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Mamrath S, Greenfield M, Fernandez Turienzo C, Fallon V, Silverio SA. Experiences of postpartum anxiety during the COVID-19 pandemic: A mixed methods study and demographic analysis. PLoS One 2024; 19:e0297454. [PMID: 38451908 PMCID: PMC10919661 DOI: 10.1371/journal.pone.0297454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 01/04/2024] [Indexed: 03/09/2024] Open
Abstract
INTRODUCTION The first wave of the COVID-19 pandemic saw the reconfiguration of perinatal and maternity services, national lockdowns, and social distancing measures which affected the perinatal experiences of new and expectant parents. This study aimed to explore the occurrence of postpartum anxieties in people who gave birth during the pandemic. METHODS An exploratory concurrent mixed-methods design was chosen to collect and analyse the quantitative and qualitative data of an online survey during the first UK lockdown. The survey included the Postpartum Specific Anxiety Scale-Research Short Form-for use in global Crises [PSAS-RSF-C] psychometric tool, and open-ended questions in relation to changes in birth plans and feelings about those changes and giving birth in a pandemic. Differences in measured scores were analysed for the participant's ethnicity, sexual orientation and disability using independent Student's t-tests, and for age, the analysis was completed using Pearson's correlation. Qualitative data from open-ended questions were analysed using a template analysis. RESULTS A total of 1,754 new and expectant parents completed the survey between 10th and 24th April 2020, and 381 eligible postnatal women completed the psychometric test. We found 52.5% of participants reported symptoms consistent with a diagnosis of postnatal anxiety-significantly higher than the rates usually reported. Younger women and sexual minority women were more likely to score highly on the PSAS-RSF-C than their older or heterosexual counterparts (p<0.001). Younger participants reported anxieties in the 'infant safety and welfare' category, whilst lesbian, gay, bisexual, and pansexual participants scored highly in the 'psychosocial adjustment to motherhood' category. DISCUSSION Postpartum anxiety is under-reported, and demographic differences in the rates of postpartum anxiety are under-researched. This research demonstrates for the first time a difference in postpartum anxiety rates amongst sexual minority women.
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Affiliation(s)
- Simran Mamrath
- Department of Women & Children’s Health, School of Life Course & Population Sciences, Faculty of Life Sciences & Medicine, King’s College London, London, United Kingdom
| | - Mari Greenfield
- Department of Women & Children’s Health, School of Life Course & Population Sciences, Faculty of Life Sciences & Medicine, King’s College London, London, United Kingdom
- School of Health, Wellbeing and Social Care, Department of Wellbeing, Education, Languages and Social Care, The Open University, Milton Keynes, United Kingdom
| | - Cristina Fernandez Turienzo
- Department of Women & Children’s Health, School of Life Course & Population Sciences, Faculty of Life Sciences & Medicine, King’s College London, London, United Kingdom
| | - Victoria Fallon
- Department of Psychology, Institute of Population Health, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Sergio A. Silverio
- Department of Women & Children’s Health, School of Life Course & Population Sciences, Faculty of Life Sciences & Medicine, King’s College London, London, United Kingdom
- School of Psychology, Faculty of Health, Liverpool John Moores University, Liverpool, United Kingdom
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Greenfield M, Darwin Z. LGBTQ+ new and expectant parents' experiences of perinatal services during the UK's first COVID-19 lockdown. Birth 2024; 51:134-143. [PMID: 37803934 DOI: 10.1111/birt.12780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 09/09/2023] [Accepted: 09/15/2023] [Indexed: 10/08/2023]
Abstract
BACKGROUND COVID-19 created specific challenges for new and expectant parents and perinatal services. Services changed rapidly in the United Kingdom (UK), including the withdrawal of home birth services, birth center closures, and restrictions on the number of birth partners allowed in the birth room. The purpose of this study was to examine how these changes affected the experiences of LGBTQ+ parents in the UK. METHODS An online survey was conducted in April 2020 to provide real-time data capture of new and expectant families' experiences. It was open to those in the third trimester, or to those who had given birth since the beginning of the first UK lockdown period, and their partners. The survey asked open-ended questions about perinatal experiences. Demographic data were also collected, including sexual orientation and gender. Responses were collected from 1754 participants, including 76 who self-identified as LGBTQ+. RESULTS Thematic analysis identified that LGBTQ+ new and expectant parents faced similar issues to cisgendered, heterosexual expectant parents, though additional concerns were also noted relating to support and recognition. Heterocentric policies negatively affect lesbian families. Non-birthing co-mothers feared invalidation as parents. Sexual minority pregnant women were more likely than heterosexual pregnant women to consider additional birth supporters and to consider freebirthing. DISCUSSION Service changes introduced in the pandemic were cisheteronormative, creating additional challenges for LGBTQ+ new and expectant parents and compounding existing inequalities. When planning, changing, or evaluating perinatal services, specific consideration is needed to include birthing parents who are not mothers and mothers who did not give birth. If appropriate care is not available, consequences may include impaired perinatal wellbeing and restricted birth choices. Including sexual orientation and gender in data collection enables different perspectives to be considered.
