{"id":1429607,"date":"2025-05-01T16:00:54","date_gmt":"2025-05-01T15:00:54","guid":{"rendered":"https:\/\/www.gaytimes.com\/?p=1429607"},"modified":"2025-05-01T16:00:54","modified_gmt":"2025-05-01T15:00:54","slug":"why-lesbians-face-a-maternal-healthcare-crisis","status":"publish","type":"post","link":"https:\/\/www.gaytimes.com\/uncloseted\/why-lesbians-face-a-maternal-healthcare-crisis\/","title":{"rendered":"Why lesbians face a maternal healthcare crisis"},"content":{"rendered":"\r\n
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Eighty-three percent of queer women reported birthing complications. From systemic bias to outdated medical policies, lesbians face a maternal health system that was never designed with them in mind.<\/p>\n

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THIS ARTICLE FIRST APPEARED ON\u00a0UNCLOSETED MEDIA<\/a>\u00a0A NEW INVESTIGATIVE LGBTQIA+ FOCUSSED NEWS PUBLICATION.<\/strong><\/p>\n

WORDS\u00a0SAM DONNDELINGER<\/strong><\/p>\n<\/div>\n

<\/p>

In January, a lesbian couple from New Jersey had a labor playlist picked out, electronic candles ready to go and an \u201catmosphere\u201d they wanted to create while birthing their first child. They were eager and \u201cnot at all worried.\u201d<\/p>\n

But Amy and Jessica say their plans for a smooth birth went out the window when a routine check-up turned into a harrowing eight-day hospital stay. \u201cIt was awful. It was horrendous,\u201d Amy, the birthing mother, told Uncloseted Media<\/em>.<\/p>\n

At 37 weeks pregnant following in vitro fertilization (IVF),<\/a> the couple, who asked to use pseudonyms because they are considering litigation against the hospital, was told that the birthing mother needed to have her labour induced immediately due to high blood pressure. After three days of failed induction, doctors performed an emergency C-section during which she haemorrhaged and lost four litres of blood. The doctors eventually had to remove her uterus to \u201csave her life.\u201d<\/p>\n

\u201cWe did research later and found out that induction medication and IVF both increase the risk of haemorrhage. It just felt like no one was listening to us or informing us,\u201d says Jessica.<\/p>\n

\u201cIf pregnancy were a men’s health field, this wouldn’t be happening,\u201d Amy says. \u201cYou think of medicine now and it’s so modernised and there are so many technologies, but there is something so lacking in women’s health care.\u201d<\/p>\n

According to a 2022 study in the Association of American Medical Colleges, more than half of queer women reported<\/a> that the quality of their experience with pregnancy, birth and postpartum care was impacted by bias or discrimination, compared to 35% of heterosexual people. In addition, 83% of queer women reported birthing complications<\/a> compared to 63% of their heterosexual counterparts. Queer women also have higher rates<\/a> of stillbirths, miscarriages and premature births.<\/p>\n

\u201cFemale-bodied people have been ignored in medicine for so long, and taking on the queer identity makes it worse,\u201d says Marea Goodman, midwife and founder of PregnantTogether, an LGBTQIA+ focused midwife practice. \u201cClinics arose out of a need to support heterosexual people who are experiencing infertility and for many years queer folks were barred from accessing fertility care. They’re just not for creative family structures.\u201d<\/p>\n

The American healthcare system was not built for queer women<\/strong><\/h3>\n

While roughly 59% of bisexual women and 31% of lesbians give birth in their lifetime<\/a>, bringing tens of thousands of babies into the world each year, the healthcare system is hard for them to navigate.<\/p>\n

A 2022 study <\/a>found that LGBTQIA+ couples are more afraid of childbirth than heterosexual couples. And it\u2019s not just the pregnancy itself that is scary. According to Anna Malmquist, one of the authors of the study and a researcher at Sweden\u2019s Link\u00f6ping University, there are many concerns queer women face when walking into a hospital.<\/p>\n

\u201c\u2018What if they misgender me?\u2019\u201d she says. \u201c\u2018What if they don\u2019t recognise my partner as my partner? What if they don’t respect my pronouns? I cannot just go away and seek care somewhere else, because the baby has to come out.\u2019 So the minority stress becomes a second layer added to these bodily fears.\u201d<\/p>\n

One reason queer women may face these concerns is that medical school curricula often fall short in teaching prospective physicians about LGBTQIA+ reproductive health.<\/p>\n

One study reported that the median instructional <\/a>time on all LGBTQIA+ topics was just 11 hours across four years, with many programs failing to address disparities faced by lesbian patients in accessing prenatal care and family planning services. In a 2021 study<\/a>, half of OB-GYN residents reported feeling unprepared to care for lesbian or bisexual patients and 92% desired more education on how to provide healthcare to LGBTQIA+ patients.<\/p>\n

