Exploring the Attitudes of Ontario Midwives Towards Sexual and Gender Minority People

Midwives have an ethical duty to ensure the provision of safe, inclusive, quality care to all sexual and/or gender minority people (SGM), underpinned by midwifery tenets and regulations. Rooted in principles of feminism and social justice, the tenets of Ontario midwifery care provide a foundation for safe, quality care for SGM, in theory. Midwives provide informed choice: the client is the primary decision maker about all aspects of their care. Often invisibilized in health care settings, SGM can be empowered by the opportunity to make informed decisions about what is right for them, and be in control. 

Midwives offer choice of birthplace at home, in hospital, or, where available, at a midwife-led birth centre. The option to receive care at an alternative, inclusive health care setting is often welcomed by SGM, who might otherwise avoid accessing medical care after previous homophobic or transphobic experiences in mainstream care settings. Midwives provide care in small teams and are on call 24/7: this continuity of care enables SGM to develop trusting, respectful relationships over time with their midwifery team. Creating inclusive, safe midwifery care means SGM are free to share their stories and their identities, if they choose. Individualized and inclusive care means SGM people have access to safe, quality care during their experience of becoming new - or new again - parents.

As primary care providers, midwives have the potential to significantly shape the experiences of SGM accessing midwifery care. But do midwives uniformly demonstrate positive and caring attitudes towards SGM? A systematic literature search identified published literature exploring the attitudes of midwives towards SGM, aiming to understand how these attitudes might influence the midwifery care of SGM. Two themes emerged: both midwives' attitudes (positive, negative or neutral) and the heteronormativity of midwifery care do impact the care experiences of lesbian women.

Exploring Ontario Midwives' Attitudes Towards Sexual and Gender Minority People is a paper- and web-based survey that aims to produce new knowledge about midwives' attitudes and how they might be shaped. This research matters because understanding what shapes Ontario midwives' attitudes towards SGM might help ensure midwives are able to provide quality, inclusive care to all SGM, which could play an important role in reducing health disparities of SGM and creating midwifery care that is inclusive, safe and celebratory of SGM.

The package of surveys received by midwives includes a reference card to sexual and gender identity terms and definitions.

Funding:

Association of Ontario Midwives Mentored Midwifery Research Grant.

Team Members:

• Primary contact:
  Jen Goldberg, RM, MPH
  Primary Investigator
  Doctoral Student, Dalla Lana School of Public Health

• Tatiana Graf, RN
  Research Assistant
  Master's Student, Health Education, University of Education, Freiburg, Germany

• Lori Ross, PhD
  Supervisor
  Assistant Professor, Dalla Lana School of Public Health