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Affiliation(s)
- Mari Greenfield
- Faculty of Life Sciences and Medicine, King's College, London, UK
- The Open University, Milton Keynes, UK
| | - Zoe Darwin
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
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Lapping-Carr L, Dennard A, Wisner KL, Tandon SD. Perinatal Depression Screening Among Sexual Minority Women. JAMA Psychiatry 2023; 80:1142-1149. [PMID: 37531104 PMCID: PMC10398540 DOI: 10.1001/jamapsychiatry.2023.2619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 05/31/2023] [Indexed: 08/03/2023]
Abstract
Importance A substantial number of births in the US are to sexual minority women (17% based on a nationally representative survey), yet there is little research on perinatal depression screening rates or symptom endorsement among sexual minority women (including women who identify as lesbian, bisexual, queer, pansexual, asexual, demisexual, and kinky as well as other-identified women who have sex with women). High rates of risk factors for perinatal depression (eg, intimate partner violence and history of mental illness) among sexual minority individuals magnify this gap in the literature. Objective To describe the prevalence of female-identified sexual minority people giving birth in an academic medical center and compare perinatal depression screening rates and scores among sexual minority women and heterosexual cisgender women. Design, Setting, and Participants This retrospective cohort study used deidentified medical record review of 18 243 female-identified individuals who gave birth at an academic medical center in Chicago, Illinois, between January 1 and December 31, 2019. Data were analyzed from April 5, 2021, to August 1, 2022. Main Outcomes and Measures Proportion of women identified as having sexual minority status in the medical record, rates of standard care administration of the 9-item Patient Health Questionnaire between sexual minority women and heterosexual women, and depression screening scores and rates of positive depression screening results for sexual minority and heterosexual women. Results Among 18 243 women (mean [SD] age, 33.8 [5.1] years; 10 453 [57.3%] of non-Hispanic White race and ethnicity), only 280 (1.5%; 95% CI, 1.3%-1.7%) were identified as having sexual minority status in the medical record. Significantly more sexual minority women vs heterosexual women attended at least 1 prenatal care visit (56 [20.0%] vs 2459 [13.7%]; P = .002) and at least 1 postpartum care visit (52 [18.6%] vs 2304 [12.8%]; P = .004). Sexual minority women were more likely to be screened for depression during postpartum care (odds ratio, 1.77; 95% CI, 1.22-2.52; P = .002) and more likely to screen positive for depression during the postpartum period (odds ratio, 2.38; 95% CI, 0.99-5.02; P = .03) than heterosexual women. Conclusions and Relevance In this cohort study, sexual minority women identified in the medical record were highly engaged in obstetric care yet at high risk of postpartum depression. In addition, their sexual orientation was largely undocumented in medical records. These results highlight the need for investigations that include strategies for measuring sexual orientation because medical record review is unlikely to reliably capture these sexual identities during the perinatal period.
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Affiliation(s)
- Leiszle Lapping-Carr
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Ashley Dennard
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Katherine L. Wisner
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - S. Darius Tandon
- Department of Medical Social Sciences, Northwestern University, Chicago, Illinois
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Le J, Alhusen J, Dreisbach C. Screening for Partner Postpartum Depression: A Systematic Review. MCN Am J Matern Child Nurs 2023; 48:142-150. [PMID: 36744867 DOI: 10.1097/nmc.0000000000000907] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Postpartum depression is a significant mental health condition affecting an estimated 7% to 20% of women, with higher rates among individuals with increased risk factors. Most research on postpartum depression has focused on mothers, with less recognition of the mental health changes experienced by their partners. Research suggests almost 20% of partners may experience postpartum depression, yet our understanding is limited. An enhanced understanding of postpartum depression in a birthing person's partner is critical, given the mental and physical health sequelae associated with depression. PURPOSE The purpose of this review was to systematically examine the current tools available to assess partner postpartum depression. METHODS We conducted a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eligible studies were identified using selected key terms in PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, and Ovid MEDLINE. Studies were included if they assessed partner depressive symptoms and identified the specified use of a tool or screening measure. RESULTS Seventeen studies met inclusion criteria. Seven different measures were used to assess postpartum depression. The Edinburgh Postnatal Depression Scale (EPDS) was used in 16 out of the 17 studies for depression assessment. CLINICAL IMPLICATIONS Routine screening of partners for postpartum depression should be recommended as part of standard care. Nurses are critical liaisons for assessing risk and connecting relevant and timely resources to birthing people and their partners. Identifying the available screening tools may help to avoid adverse clinical outcomes associated with increased symptom severity and burden.
