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.