Historically, maternal care has been built around an assumption that the parents are a heterosexual couple. This poses challenges for pregnant women in same-sex relationships, according to research from the School of Nursing.
鈥淲hen a woman comes into birth there are assumptions made that she鈥檚 heterosexual,鈥� says Lisa Goldberg, associate professor at Dalhousie. 鈥淢any of the policies, procedures and documentation within hospital settings are really directed around being a straight woman.鈥�
The research indicates that members of the lesbian, gay, bisexual, transgender/transsexual and queer (LGBTQ) community can feel anxiety, fear, and uncertainty in 鈥渉eteronormative鈥� settings 鈥� those that are rooted in traditional heterosexual views. Language on patient intake forms, assumptions about the child鈥檚 parentage and use of incorrect pronouns when addressing the parents are some of the ways the system can make people feel out of place.
Dr. Goldberg says these systemic issues need to be addressed at institutional, provincial and federal levels. She integrates case studies into her teaching so nursing students can learn early on that assumptions and language often have an impact on an individual鈥檚 health-care experience.
鈥淚 think it takes a lot courage from both [LGBTQ individuals and health-care providers] to not make assumptions and to ask when you don鈥檛 know,鈥� says Dr. Goldberg.
Care and support
Though Dr. Goldberg acknowledges that more work needs to be done, she notes that there are already programs available to support and service the LGBTQ community in HRM.
A partnership between the IWK Health Centre and Capital Health, prideHealth intends to bring primary health-care services to the 鈥渞ainbow community鈥� in comfortable and safe settings. prideHealth also offers training to health-care providers and other professionals who work with the LGBTQ community.
Anita Keeping, a prideHealth nurse, says it鈥檚 not unusual for LGBTQ individuals to avoid seeking health care because of negative experiences in the past or among their peers.
鈥減rideHealth is providing services to some people that may not seek services otherwise,鈥� says Keeping.
Building on best intentions
Meanwhile, Dr. Goldberg is broadening her research with colleagues across rural Nova Scotia, through provincial and national partnership funding, to examine the health-care experience of LGBTQ women and the providers who attend to their care during the birthing experience.
鈥淥ur research shows that nurses and other health-care providers are incredibly well-intended and committed to not causing offense to the populations they serve,鈥� says Dr. Goldberg. 鈥淭his provides a wonderful starting point to implement educational interventions needed for dealing with marginalized, vulnerable or at risk populations鈥� that鈥檚 where we haven鈥檛 really done well yet.鈥�
鈥淎dvocacy is inherent in what it is to be a nurse,鈥� she adds. 鈥淚t strikes me that nurses have a really important opportunity here to contribute to the vital conversation around increasing understanding on how to work with various communities, including the LGBTQ community.鈥�
For more on research in the School of Nursing, .