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Postpartum Depression Among Gay Fathers With Children Born Through Surrogacy: A Cross-sectional Study. J Psychiatr Pract 2023; 29:3-10. [PMID: 36649546 DOI: 10.1097/pra.0000000000000684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Studies on postpartum depression (PPD) in gay fathers are scarce. The goals of this study were to examine the prevalence of PPD among Israeli gay fathers with children born through surrogacy and to identify characteristics associated with PPD in this population. METHODS In this descriptive cross-sectional study, we sent surveys to gay fathers who had children who were 0 to 12 months of age and were born through surrogacy. Surveys were sent through 3 major surrogacy agencies in Israel and through the media. Data were collected concerning sociodemographic, medical, and lifestyle factors as well as concerning satisfaction with partners, family, and social support. Each respondent completed the Edinburgh Postnatal Depression Scale, which screens for PPD. Characteristics of fathers with and without probable PPD were compared. RESULTS Between July 2018 and December 2019, 66 men answered our questionnaire. The respondents, mean age of 37.5 years, were mostly first-time fathers (82%), with high rates of twin pregnancies (42%). Eight respondents (12%) were classified as having depressive symptoms (95% CI: 5.4%-22.5%), and 16 respondents (25%) reported current or past use of antidepressant medications. A negative association was observed between satisfaction with family support and report of depressive symptoms (χ22=6.53, P=0.038) and Spearman correlation test (rs=-0.34, P=0.005). CONCLUSIONS The incidence of probable PPD among gay fathers was 12% compared with 8.8% reported in fathers in the general population. High satisfaction with family support was associated with a lower incidence of probable PPD among gay fathers. Increased awareness of the potential for PPD in gay fathers can improve early diagnosis and treatment.
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Huller Harari L, Blasbalg U, Arnon S, Ben-Sheetrit J, Toren P. Risk factors for postpartum depression among sexual minority and heterosexual parents. Australas Psychiatry 2022; 30:718-721. [PMID: 36264652 DOI: 10.1177/10398562221133990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Postpartum depression (PPD), a major depressive episode with postpartum onset, develops in 15% of mothers. Although findings suggest sexual minority parents may be at risk for PPD, research among this population is scarce. We evaluated risk factors for PPD in a sample of sexual minority and heterosexual parents. METHOD Four hundred and twenty seven heterosexual and one hundred and eleven sexual minority parents responded to a questionnaire distributed via social media that included demographics, the Edinburgh Postnatal Depression Scale, and the Multidimensional Scale of Perceived Social Support. RESULTS Sexual minority identity was not associated with increased risk for PPD. Pregnancy had no significant effect on the likelihood for PPD. Social support was negatively and significantly associated with probability for PPD. CONCLUSIONS Our data suggest that sexual minority parents are not at increased risk for PPD, contrary to previous findings. The parental role, a psychosocial factor, is a more dominant risk factor than pregnancy itself, in the development of PPD.
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Affiliation(s)
- Liat Huller Harari
- Clalit Health Services, 61307Tel-Aviv Brüll Community Mental Health Center, Israel, Faculty of Medicine, 58408Tel-Aviv University Sackler, Israel
| | - Uri Blasbalg
- Clalit Health Services, 61307Tel-Aviv Brüll Community Mental Health Center, Israel
| | - Shay Arnon
- Clalit Health Services, 61307Tel-Aviv Brüll Community Mental Health Center, Israel
| | - Joseph Ben-Sheetrit
- Clalit Health Services, 61307Tel-Aviv Brüll Community Mental Health Center, Israel
| | - Paz Toren
- Clalit Health Services, 61307Tel-Aviv Brüll Community Mental Health Center, Israel, Faculty of Medicine, 58408Tel-Aviv University Sackler, Israel
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Kirubarajan A, Barker LC, Leung S, Ross LE, Zaheer J, Park B, Abramovich A, Yudin MH, Lam JSH. LGBTQ2S+ childbearing individuals and perinatal mental health: A systematic review. BJOG 2022; 129:1630-1643. [PMID: 35048502 DOI: 10.1111/1471-0528.17103] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 12/29/2021] [Accepted: 01/06/2022] [Indexed: 12/17/2022]
Abstract
BACKGROUND The perinatal period may uniquely impact the mental health and wellbeing of lesbian, gay, bisexual, transgender, queer, and Two-Spirit (LGBTQ2S+) childbearing individuals. OBJECTIVES To characterise and synthesise the experiences of LGBTQ2S+ childbearing individuals regarding perinatal mental health, including symptomatology, access to care and care-seeking. SEARCH STRATEGY We conducted and reported a systematic review following PRISMA guidelines of eight databases (EMBASE, MEDLINE-OVID, CINAHL, Scopus, Web of Science: Core Collection, Sociological Abstracts, Social Work Abstract, and PsycINFO) from inception to 1 March 2021. SELECTION CRITERIA Original, peer-reviewed research related to LGBTQ2S+ mental health was eligible for inclusion if the study was specific to the perinatal period (defined as pregnancy planning, conception, pregnancy, childbirth, and first year postpartum; includes miscarriages, fertility treatments and surrogacy). DATA COLLECTION AND ANALYSIS Findings were synthesised qualitatively via meta-aggregation using the Joanna Briggs Institute System for the Unified Management, Assessment and Review of Information (JBI SUMARI), and the ConQual approach. MAIN RESULTS Our systematic search included 26 eligible studies encompassing 1199 LGBTQ2S+ childbearing participants. Using the JBI SUMARI approach, we reported 65 results, which we synthesised as six key findings. The studies described unique considerations for LGBTQ2S+ individuals' perinatal mental health, including heteronormativity, cisnormativity, isolation, exclusion from traditional pregnancy care, stigma, and distressing situations from the gendered nature of pregnancy. Many participants described a lack of knowledge from healthcare providers related to care for LGBTQ2S+ individuals. In addition, LGBTQ2S+ individuals described barriers to accessing mental healthcare and gaps in health systems. Strategies to improve care include provider education, avoidance of gendered language, documentation of correct pronouns, trauma-informed practices, cultural humility training and tailored care for LGBTQ2S+ people. CONCLUSIONS Pregnancy, postpartum, and the perinatal period uniquely impacts the mental health and wellbeing of LGBTQ2S+individuals, largely due to systems-level inequities and exclusion from perinatal care. Healthcare providers should implement the identified strategies to improve perinatal care and address inequities.
