique structural and interpersonal challenges and employ critically important resilience strategies and coping techniques to manage an overwhelming heterocisnormative experience. These findings provide an important target for health care organizations and professionals to improve SGD perinatal health. In addition, this metasynthesis identified persistent gaps in our understanding of this marginalized childbearing population, which have important implications for reducing health disparities that SGD parents experience.

"Who's the Mom?": Heterosexism in Patient-Provider Interactions of Queer Pregnant Couples

Previous scholarship has discussed how queer individuals experience discrimination in healthcare settings. This study furthers this area of research by exploring how queer pregnant couples encountered heterosexism within patient-provider interactions. Heterosexism is being used as a framework for the study by looking at how healthcare acts as a power system to promote heterosexual identity. Through using a multiadic analysis, I interviewed 16 couples both together and separately, resulting in 46 total interviews. The analysis demonstrated that the couples experienced heterosexism by providers not understanding who the "mom" is, having to explain sexual identity to providers and providers reinforcing heterosexist expectations. The couples also provided advice for healthcare providers to improve their interactions with future queer pregnant couples.

LGBTQ+ Persons' Experiences of Parenthood in the Context of Maternal and Child Health Care: A Meta-ethnography

This study aims to integrate and synthesize knowledge of lesbian, gay, bisexual, transgender and queer (LGBTQ+) persons' experiences of parenthood in the context of maternal and child health care. For nurses to provide optimal care for LGBTQ+ parents, we need to derive knowledge from their perspectives. An interpretive meta-synthesis approach, meta-ethnography, was chosen for this study. A lines-of-argument synthesis based on four themes was developed: (1) Entering the world of LGBTQ+ parenthood; (2) The emotional journey in LGBTQ+ parenthood; (3) Struggling with the system as a LGBTQ+ parent and (4) A need to expand the knowledge horizon of LGBTQ+ parenthood. The overarching metaphor, "To be recognised as parents, unique and good enough, like everybody else," reflects how recognition and inclusion may support LGBTQ+ persons in their parenthood and broaden the understanding of parenthood. Knowledge of the LGBTQ+ family needs to be given greater attention in maternity and child health care settings, and in education and health policies.

The Motherhood Experiences of Non-Birth Mothers in Same-Sex Parent Families

In this qualitative study, we explored the experiences of non-birth mothers whose child(ren) were planned and conceived within their same-sex relationship. We conducted semi-structured, face-to-face interviews with 14 participants in Ireland. We transcribed the interviews verbatim and analyzed the data using interpretative phenomenological analysis. Our findings comprised three superordinate themes: A Question of Recognition, An Insecure Connection, and Carving Your Own Way and related subordinate themes. Motherhood experiences were characterized by resilience and vulnerability in parenting their children without legal parental rights and within a heteronormative society that privileged biological motherhood. The dynamic relationship between seeking connection and seeking legitimacy that is at the heart of the participants’ experiences of motherhood is highlighted. Participants encountered challenges to their maternal legitimacy within their families and communities and in their interactions with legal and social institutions. Participants described using various strategies to reinforce their parental identity. Despite the challenges, participants were engaged in constructing satisfying parenting roles. The findings highlight the importance of legitimizing the parental identity of non-birth mothers. Therapists should be sensitive to the additional marginalization of non-birth mothers in same-sex parent families. Validating their vulnerability and their resilience in the face of obstacles may enhance their coping resources. Online slides for instructors who want to use this article for teaching are available on PWQ’s website at http://journals.sagepub.com/doi/suppl/10.1177/03616843211003072

Gay Fatherhood in the NICU: Supporting the "Gayby" Boom

BACKGROUND

With advances in reproductive health, gay males are increasingly given the opportunity to reproduce. It is not a common occurrence for infants of gay male fathers to enter the neonatal intensive care unit (NICU); however, this may change and should be acknowledged.

PURPOSE

To give insight into the barriers, perspectives, and stresses of gay male caregivers (families) in their time spent in the NICU and to offer recommendations as to how better to serve them and their families.

METHODS/SEARCH STRATEGY

Searched using PubMed, CINAHL, SCOPUS, and Google Scholar. Key words used were "gay families," "fatherhood," "neonatal intensive care unit," "lesbians," and "surrogacy."

FINDINGS/RESULTS

There remains a very limited amount of data for healthcare providers as these relate to gay male fathers in the NICU, aside from narratives. Most of the research and literature that highlight potential barriers stem from heterosexual fatherhood in the NICU and lesbian parenting in the healthcare system.

IMPLICATIONS FOR PRACTICE

To have an understanding and knowledge to improve support for gay fathers in the NICU.

IMPLICATIONS FOR RESEARCH

Research on gay fathers in the NICU and further research on lower economic gay fatherhood and gay men of color and fatherhood are required. Because of the small sample size, multicentered studies may warranted to aid in clinical significance.

Identity Transformation During the Transition to Parenthood Among Same-Sex Couples: An Ecological, Stress-Strategy-Adaptation Perspective

This article reviews the current research on the potential stressors associated with identity transformation experienced by same-sex couples during the transition to parenthood and the coping strategies they employ. By integrating disparate findings into an ecological, stress-strategy-adaptation framework, we demonstrate that the identity transformation experiences among same-sex couples during the transition to parenthood (a) involve various adaptive processes of navigating different stressors via their human agency within multiple nested contexts; (b) are products of the intersections of individual characteristics, relational dynamics, LGBT community culture, and heterosexual sociostructural norms; and (c) are complicated by social contextual factors such as social class, race/ethnicity, family structure, and the sociocultural environment associated with geographic location. Last, several avenues for future inquiry are suggested.

Partners' perspective on care-system support before, during and after childbirth in relation to parenting roles

OBJECTIVES

To explore (i) ways in which partners experience support from care systems before, during, and after childbirth in relation to their parenting roles and (ii) ways in which support can improve.

METHODS

Four focus group interviews (n = 17; median age = 35; age range = 24-46) and inductive content analysis.

RESULTS

Analysis revealed the following three categories: (1) Care staff include or exclude in relation to partners' parenting role; (2) Care systems continuity; (3) Being a supportive partner. The latent content of the categories was formulated into a theme: being engaged and wanting to be included.

CONCLUSIONS

Because partners are engaged parents, who support the woman giving birth, they must feel included during pregnancy, birth, and postpartum care and during encounters within child health care units. This would require (i) information that directly targets partners before and after childbirth, (ii) specially adapted venues for parent education, and (iii) personal, partner-focused discussions with care staff.