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.
“When a woman comes into birth there are assumptions made that she’s heterosexual,” says Lisa Goldberg, associate professor at Dalhousie. “Many of the policies, procedures and documentation within hospital settings are really directed around being a straight woman.”
The research indicates that members of the lesbian, gay, bisexual, transgender/transsexual and queer (LGBTQ) community can feel anxiety, fear, and uncertainty in “heteronormative” settings — those that are rooted in traditional heterosexual views. Language on patient intake forms, assumptions about the child’s 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’s health-care experience.
“I think it takes a lot courage from both [LGBTQ individuals and health-care providers] to not make assumptions and to ask when you don’t know,” 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 “rainbow community” 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’s not unusual for LGBTQ individuals to avoid seeking health care because of negative experiences in the past or among their peers.
“prideHealth is providing services to some people that may not seek services otherwise,” 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.
“Our research shows that nurses and other health-care providers are incredibly well-intended and committed to not causing offense to the populations they serve,” says Dr. Goldberg. “This provides a wonderful starting point to implement educational interventions needed for dealing with marginalized, vulnerable or at risk populations… that’s where we haven’t really done well yet.”
“Advocacy is inherent in what it is to be a nurse,” she adds. “It 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.”
For more on research in the School of Nursing, visit its website.