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Affiliation(s)
- Abirami Kirubarajan
- University of Toronto Faculty of Medicine, Toronto, ON, Canada.,University of Toronto Institute of Health Policy, Management, and Evaluation, Toronto, ON, Canada
| | - Lucy C Barker
- University of Toronto Institute of Health Policy, Management, and Evaluation, Toronto, ON, Canada.,University of Toronto Department of Psychiatry, Toronto, ON, Canada.,Department of Psychiatry, Women's College Hospital, Toronto, ON, Canada
| | - Shannon Leung
- University of Toronto Faculty of Medicine, Toronto, ON, Canada
| | - Lori E Ross
- University of Toronto Dalla Lana School of Public Health, Toronto, ON, Canada
| | - Juveria Zaheer
- University of Toronto Department of Psychiatry, Toronto, ON, Canada.,Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, ON, Canada
| | - Bomi Park
- University of Toronto Faculty of Medicine, Toronto, ON, Canada
| | - Alex Abramovich
- University of Toronto Dalla Lana School of Public Health, Toronto, ON, Canada.,Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, ON, Canada
| | - Mark H Yudin
- University of Toronto Department of Obstetrics and Gynaecology, Toronto, ON, Canada.,Department of Obstetrics and Gynaecology, Unity Health, St Michael's Hospital, Toronto, ON, Canada
| | - June Sing Hong Lam
- University of Toronto Institute of Health Policy, Management, and Evaluation, Toronto, ON, Canada.,University of Toronto Department of Psychiatry, Toronto, ON, Canada.,Centre for Addiction and Mental Health, Toronto, ON, Canada
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Marsland S, Treyvaud K, Pepping CA. Prevalence and risk factors associated with perinatal depression in sexual minority women. Clin Psychol Psychother 2021; 29:611-621. [PMID: 34302411 DOI: 10.1002/cpp.2653] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 07/16/2021] [Indexed: 11/05/2022]
Abstract
Perinatal depression is associated with wide-ranging negative outcomes for women and their families, though little research has examined perinatal depression in sexual minority women. We examined depression in sexual minority women in the perinatal period, and whether there were unique minority stress-related risk and protective factors that predicted perinatal depression. One hundred ninety-four perinatal sexual minority women aged 18 years and older were recruited from the US and Australia. Participants completed an online questionnaire incorporating the Edinburgh Postnatal Depression Scale (EPDS) and measures of minority stress and social support. Over one third (35.6%) of the sample scored in the clinical range on the EPDS. Experiences of discrimination were associated with greater depression symptoms via poor social support from family. Higher concealment motivation was associated with greater depression symptoms via poor family and partner support. There were no direct or indirect effects of internalized stigma on depression. Rates of clinically elevated perinatal depression symptoms among sexual minority women are high, extending previous research demonstrating mental health disparities between sexual minorities and their heterosexual counterparts to the perinatal period. The role of social support in mediating the relationships between minority stress and depression suggests that increasing partner and family support might be effective targets for therapeutic interventions during the perinatal period.
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Affiliation(s)
- Sophie Marsland
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Karli Treyvaud
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia.,Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Christopher A Pepping
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
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Everett BG, Limburg A, Charlton BM, Downing JM, Matthews PA. Sexual Identity and Birth Outcomes: A Focus on the Moderating Role of Race-ethnicity. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2021; 62:183-201. [PMID: 33687305 PMCID: PMC10368195 DOI: 10.1177/0022146521997811] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Race-ethnic disparities in birth outcomes are well established, and new research suggests that there may also be important sexual identity disparities in birth weight and preterm birth. This study uses the National Longitudinal Study of Adolescent to Adult Health and is the first to examine disparities in birth outcomes at the intersection of race-ethnicity and sexual identity. We use ordinary least sqaures and logistic regression models with live births (n = 10,318) as the unit of analysis clustered on mother ID (n = 5,105), allowing us to adjust for preconception and pregnancy-specific perinatal risk factors as well as neighborhood characteristics. Results show a striking reversal in the effect of lesbian or bisexual identity on birth outcomes across race-ethnicities: For white women, a bisexual or lesbian identity is associated with better birth outcomes than their white heterosexual counterparts, but for Black and Latina women, it is associated with worse birth outcomes than their heterosexual peers.