This lack of education can result in queer women feeling out of place. \u201cWalking down the halls of my clinic, all of the stock art of couples was white and heterosexual, nothing queer, and the literature all said \u2018mom and dad,\u2019\u201d says Angela Thompson, a Verizon IT tech from Columbia, South Carolina.<\/p>\n

Alyssa and Sam Darling delivered their first child in 2019 in Los Angeles.<\/p>\n

When they went back to the delivery ward after the birth to do a routine check-up with their child, one of the nurses at the door stopped Alyssa, the non-birthing partner.<\/p>\n

\u201cShe physically put her hand on my chest and stopped me, and said, \u2018It\u2019s parents only,\u2019\u201d she remembers. \u201cThe baby was my eggs, so biologically mine. \u2026 It was just so confusing. \u2026 We were exhausted, we just wanted to go home, and it was the last thing we wanted to deal with.\u201d<\/p>\n

\u201cIt\u2019s like you’re having to come out time and time again,\u201d Sam adds. \u201cAnd for some people, that can be extremely triggering.\u201d<\/p>\n

Beyond that, Alyssa is listed as \u201cfather\u201d on both of her children\u2019s birth certificates because there wasn\u2019t a place to write a second mother.<\/p>\n

Since 2017<\/a>, married same-sex parents in the U.S. have had the right to write both their names on their child’s birth certificate. However, the federal government\u2019s standard birth certificate application form<\/a> hasn\u2019t been revised since 2003<\/a>, leaving the sections as \u201cmother\u201d and \u201cfather.\u201d To amend this, it\u2019s on the respective hospital to file additional paperwork.<\/p>\n

\u201cI asked them what to do, and the nurse was like, \u2018Well, you put the father’s information,\u2019 and I was like, \u2018We’re a two-mom couple, she doesn’t have a dad.\u2019 And she’s like, \u2018We’re gonna need dad’s information.\u2019 And I’m like, \u2018But there is no dad.\u2019\u201d<\/p>\n

Alyssa circled the option at the bottom of the certificate to be listed as \u201cparent\u201d instead of father, but due to a clerical error, the certificate she received in the mail still says \u201cFather: Alyssa Darling.\u201d<\/p>\n

The physical toll of discrimination and hate<\/strong><\/h3>\n

\u201cThe experience of the mother during pregnancy directly impacts the health of the infant,\u201d says Bethany Everett, adjunct associate professor of obstetrics and gynaecology at the University of Utah. \u201cTending to mothers is a critical period for public health interventions if we want to improve population health at large.\u201d<\/p>\n

While research around queer pregnancy is limited, a 2022 study<\/a> found that lesbian women living in states with stronger legal protections for sexual minorities had better birth outcomes, including higher birth weights and lower rates of preterm births, compared to those in states without such protections. Conversely, the study found no significant difference in birth outcomes between heterosexual women in states with and without sexual minority protections.<\/p>\n

\u201cIf you can be fired because you’re gay or you can’t be legally recognised in your partnership, those things impact your real quality of life,\u201d says Everett. \u201cAnd those forms of stigma and discrimination can negatively impact the health of the pregnant woman and translate to the health of the foetus.\u201d<\/p>\n

\u201cLong-term exposure to distress and discrimination results in chronic inflammation and immune dysfunction,\u201d she says. \u201cIt\u2019s not about the person, it\u2019s about the environment that they’re giving birth in.\u201d<\/p>\n

Angela Thompson remembers not holding hands with her wife when she was visibly pregnant. \u201cWe have felt uncomfortable in public, especially in more rural areas after the [Presidential] Election,\u201d Thompson says. \u201cOnce, we were at a restaurant in Myrtle Beach, and we weren\u2019t holding hands or sitting next to each other, but people still gave us dirty looks. It\u2019s stressful.\u201d<\/p>\n

Unfortunately, providers aren\u2019t always immune to stigma and homophobia. As of 2022, more than one in eight LGBTQIA+ people live in states where doctors, nurses and other health care professionals can legally refuse to treat them.<\/a><\/p>\n

This translates to negative health outcomes for queer women in the delivery room.<\/p>\n

According to a 2023 survey<\/a>, LGBTQIA+ people were twice as likely to experience medical gaslighting compared to their cis and heterosexual counterparts. When asked to agree with the following statement, \u201cMy doctor listens to me when I express concerns about treatments and prescriptions,\u201d 49% of queer respondents agreed compared to 61% of straight and cis respondents.<\/p>\n

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Thompson\u2019s son was underweight at birth and two weeks early. After an emergency C-section, the baby didn\u2019t cry, which was alarming to the nurses.<\/p>\n

\u201cThere was not enough of the cord connected to the placenta which meant he wasn’t getting as much nutrients toward the end of the pregnancy, which is why he couldn’t tolerate labour,\u201d she says. \u201cThey don\u2019t know how they missed it. I had concerns about it and I told them to check it earlier but they either missed it [or didn\u2019t check].\u201d<\/p>\n

\u201cThe whole process feels very disjointed,\u201d says Amy, the birthing mother in New Jersey. \u201cI wish I had been given more information about the risks because this is an IVF baby.\u201d<\/p>\n

