The Effect of Language on Lesbian Nonbirth Mothers

[Care and Support for same-sex Couples during Pregnancy and Childbirth]

INTRODUCTION

Since 2015, same-sex couples in Austria have been able to fulfil their desire to have children with the help of reproductive medicine services. The aim of this study was to determine the needs of women and the special features of care for women in couple relationships during pregnancy and childbirth.

METHODOLOGY

Eight interviews were conducted with Austrian women in same-sex relationships using a semi-structured guideline. The women were recruited by means of a convenience sample via an association and word of mouth. The content of the collected data was analysed using the recommended Mayring method.

RESULTS

In the obstetric accompaniment of same-sex female couples, it became obvious that the usual use of language was inappropriate and alternatives to the term father, such as the term co-mother, were insufficiently established. Openness, acceptance and understanding as well as being seen as a holistic family were considered important prerequisites for improving the quality of care. In addition, the inclusion of the non-pregnant mother was considered essential. Despite their non-traditional couple relationship, female couples wanted care without special status and prejudice.

DISCUSSION AND CONCLUSION

A comprehensive socio-political discourse is still needed to promote the normality of family models beyond heteronormativity. Unbiased, supportive obstetric care can offer rainbow families a framework in which children can develop healthily from the outset.

Homoparenting as a public health issue: a scoping review

OBJECTIVE

To map global scientific production on homoparenting in the field of collective health or public health.

METHODS

In terms of methodological procedures, a scoping review was carried out, guided by the following question: What are the aspects addressed in global scientific production regarding homoparental families in the field of collective or public health? The searches were carried out in seven sources of scientific literature, including 58 studies, involving scientific articles and dissertations. The analytical treatment given to the studies, most of which were qualitative, followed the content analysis technique in the thematic modality.

RESULTS

The results indicate that the perceptions of homosexuals and professionals about the care provided and health services in general was the topic addressed by the largest number of studies (n = 31), followed by heteronormative context of health services (n = 26); disclosure of sexual orientation (n = 20); fertilization (n = 14); educational information and actions (n = 5).

CONCLUSION

Although the issue of same-sex parenthood has been discussed in some health sectors, there is awareness that it is necessary to rely on a consolidated basis through numerous studies when discussing this issue. It is concluded that, among other aspects, the scope of this review is not sufficiently problematized within the scope of health professionals' training and performance.

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.

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.

Same-sex mothers' experiences of equal treatment, parenting stress and disclosure to offspring: a population-based study of parenthood following identity-release sperm donation

STUDY QUESTION

What are the experiences of same-sex mothers following identity-release sperm donation regarding equal treatment in society, parenting stress and disclosure to child?

SUMMARY ANSWER

Mothers predominantly reported equal treatment in society, low levels of parenting stress and early disclosure of the donor conception to the child, and half of the couples had also informed the child of his/her right to obtain the donor’s identity.

WHAT IS KNOWN ALREADY

The number of two-mother families is increasing, and previous studies have reported about challenges related to heteronormativity, discrimination and the status of the non-birth mother. Same-sex mothers have been found to disclose the child’s donor conception earlier than different-sex parents, but little is known regarding disclosure of the child’s right to obtain identifying information about the donor.

STUDY DESIGN, SIZE, DURATION

The present study concerns the fourth wave of data collection of a nation-wide longitudinal study. A total of 143 same-sex mothers (73% response rate) following identity-release sperm donation completed individual surveys when their donor-conceived child had reached age 7. These women represent a total of 82 couples who had undergone sperm donation treatment.

PARTICIPANTS/MATERIALS, SETTING, METHODS

The study is part of the longitudinal Swedish Study on Gamete Donation (SSGD). Couples accepted for gamete donation treatment at seven Swedish University hospitals were recruited between 2005 and 2008 and were requested to complete postal surveys during four waves of data collection. The present study sample includes same-sex mothers who completed a survey when their donor-conceived child had reached 7 years of age. Data were collected with the Swedish Parenting Stress Questionnaire (SPSQ), and study-specific items on experiences of treatment in society and disclosure behavior. Group comparisons (birth mothers vs non-birth mothers) were conducted using Chi²-tests, independent t-tests and Mann–Whitney U-tests, and written comments provided for open-response items were analyzed by qualitative content analysis.