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Affiliation(s)
| | | | - Brittany M Charlton
- Boston Children's Hospital, Boston, MA, USA
- Harvard University, Boston, MA, USA
- Brigham and Women's Hospital, Boston, MA, USA
| | - Jae M Downing
- Oregon Health and Science University, Portland, OR, USA
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Pilkington PD, Whelan TA, Milne LC. A review of partner‐inclusive interventions for preventing postnatal depression and anxiety. CLIN PSYCHOL-UK 2020. [DOI: 10.1111/cp.12054] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Pamela D. Pilkington
- School of Psychology, Faculty of Health Sciences, Australian Catholic University, Fitzroy, Victoria, Australia,
| | - Thomas A. Whelan
- School of Psychology, Faculty of Health Sciences, Australian Catholic University, Fitzroy, Victoria, Australia,
| | - Lisa C. Milne
- School of Psychology, Faculty of Health Sciences, Australian Catholic University, Fitzroy, Victoria, Australia,
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Van Ewyk J, Kruger LM. The Emotional Experience of Motherhood in Planned Lesbian Families in the South African Context: "… Look How Good a Job I'm Doing, Look How Amazing We Are". JOURNAL OF HOMOSEXUALITY 2016; 64:343-366. [PMID: 27185411 DOI: 10.1080/00918369.2016.1190216] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This article focuses on lesbian mothers' emotional experience of motherhood. It forms part of a larger qualitative and exploratory study with 10 lesbian couples in South Africa on their lived experience of planned motherhood. The study is located in a feminist phenomenological framework. Semi-structured interviews were conducted and interview transcripts were analyzed using thematic analysis. Participants described many different emotions associated with new motherhood: hope, joy, love, anxiety, helplessness, exhaustion, and feeling companionship and togetherness as well as feeling compromised and deprived. Mothers described these emotions but also focused on the development of a new identity, that of being a mother.
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Affiliation(s)
- Jacquetta Van Ewyk
- a Department of Psychology , Stellenbosch University , Matieland , South Africa
| | - Lou-Marié Kruger
- b Department of Psychology , Stellenbosch University , Matieland , South Africa
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12
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Postpartum depression among visible and invisible sexual minority women: a pilot study. Arch Womens Ment Health 2016; 19:299-305. [PMID: 26267062 DOI: 10.1007/s00737-015-0566-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 07/30/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE Significant numbers of sexual minority women are choosing to parent. Despite this, there is limited research on postpartum depression (PPD) with sexual minority mothers and less research considering differences within sexual minority women in the experience of PPD. This research examines two questions to address this gap in research: (1) Do experiences of PPD symptoms vary between different subgroups of sexual minority women, and (2) Which recruitment strategies effectively address the challenge of recruiting sexual minority women who are pregnant? METHODS Two Canadian studies recruited participants via consecutive or convenience sampling from midwifery clinics and hospital sites. Participants completed prenatal and postnatal measures of PPD symptoms, social support, and perceived discrimination. RESULTS Considering our first question, we found an interaction effect between past sexual behavior and current partner gender. Women currently partnered with men reported higher scores on the Edinburgh Postpartum Depression Scale when their sexual history included partners of more than one gender, whereas this effect was not found among women who were currently partnered with women or not partnered. Regarding our second question, most sexual minority participants recruited through convenience sampling were partnered with women and identified as lesbian or queer, while most participants recruited through consecutive sampling were partnered with men and identified as bisexual. CONCLUSIONS Women whose sexual histories include more than one gender and are currently partnered with men may be at a higher risk for PPD symptoms. Recruitment method may influence the type of sample recruited for perinatal mental health research among sexual minority women.
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Mosovsky S, Nolan BAD, Markovic N, Stall R. RADICLE Moms study: Minority stress and implications for lesbian mothers. Women Health 2016; 56:859-70. [DOI: 10.1080/03630242.2016.1141827] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Pilkington P, Milne L, Cairns K, Whelan T. Enhancing reciprocal partner support to prevent perinatal depression and anxiety: a Delphi consensus study. BMC Psychiatry 2016; 16:23. [PMID: 26842065 PMCID: PMC4739319 DOI: 10.1186/s12888-016-0721-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Accepted: 01/18/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Systematic reviews have established that partner support protects against perinatal mood problems. It is therefore a key target for interventions designed to prevent maternal and paternal depression and anxiety. Nonetheless, the extant literature is yet to be translated into specific actions that parents can implement. Prevention efforts aiming to facilitate reciprocal partner support within the couple dyad need to provide specific guidance on how partners can support one another to reduce their vulnerability to perinatal depression and anxiety. METHOD Two panels of experts in perinatal mental health (21 consumer advocates and 39 professionals) participated in a Delphi consensus study to establish how partners can support one another to reduce their risk of developing depression and anxiety during pregnancy and the postpartum period. RESULTS A total of 214 recommendations on how partners can support each other were endorsed by at least 80 % of both panels as important or essential in reducing the risk of perinatal depression and anxiety. The recommendations were grouped under the following categories: becoming a parent, supporting each other through pregnancy and childbirth, communication, conflict, division of labor, practical support, emotional support, emotional closeness, sexual satisfaction, using alcohol and drugs, encouraging self-care, developing acceptance, and help-seeking. CONCLUSION This study established consensus between consumers and professionals in order to produce a set of guidelines on how partners can support each other to prevent depression and anxiety during pregnancy and following childbirth. It is hoped that these guidelines will inform the development of perinatal depression and anxiety prevention efforts.
