Experiences in the delivery of preconception and pregnancy care for LGBTIQA+ people: A systematic review and thematic synthesis of patient and healthcare provider perspectives

Jess Permezel, Amelia St Clair Arnold, Jacob Thomas, Anita Lorelle Maepioh, Rhonda Brown, Trish Hafford-Letchfield, Helen Skouteris, Kostas Hatzikiriakidis, Ruth P. McNair

Research output: Contribution to journalArticleResearchpeer-review

4 Citations (Scopus)

Abstract

Background: The widespread availability of reproductive technology and family planning services has led to an increase in the number of available pathways to parenthood for LGBTIQA+ people. However, emerging research indicates that significant healthcare inequities have been documented among LGBTIQA+ people and attributed to the pervasiveness of structural and systemic discrimination that extends to preconception and pregnancy care. Aim: The aim of this systematic review was to synthesise qualitative research that has explored the experiences of LGBTIQA+ people in navigating preconception and pregnancy care services to inform healthcare quality improvement. Method: Six databases were searched for relevant research published between 2012 and 2023. The findings of all included studies underwent a secondary thematic synthesis, and methodological quality was assessed using the Joanna Briggs Institute Checklist for Qualitative Research. Findings: A total of 37 studies were eligible for inclusion. Four major themes were constructed through thematic synthesis: (1) unavailability of information, services, and support; (2) clinical competencies of healthcare staff; (3) hetero- and cis-sexist care experiences; and (4) discrimination and traumatisation. Conclusions and implications for practice: The findings of this review indicate that LGBTIQA+ people experience significant challenges during the journey towards parenthood, marked predominantly by the pervasiveness of inequity, and defined by discriminatory healthcare processes. This review has led to several recommendations for future healthcare quality improvement through an investment in policies, procedures, and interactions that are sensitive to the needs of LGBTIQA+ people. Importantly, future research must be co-designed and led by LGBTIQA+ community input.

Original languageEnglish
Article number103712
Number of pages24
JournalMidwifery
Volume123
DOIs
Publication statusPublished - Aug 2023

Keywords

  • Health equity
  • LGBTIQA+
  • Preconception
  • Pregnancy
  • Queer
  • Systematic review

Cite this