MAIN RESULTS AND ROLE OF CHANCE

The mothers were generally open about the child’s donor conception and the large majority (>80%) reported being treated positively and in the same way as other parents. However, satisfaction with treatment in health care settings was significantly lower than that reported in contacts with the child’s school and recreational activities (P < 0.001) and open-response comments indicate that this may be related predominantly to heteronormative language and assumptions. Birth mothers and non-birth mothers reported similar treatment in society and similar levels of parenting stress. All but one couple had already talked with their 7-year-old child about his/her conception with donor sperm. Half of the couples had also informed the child about his/her opportunity to obtain identifying information about the donor, and remaining couples planned later disclosure. Children’s reactions were generally described as neutral, positive or characterized by interest and curiosity.

LIMITATIONS, REASONS FOR CAUTION

The present study was performed within the context of the Swedish legislation on identity-release donation, which limits the generalizability to same-sex couples using anonymous or known sperm donors. Although no evidence of attrition bias was found, it is possible that those couples who initially declined participation in the SSGD (23%) or dropped out at the fourth wave of data collection (27%) differ from the study sample in terms of variables that we were unable to control for.

WIDER IMPLICATION OF THE FINDINGS

The present finding that most same-sex mothers in a population-based sample experience equal treatment in society is encouraging and validates previous results from predominantly qualitative studies. Nevertheless, the fact that a subgroup experiences discrimination and less favorable treatment indicates that further action is needed, particularly in child health care settings. The present study is the first to report on the timing of parents’ disclosure of the child’s right to identifying donor information and suggests that disclosure during preschool ages is feasible and does not appear to be related to negative consequences. In view of the increased availability and use of identity-release donation, there is a pressing need to investigate parents’ intentions, behaviors and needs with regard to talking with their child about his/her opportunity to obtain the donor’s identity.

STUDY FUNDING/COMPETING INTEREST(S)

Financial support from the Swedish Research Council (2013-2712) and the Swedish Research Council for Health, Working Life and Welfare (2014-00876). There are no conflicts of interest to declare.

TRIAL REGISTRATION NUMBER

N/A.

Associations between heteronormative information, parental support and stress among same-sex mothers in Sweden-A web survey

Aim

The aim was to investigate same‐sex mothers’ self‐assessed experiences of forming a family, and the association between heteronormative information, parental support and parenting stress.

Design

A quantitative, cross‐sectional study.

Methods

In a web survey conducted in Sweden in 2019, same‐sex mothers (N = 146) with a child aged 1–3 years answered questions about their experiences of forming a family through assisted reproduction and questions about parenting stress. Descriptive statistics describes the process of forming a family. Pearson's correlation analyses and independent sample t tests were used to test hypotheses about heteronormative information, parental support and parenting stress.

Results

Same‐sex mothers experienced going through assisted reproduction treatment as stressful, and parental groups as not being supportive. Heteronormative information correlated with both lower perceived parental support and higher perceived parenting stress. Non‐birth mothers experienced less acknowledgement and support than birthmothers.

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

Breastfeeding experiences of same-sex mothers

BACKGROUND

Family structures are diversifying in the United States, and more same-sex female couples are building families. For two-mother families, complexity exists for breastfeeding as more than one mother can provide human milk. The purpose of this study was to explore the lactation experience and level of lactation support of birth mothers in a same-sex (two female) relationship.

METHODS

This study consists of a mixed methods design using an online survey to identify the demographic of same-sex mothers and qualitative interviews to provide an in-depth understanding of the mothers' experiences. Qualitative content analysis is applied to develop themes from the interviews.

