Accessing new understandings of trauma‐informed care with queer birthing women in a rural context

Abstract

Aims and objectives Participant narratives from a feminist and queer phenomenological study aim to broaden current understandings of trauma. Examining structural marginalisation within perinatal care relationships provides insights into the impact of dominant models of care on queer birthing women. More specifically, validation of queer experience as a key finding from the study offers trauma‐informed strategies that reconstruct formerly disempowering perinatal relationships. Background Heteronormativity governs birthing spaces and presents considerable challenges for queer birthing women who may also have an increased risk of trauma due to structurally marginalising processes that create and maintain socially constructed differences. Design Analysis of the qualitative data was guided by feminist and queer phenomenology. This was well suited to understanding queer women's storied narratives of trauma, including disempowering processes of structural marginalisation. Methods Semistructured and conversational interviews were conducted with a purposeful sample of thirteen queer‐identified women who had experiences of birthing in rural Nova Scotia, Canada. Results Validation was identified as meaningful for queer women in the context of perinatal care in rural Nova Scotia. Offering new perspectives on traditional models of assessment provide strategies to create a context of care that reconstructs the birthing space insofar as women at risk do not have to come out as queer in opposition to the expectation of heterosexuality. Conclusions Normative practices were found to further the effects of structural marginalisation suggesting that perinatal care providers, including nurses, can challenge dominant models of care and reconstruct the relationality between queer women and formerly disempowering expectations of heteronormativity that govern birthing spaces. Relevance to clinical practice New trauma‐informed assessment strategies reconstruct the relationality within historically disempowering perinatal relationships through potentiating difference which avoids retraumatising women with re‐experiencing the process of coming out as queer in opposition to the expectation of heterosexuality.

Healing The Past By Nurturing The Future: A qualitative systematic review and meta-synthesis of pregnancy, birth and early postpartum experiences and views of parents with a history of childhood maltreatment

“…There were also no included studies involving parents with sexual diversity. However, a recent study of queer-identifying mothers highlights many of the issues identified in this review as important, with these women experiencing greater marginalisation within the maternity care system [77]. Olsen [78] found limited evidence of screening for child maltreatment during routine prenatal care, but that qualitative evidence suggested women were likely to be supportive of screening in prenatal care.…”

The Prenatal Primary Nursing Care Experience of Pregnant Women in Contexts of Vulnerability

“… Abbreviations: ANHSU, antenatal health service utilization; GDM, gestational diabetes mellitus; HIV, human immunodeficiency virus; SDOH, social determinants of health; QSEN, quality of safety education for nurses; Queer, member of the lesbian, gay, bisexual, queer, pansexual and two spirit (LGBQP2S) communities. 41 …”

Sexual and gender minorities educational content within obstetric anesthesia fellowship programs: a survey

“…We have a responsibility to advocate for inclusive forms and policies, as well as to actively discourage heteronormativity in a realm that is all too easily centred on just that. 43 Educators and training programs can create culture within an institution, as well as on a larger scale within communities. The identification of gaps in various stages of medical education is a necessary step to improve provision of care for all patients.…”