Pregnancy outcomes for lesbian and bisexual women
Sex and gender minority individuals comprise a vast range of sexual
preferences that contribute to their specific reproductive
needs.6 Worse outcomes have been reported in sex and
gender minority individuals in both their ability to achieve a
successful pregnancy, and in perinatal outcomes. Pregnancy success rates
are overall poorer as compared to heterosexual women. For lesbian and
bisexual women, the pregnancy success rate overall is greatly reduced
(9-fold lower in lesbian and 2-fold lower in bisexual patients) as
compared to heterosexual women, despite parental wishes to become
pregnant.2, 7 Additionally, sexual minority women are
over 12 times more likely to use fertility treatments, with up to 80%
of same-sex couples using anonymous sperm donors.8Though there are higher success rates of reproductive assistance in
lesbians as compared to heterosexual women, both lesbian and bisexual
populations reported increased rates of preterm birth (OR 1.84, 95% CI
1.11-3.04) and stillbirth (OR 2.85, 95% CI
1.34-2.35).1 Pregnant lesbian and bisexual patients
also exhibit higher risk for depression (OR 2.85, 95% CI 1.47-5.52) and
mental distress with onset in pregnancy (OR 3.13, 95% 1.45-6.75), and
are at a higher risk for pre-existing chronic medical conditions (OR
2.09, 95% CI 1.11-3.93) as compared to pregnant heterosexual women,
after adjusting for sociodemographic factors.5 Of
note, sexual minority women have equal to or higher rates of unintended
pregnancies as compared to heterosexual women, and significantly higher
rates of sexual violence.9