Clinical perspectives
From a clinical perspective, it is important to emphasize that sexual minority individuals may approach perinatal and reproductive care with higher levels of anxiety compared to heterosexual women.13 Both sexual minority and heterosexual pregnant patients may experience fear of childbirth, which refers to fear caused by different events, such as becoming pregnant, being pregnant, or giving birth.13 However, sexual minority individuals may also experience discrimination which can ultimately lead to higher levels of perinatal stress.13 Therefore, prenatal clinics should be more inclusive, as recently advocated by ACOG4 This can be obtained by promoting training and education among all medical and non-medical staff, regarding aspects of a prenatal care visit of sexual minority individuals. Added to the above stressors are the logistical issues of financing reproductive care: from assisted reproductive technology procedures like in vitro fertilization to finding healthcare professionals trained in the diverse needs of this population, pregnancy for sexual minority individuals is costly.1, 7 The creation of multidisciplinary services and collaboration with policymakers to make prenatal care more affordable is crucial, similarly to what has been advocated for transgender and nonbinary pediatric patients.14Multidisciplinary prenatal clinics in this population would include obstetricians, midwives, lactation consultants, psychologists, psychiatrics, social workers and medical subspecialists as needed, with expertise in pregnant sexual minority individuals, and would facilitate the delivery of much needed physical and mental health services.