The Polyamorous Childbearing and Birth Experiences Study (POLYBABES): a qualitative study of the health care experiences of polyamorous families during pregnancy and birth

Abstract

P olyamory, a type of consensual nonmonogamy, is "characterized by simultaneous consensual romantic relationships with multiple partners." 1 Prevalence estimates of polyamory are sparse and often subject to methodological limitations. 2 The most recent estimate suggests that 1 in 5 single Americans have engaged in some form of consensual nonmonogamy in their lifetime. 2 This estimate encompasses all forms of consensual nonmonogamy and does not account for married populations or alternatively arranged families who are engaging in the practice. A Canadian-based survey (n = 547) reported that most polyamorous relationships contain at least 1 married couple. 3 This survey found that 75% of respondents were of child-bearing age and 23.2% of them had at least 1 child younger than 19 years living at home under the care of at least 1 parent or guardian. 3 It has been consistently reported that people who identify as gay, lesbian or bisexual are more likely to engage in consensual nonmonogamy. 2 Debate exists as to whether polyamory should be interpreted as part of one's sexual orientation rather than as a relationship orientation or practice. 5 Many who practise polyamory describe being polyamorous as part of their identity. 5 Few studies have investigated the experiences of those practising polyamory, and much of the available literature is from the RESEARCH

“It’s a Little Bit Tricky”: Results from the POLYamorous Childbearing and Birth Experiences Study (POLYBABES)

“…Power Struggle Our interviews included several lengthy discussions of the barriers faced by polyamorous pregnant folks and their families within the healthcare system during pregnancy and birth. These were largely discussed previously in Arseneau et al, 2019. Not only did issues with assumptions of monogamy arise in issues related specifically to health, but also in all issues surrounding interactions such as experiences of physical space in hospitals and clinics, discussions with administrative staff in these centers, and the need to frequently "come out" to new care providers.…”

Reducing barriers to care for patients who practise consensual nonmonogamy

“…L inked research by Arseneau and colleagues highlights diffi culties faced by individuals in consensually nonmonoga mous relationships when they access health care. 1 Consen sual nonmonogamy encompasses a wide variety of relationships that include "the practice of, belief in, or willingness to engage in multiple [intimate], romantic and/or sexual relationships with the informed consent of everyone involved." 2 Both interest and engagement in consensual nonmonogamy seem to be increas ing.…”

“…Although existing research is limited, several qualitative studies have documented the concerns of patients in consensually non monogamous relationships regarding their health care experi ences: concerns that may affect their willingness to access health care and concerns about the quality of their care when they do. 1,4 These individuals face great stigma and are often patholo gized based on inaccurate assumptions. 5 However, several studies have failed to find differences in relationship satisfaction and other indices of relationship functioning between monoga mous and consensually nonmonogamous relationships.…”

“…Explicit indicators of inclusivity include asking about relationship structure during intake, using inclusive language on forms and providing space to list multiple partners, asking openended questions, allowing for multiple partners to be present during treatment and promoting riskinformed sexual practices rather than exclusively promoting monogamy. 1,4,11 Providing sexual health resources as well as accessible and customizable STI screenings with easily shareable results may address unique health needs of patients in consensually nonmonogamous relationships. 4 To foster effective partnerships with these patients, providers should work to reduce their implicit biases.…”

“…To this end, medical schools and continuing education programs should address the current lack of training regarding consensual nonmonogamy, which could alleviate the burden that some patients feel to have to educate their provider. 1,4 In the meantime, to protect themselves from anticipated stigma and judgment, patients in consensually nonmonogamous relationships have expressed the desire to pre screen providers to identify those who are inclusive and affirming of consensual nonmonogamy, and health care organizations can reduce this burden by adding search terms regarding consensual nonmonogamy competency to provider directories. 4,11 This may serve as a stopgap measure until training and continuing educa tion programming systemically include both biasreduction and essential practices to work effectively with patients in consensually nonmonogamous relationships.…”