RESULTS

Sixty-eight participants completed the online survey. Thirty-seven mothers (59%) reported breastfeeding for more than one year. Fourteen (21%) respondents reported accessing induced lactation information for the nongestational parent from their health care practitioner. Forty-three (63%) respondents reported receiving breastfeeding and induced lactation information from other sources. Only nine (13%) nongestational parents underwent induced lactation. Eighteen gestational mothers participated in qualitative interviews. Five themes emerged from the qualitative data: (a) committed to a year, (b) deciding "how to do it," (c) sources of information, (d) involvement of partner, and (e) need for inclusive and educated health care practitioners.

CONCLUSIONS

Same-sex mothers have strong intentions to breastfeed and are resourceful in educating themselves for induced lactation and conursing. Nongestational parents are essential support partners and equivalent in motherhood. Providers need to better equip themselves and incorporate inclusive language in breastfeeding policy statements to support lactation outcomes.

Mothers in same-sex relationships-Striving for equal parenthood: A grounded theory study

AIMS AND OBJECTIVES

To get a deeper understanding of how mothers in same-sex relationships think and reason about their parenthood in terms of gender equality, and how they experience early parental support from child healthcare professionals.

BACKGROUND

There is an increasing amount of research on how women in same-sex relationships experience healthcare services when forming a family. Yet there is limited knowledge of what kind of early parental support these women may request.

DESIGN

Grounded theory. Follows guidelines for qualitative research (COREQ).

METHOD

Twenty women ranging from 25 to 42 years of age participated in semi-structured interviews. Data collection and analysis took place in parallel, as recommended in grounded theory methodology.

RESULTS

The results are described by the core category Same-sex mothers request professional support to achieve equal parenthood, which includes five categories: (a) equality in everyday life, (b) diversity in mother and child attachment, (c) justification of the family structure, (d) ambivalent thoughts about their child's future and (e) a special need for networking and request for professional support. These findings provide a deeper understanding of how same-sex mothers experience their parenthood and the parental support that is offered.

CONCLUSION

Child healthcare professionals need to be sensitive and recognise both mothers as equal parents and offer early parenting groups where two-mother families feel included and supported.

RELEVANCE TO CLINICAL PRACTICE

Healthcare professionals need to be aware of diverse family formations and meet each parent as a unique individual without heteronormative assumptions. Same-sex mothers must be treated as equal parents and acknowledged as mothers. Healthcare professionals should offer inclusive and supportive parental groups to same-sex families. They should also inform and support nonbirth mothers about the possibility to breastfeed.

Lesbian, gay, and bisexual (LGB) people's experiences of nursing health care: An emancipatory nursing practice integrative review

AIM

To review current research on lesbian, gay, and bisexual (LGB) individuals' experience of nursing services from an emancipatory nursing practice framework.

BACKGROUND

As LGB issues are marginalized in health care, it is important to understand LGB individuals' experiences of nursing.

DESIGN

An integrative literature review using critical analysis based on an emancipatory nursing practice framework was conducted.

DATA SOURCES

A search of all English nursing journals in the World of Science database was conducted.

REVIEW METHODS

Established methods were used to search, identify, and appraise articles meeting the criteria of examining LGB individuals' experiences of nursing services, published in the years 2009 to 2015. Sixteen articles that met the inclusion criteria were identified independently by the two authors. Data were analysed using descriptive and critical phases of enquiry.

RESULTS

Results show a nexus of experiences of exclusion and oppressive social norms. Our analytical framework highlighted absences in nursing practice. No research indicates that LGB people experience nurses as advocates or participatory health care processes.

CONCLUSION

Standards, training, and systems need to be devised that ensure inclusionary nursing practices, that encourage nurses to act as advocates for LGB health care justice, and that allow LGB individual to participate in the development of health care policies and procedures.

Hearing the Silenced Voices of Underserved Women: The Role of Qualitative Research in Gynecologic and Reproductive Care

In order to provide effective evidence-based health care to women, rigorous research that examines women's lived experiences in their own voices is needed. However, clinical health research has often excluded the experiences of women and minority patient populations. Further, clinical research has often relied on quantitative research strategies; this provides an interesting but limited understanding of women's health experiences and hinders the provision of effective patient-centered care. This article defines qualitative research and its unique contributions to research, and provides examples of how qualitative research has given insights into the reproductive health perspectives and behaviors of underserved women.