Pregnancy in LGBTQ+ community – Mayo Clinic Health System

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According to a recent Gallup poll, 8% of millennials — people born between 1981–1996 — and 22.3% of Generation Z — people born between 1997–2004 — identify as LGBT, or lesbian, gay, bisexual, transgender or intersex, among other identifiers.

People who identify as LGBTQ+ can have healthy pregnancies and babies through multiple paths of conception. However, they may face challenges that affect their health and pregnancies.

Pregnancy care most often is focused on the pregnant person. However, not all people who are pregnant identify as women. Their gender identity may be different from their assigned sex at birth. Regardless of gender or identity, prenatal care is essential for people who are pregnant.

Care before and during pregnancy

Obstetric care providers ensure that all patients receive comprehensive, compassionate care regardless of their gender identity or sexual orientation. Prepregnancy planning before conception, genetic counseling or carrier screening can be vital to family-building. Anyone thinking about becoming pregnant should consider those services and any personal health risk factors. Also, anyone considering hormone therapy for gender-affirming care should discuss with their healthcare team whether they want to pursue fertility preservation before starting medication.

Open, respectful communication between patients and their care team creates an environment that fosters trust and inclusivity, including using gender-neutral or gender-affirming pronouns. People should find a care team with whom they feel comfortable having honest, proactive conversations about any concerns, including prior obstetric or pregnancy experiences, trauma, abuse or chronic health conditions.

Each pregnancy, labor and delivery is unique, and focusing on healthy outcomes for the pregnant person and baby can decrease anxiety and worry.

Focus on support and well-being

Support during pregnancy is a priority, regardless of relationship type or status. A strong support system can include a partner, family or friends. It’s crucial to care for the mental health of a person who is pregnant during pregnancy and the postpartum period.

Studies show that rates of postpartum depression tend to be higher in LGBTQ+ families. LGBTQ+ adults have a higher likelihood of experiencing a mental health condition than heterosexual adults. Risk factors for postpartum and anxiety disorders can be related to pregnancy, infant loss or preterm delivery.

Mental health screening can identify depression symptoms during pregnancy and the postpartum period. While there’s a tendency to focus on a person’s physical health during pregnancy, it’s imperative to continually evaluate their emotional health during obstetric care. People shouldn’t hesitate to discuss their feelings or changes in mood during pregnancy with their care team.

An obstetrics professional can discuss and recommend mental health treatment options that are safe during pregnancy.

Creating an inclusive care environment

Inclusive obstetric care for LGBTQ+ people is a vital part of delivering equitable and compassionate healthcare. From prepregnancy planning and prenatal care to labor and delivery, care teams should support and respect everyone, meeting patients where they are, regardless of their sexual orientation, gender identity or family composition.

Ongoing efforts and education strive to create an inclusive environment where everyone receives the care and support they need. Open conversations between patients and their care teams help those teams provide quality care, mental health support and address reproductive concerns so all people feel respected throughout their pregnancies and family-building journeys.

Sara Robinson, M.D., is a Family Medicine physician in Mankato, Minnesota.

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