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Affiliation(s)
- Pamela Pilkington
- School of Psychology, Faculty of Health Sciences, Australian Catholic University, Locked Bag 4115, Fitzroy, Victoria, 3065, Australia.
| | - Lisa Milne
- School of Psychology, Faculty of Health Sciences, Australian Catholic University, Locked Bag 4115, Fitzroy, Victoria, 3065, Australia.
| | - Kathryn Cairns
- Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Melbourne, Victoria, 3010, Australia.
| | - Thomas Whelan
- School of Psychology, Faculty of Health Sciences, Australian Catholic University, Locked Bag 4115, Fitzroy, Victoria, 3065, Australia.
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15
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Pilkington PD, Milne LC, Cairns KE, Lewis J, Whelan TA. Modifiable partner factors associated with perinatal depression and anxiety: a systematic review and meta-analysis. J Affect Disord 2015; 178:165-80. [PMID: 25837550 DOI: 10.1016/j.jad.2015.02.023] [Citation(s) in RCA: 94] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Revised: 02/20/2015] [Accepted: 02/23/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Perinatal distress is a significant public health problem that adversely impacts the individual and their family. The primary objective of this systematic review and meta-analysis was to identify factors that partners can modify to protect each other from developing perinatal depression and anxiety. METHOD In accordance with the PRISMA statement, we reviewed the risk and protective factors associated with perinatal depression and anxiety symptoms that partners can potentially modify without professional assistance (PROSPERO reference CRD42014007524). Participants were new or expectant parents aged 16 years or older. The partner factors were sub-grouped into themes (e.g., instrumental support) based on a content analysis of the scale items and measure descriptions. A series of meta-analyses were conducted to estimate the pooled effect sizes of associations. RESULTS We included 120 publications, reporting 245 associations with depression and 44 with anxiety. Partner factors with sound evidence that they protect against both perinatal depression and anxiety are: emotional closeness and global support. Partner factors with a sound evidence base for depression only are communication, conflict, emotional and instrumental support, and relationship satisfaction. LIMITATIONS This review is limited by the lack of generalizability to single parents and the inability to systematically review moderators and mediators, or control for baseline symptoms. CONCLUSION The findings suggest that future prevention programs targeting perinatal depression and anxiety should aim to enhance relationship satisfaction, communication, and emotional closeness, facilitate instrumental and emotional support, and minimize conflict between partners.
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Affiliation(s)
- Pamela D Pilkington
- School of Psychology, Faculty of Health Sciences, Australian Catholic University, Australia.
| | - Lisa C Milne
- School of Psychology, Faculty of Health Sciences, Australian Catholic University, Australia
| | - Kathryn E Cairns
- Melbourne School of Population and Global Health, University of Melbourne, Australia
| | - James Lewis
- School of Psychological Science, Faculty of Science, Technology and Engineering, La Trobe University, Australia
| | - Thomas A Whelan
- School of Psychology, Faculty of Health Sciences, Australian Catholic University, Australia
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Alang SM, Fomotar M. Postpartum Depression in an Online Community of Lesbian Mothers: Implications for Clinical Practice. JOURNAL OF GAY & LESBIAN MENTAL HEALTH 2015. [DOI: 10.1080/19359705.2014.910853] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Abelsohn KA, Epstein R, Ross LE. Celebrating the “Other” Parent: Mental Health and Wellness of Expecting Lesbian, Bisexual, and Queer Non-Birth Parents. JOURNAL OF GAY & LESBIAN MENTAL HEALTH 2013. [DOI: 10.1080/19359705.2013.771808] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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18
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Borneskog C, Sydsjö G, Lampic C, Bladh M, Svanberg AS. Symptoms of anxiety and depression in lesbian couples treated with donated sperm: a descriptive study. BJOG 2013; 120:839-46. [PMID: 23489411 PMCID: PMC3672688 DOI: 10.1111/1471-0528.12214] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2013] [Indexed: 11/30/2022]
Abstract
Objective To investigate symptoms of anxiety and depression in lesbian couples undergoing assisted reproductive treatment (ART), and to study the relationship of demographic data, pregnancy outcome and future reproductive plans with symptoms of anxiety and depression. Design Descriptive, a part of the prospective longitudinal ‘Swedish study on gamete donation’. Setting All university clinics in Sweden performing gamete donation. Population A consecutive sample of 214 lesbian couples requesting assisted reproduction, 165 of whom participated. Methods Participants individually completed three study-specific questionnaires and the Hospital Anxiety and Depression Scale (HADS): time point 1 (T1), at commencement of ART; time point 2 (T2), approximately 2 months after treatment; and time point 3 (T3), 2–5 years after first treatment. Main outcome measures Anxiety and depression (HADS), pregnancy outcome and future reproductive plans. Results The vast majority of lesbian women undergoing assisted reproduction reported no symptoms of anxiety and depression at the three assessment points. A higher percentage of the treated women, compared with the partners, reported symptoms of anxiety at T2 (14% versus 5%, P = 0.011) and T3 (10% versus 4%, P = 0.018), as well as symptoms of depression at T2 (4% versus 0%, P = 0.03) and T3 (3% versus 0%, P = 0.035). The overall pregnancy outcome was high; almost three-quarters of lesbian couples gave birth 2–5 years after sperm donation treatments. Open-ended comments illustrated joy and satisfaction about family building. Conclusion Lesbian women in Sweden reported good psychological health before and after treatment with donated sperm.