The couple says that they found out later that IVF pregnancies are at higher risk of haemorrhaging, <\/a>which also becomes a greater risk when under induction medication like Amy was.<\/p>\n

The same care but more expensive: insurance exclusion<\/strong><\/h3>\n

In addition to not feeling heard, the financial burden of IVF is another stressor that disproportionately affects queer women. A single cycle costs <\/a>between $15,000 to $30,000, and only 21 states and D.C.<\/a> have insurance laws that mandate coverage of fertility treatments. One study<\/a> found that for two-thirds of patients, it takes six or more IVF cycles for a successful pregnancy. That means it can easily cost $100,000 for one pregnancy.<\/p>\n

\u201cInsurance coverage and IVF language is an example of just how heteronormative our family building infrastructure still is and how we throw up these barriers for queer folks,\u201d says Abbie Goldberg, professor of psychology at Clark University, noting that only eight states<\/a> have policies that are inclusive of LGBTQIA+ parents due to language of their policy and requirements for the definition of \u201cinfertile.\u201d<\/p>\n

Shanell Crymes-Lincoln had to switch employers to obtain insurance that would cover IVF for her and her wife.<\/p>\n

\u201cIt was astronomical without insurance,\u201d Crymes-Lincoln, who lives in Toledo, Ohio, told Uncloseted Media<\/em>.<\/p>\n

\u201cIt was between using our savings for a baby or a house, and we wanted to do everything possible to not have to pay out of pocket.\u201d<\/p>\n

Religion and race<\/strong><\/h3>\n

Crymes-Lincoln is currently pregnant with her and her wife Nesi\u2019s second child. While the couple\u2019s first experience with an LGBTQIA+ friendly doctor was positive, with Nesi being able to catch the baby, they are nervous about their new provider who works out of a Catholic hospital.<\/p>\n

\u201cEverything went smoothly [with our first baby\u2019s doctor] \u2026 But then my insurance carrier dropped that entire medical clinic altogether, and we only have two medical clinics in this area.\u201d<\/p>\n

Both women say they feel more on edge at their new clinic because it features \u201cMother Teresa statues, prayers and things that are exclusive to certain groups.\u201d<\/p>\n

\u201cI feel like you’re going to judge me based on your religious thoughts. I don\u2019t feel comfortable displaying affection with my wife, or even calling her my wife there,\u201d says Crymes-Lincoln, who dreamed of \u201cbeing a mom\u201d as a kid. \u201cWe\u2019re worried our birth plan won\u2019t be respected here.\u201d<\/p>\n

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At their first appointment, Crymes-Lincoln felt like her questions were being \u201cbrushed off.\u201d<\/p>\n

\u201cIt could be because of my race, it could be because of my sexual orientation,\u201d she says. \u201cI’m just worried about the birth, being a Black woman and being a lesbian, we tend to get overlooked.\u201d<\/p>\n

\u201cCombined is a whammy,\u201d she says, noting that Black women in the US are more than three times<\/a> likely to die during pregnancy or childbirth than their white counterparts.<\/p>\n

Mothers just want to be heard<\/strong><\/h3>\n

Above all, mothers just want providers who listen to them.<\/p>\n

\u201cJust don\u2019t assume,\u201d Sam Darling says. \u201cThere was one instance when I was pregnant where a nurse asked if my wife was my sister. It was really awkward. I think healthcare in general needs to do better for LGBTQIA+ community members. Have a pronoun section on intake forms, and ask about your [patient\u2019s] sexual orientation.\u201d<\/p>\n

As a practitioner focused on LGBTQIA+ folks, Marea Goodman says representation is essential. \u201cWhen you go into a fertility clinic and you don’t see any other families that look like yours, it can be a really isolating experience.\u201d<\/p>\n

In Goodman\u2019s practice, there\u2019s a strong emphasis on prioritising the parents\u2019 emotional experience. For instance, Goodman allows the birthing mother\u2019s partner to push the syringe during the insemination, an intentional choice to honour the grief that can arise from not being able to conceive privately at home.<\/p>\n

Goodman suggests small changes in the system to make queer women feel more supported. \u201cI don’t think it’s too hard to improve this. If there’s one photo in the office of a queer couple, that will make a difference. I think if everyone in the office, including front desk personnel, had training, it would go a long way.\u201d<\/p>\n

Goodman also suggests having a list of organisations where folks can connect with other LGBTQIA+ families looking to conceive.<\/p>\n

\u201cPeople feel alone. People feel isolated. People don’t see themselves reflected, and society doesn’t do that for us,\u201d Goodman says. \u201cWe have to create spaces that do. That\u2019s what changes everything.\u201d<\/p>\n

If objective, nonpartisan, rigorous, LGBTQ-focused journalism is important to you, please consider making a tax-deductible donation through our fiscal sponsor, Resource Impact, by clicking this button:<\/em><\/h4>\n

Donate to Uncloseted Media<\/a><\/p>\n

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