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Affiliation(s)
- C Borneskog
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
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Cherguit J, Burns J, Pettle S, Tasker F. Lesbian co-mothers' experiences of maternity healthcare services. J Adv Nurs 2012; 69:1269-78. [DOI: 10.1111/j.1365-2648.2012.06115.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2012] [Indexed: 11/29/2022]
Affiliation(s)
| | - Jan Burns
- Department of Applied Psychology; Canterbury Christ Church Univeristy; Kent; UK
| | | | - Fiona Tasker
- Department of Psychological Sciences; Birkbeck University of London; UK
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Carman M, Corboz J, Dowsett GW. Falling through the cracks: the gap between evidence and policy in responding to depression in gay, lesbian and other homosexually active people in Australia. Aust N Z J Public Health 2012; 36:76-83. [DOI: 10.1111/j.1753-6405.2012.00828.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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PMS as a Gendered Illness Linked to the Construction and Relational Experience of Hetero-Femininity. SEX ROLES 2011. [DOI: 10.1007/s11199-011-9977-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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22
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Ross LE, Steele L, Sapiro B. Perceptions of Predisposing and Protective Factors for Perinatal Depression in Same-Sex Parents. J Midwifery Womens Health 2010; 50:e65-70. [PMID: 16260356 DOI: 10.1016/j.jmwh.2005.08.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Increasing numbers of women are choosing to have children in the context of same-sex relationships or as "out" lesbian or bisexual individuals. This study used qualitative methods to assess perceived predisposing and protective factors for perinatal depression in lesbian, gay, bisexual, and queer (LGBQ) women. Two focus groups with LGBQ women were conducted: 1) biological parents of young children and 2) nonbiological parents of young children or whose partners were currently pregnant. Three major themes emerged. Issues related to social support were primary, particularly related to disappointment with the lack of support provided by members of the family of origin. Participants also described issues related to the couple relationship, such as challenges in negotiating parenting roles. Finally, legal and policy barriers (e.g., second parent adoption) were identified as a significant source of stress during the transition to parenthood. Both lack of social support and relationship problems have previously been identified as risk factors for perinatal depression in heterosexual women, and legal and policy barriers may represent a unique risk factor for this population. Therefore, additional study of perinatal mental health among LGBQ women is warranted.
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Affiliation(s)
- Lori E Ross
- Women's Mental Health and Addiction Research Section, Centre for Addiction & Mental Health, Toronto, Ontario, Canada.
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Patterson CJ, Riskind RG. To Be a Parent: Issues in Family Formation among Gay and Lesbian Adults. JOURNAL OF GLBT FAMILY STUDIES 2010; 6:326-340. [PMID: 0 DOI: 10.1080/1550428x.2010.490902] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Abstract
BACKGROUND Although pregnancy loss is a distressing health event for many women, research typically equates women's experiences of pregnancy loss to ‘married heterosexual women's experiences of pregnancy loss’. The objective of this study was to explore lesbian and bisexual women's experiences of miscarriage, stillbirth and neonatal death. METHODS This study analysed predominantly qualitative online survey data from 60 non-heterosexual, mostly lesbian, women from the UK, USA, Canada and Australia. All but one of the pregnancies was planned. Most respondents had physically experienced one early miscarriage during their first pregnancy, although a third had experienced multiple losses. RESULTS The analysis highlights three themes: processes and practices for conception; amplification of loss; and health care and heterosexism. Of the respondents, 84% conceived using donor sperm; most used various resources to plan conception and engaged in preconception health care. The experience of loss was amplified due to contextual factors and the investment respondents reported making in impending motherhood. Most felt that their loss(es) had made a ‘significant’/‘very significant’ impact on their lives. Many respondents experienced health care during their loss. Although the majority rated the overall standard of care as ‘good’/‘very good’/‘outstanding’, a minority reported experiencing heterosexism from health professionals. CONCLUSIONS The implications for policy and practice are outlined. The main limitation was that the inflexibility of the methodology did not allow the specificities of women's experiences to be probed further. It is suggested that both coupled and single non-heterosexual women should be made more visible in reproductive health and pregnancy loss research.
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Affiliation(s)
- Elizabeth Peel
- School of Life & Health Sciences, Aston University, Birmingham B4 7ET, UK.
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Lovasz N, Clarke J. Life beyond depression: the experience of gays and lesbians who self-identify as depressed. ACTA ACUST UNITED AC 2009; 3:53-73. [PMID: 19042910 DOI: 10.1080/15574090802226600] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The purpose of this research was to compare differences in the experiences of gay men and lesbian women who describe experiences of depression or depressed mood. The 2 main research questions were how do descriptions of depression and daily life differ between gay males and lesbian females. To this end, Weblogs containing narratives of 19 gay men and 19 lesbian women were coded, analyzed, and compared using qualitative content analysis methods. Differences in described sources of depression and responses to depression, but not features of depression were found. Women and men also differed with respect to their main priorities; their descriptions of social interactions, social issues, reflections, and emotions; and a number of other daily life experiences. Findings were discussed with respect to implications for treatment and prevention of depression among sexual minorities.
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Affiliation(s)
- Nathalie Lovasz
- Clinical Psychology Program, Simon Fraser University, Burnaby, British Columbia, Canada
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Ussher JM, Perz J. Empathy, Egalitarianism and Emotion Work in the Relational Negotiation of PMS: The Experience of Women in Lesbian Relationships. FEMINISM & PSYCHOLOGY 2008. [DOI: 10.1177/0959353507084954] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Research on differences between heterosexual and lesbian relationships has reported that lesbian relationships are more satisfying, more egalitarian, more empathic, and facilitate more effective conflict resolution. These differences are of key relevance in terms of the construction and experience of PMS (Premenstrual Syndrome), as is illustrated through interviews with 15 lesbian women who experience PMS and 10 of their partners. While experiences of premenstrual distress were similar to those previously reported by heterosexual women, the lesbian relationship context and positioning of PMS were markedly different. In contrast to the lack of understanding or support, rejection, and pathologization commonly found in heterosexual women's accounts, lesbian interviewees reported awareness and recognition of premenstrual change, responsiveness to needs, open communication, and responsibility sharing. This had significant consequences for the construction and experience of premenstrual change, facilitating open expression of needs, self-care, and avoidance of guilt and self-blame, reinforcing the view that PMS needs to be understood within a framework of inter-subjectivity.
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Affiliation(s)
- Jane M. Ussher
- School of Psychology, University of Western Sydney,
Locked Bag 1797, Penrith South DC, NSW 1797, Australia,
| | - Janette Perz
- School of Psychology, University of Western Sydney,
Locked Bag 1797, Penrith South DC, NSW 1797, Australia,
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Ross LE, Steele L, Goldfinger C, Strike C. Perinatal depressive symptomatology among lesbian and bisexual women. Arch Womens Ment Health 2007; 10:53-9. [PMID: 17262172 DOI: 10.1007/s00737-007-0168-x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2006] [Accepted: 12/22/2006] [Indexed: 12/21/2022]
Abstract
Lesbian and bisexual women who were pregnant (N=16), biological (N=18) or non-biological (N=15) parents completed the Edinburgh Postnatal Depression Scale (EPDS), and scores were compared to a previously published heterosexual sample. Lesbian and bisexual biological mothers had significantly higher EPDS scores than the previously published sample of heterosexual women. Results suggest that perinatal depression is not less common and may be more common among lesbian and bisexual women relative to heterosexual women. Additional, longitudinal studies are needed.
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Affiliation(s)
- L E Ross
- Social Equity and Health Research Section, Centre for Addiction and Mental Health, Toronto, Canada.
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Ross LE, Steele LS, Epstein R. Service Use and Gaps in Services for Lesbian and Bisexual Women During Donor Insemination, Pregnancy, and the Postpartum Period. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2006; 28:505-511. [PMID: 16857118 DOI: 10.1016/s1701-2163(16)32181-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Increasing numbers of lesbian and bisexual women are choosing to have children. This qualitative study investigated the degree to which a sample of Canadian lesbian and bisexual women were satisfied with the health and social services that they received during the process of trying to conceive, during pregnancy, and during the early postpartum weeks and months. METHODS Three focus groups were conducted: (1) women who were themselves, or whose partners were, in the process of trying to conceive (n = 6); (2) biological parents of young children (n = 7); and (3) women who were non-biological parents of young children or whose partners were currently pregnant (n = 10). Participants were asked to discuss their positive and negative experiences with health and social services during their efforts to conceive and through the perinatal period. RESULTS Participants were very satisfied with the care they received from midwives, doulas, and public health nurses. Services directed specifically to lesbian, gay, and bisexual parents were also perceived to be important sources of information and support. Many participants perceived fertility services to be unsupportive or unable to address their different health care needs. CONCLUSION Participants expressed satisfaction with pregnancy-related services provided by non-physicians and dissatisfaction with services provided by physicians and fertility clinics. There is a strong desire for fertility services specific to lesbian and bisexual women, but even minor changes to existing services could improve the satisfaction of lesbian and bisexual patients.
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Affiliation(s)
- Lori E Ross
- Women's Mental Health and Addiction Research Section, Centre for Addiction and Mental Health, Toronto ON
| | - Leah S Steele
- Department of Family and Community Medicine, St. Michael's Hospital, University of Toronto, Toronto ON
| | - Rachel Epstein
- LGBT Parenting Network, Family Service Association of Toronto, Toronto ON
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