Lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority (LGBTQ+) people had large inequities in unmet health care needs and cost-related medication nonadherence in the post partum year.
This is according to a study – “Postpartum Care Differences in LGBTQ+ and Non-LGBTQ+ Individuals” by Kevin H. Nguyen, PhD1; Jamie R. Daw, PhD2; Heidi L. Allen, PhD, MSW3 – that appeared in JAMA Health Forum.
To date, LGBTQ+ people are estimated to account for 18.1% of parents in the US alone, and yet they are often not identified in pregnancy and childbirth research. “Structural discrimination may contribute to inequitable access to care and differential health care use between LGBTQ+ and non-LGBTQ+ postpartum people,” the researchers noted.
For this study, the researchers compared health insurance coverage continuity, health care access, care quality, and health care use between LGBTQ+ and non-LGBTQ+ individuals 12 to 14 months postpartum. The study sample included PAHS respondents with complete self-reported sexual orientation and gender identity data, totaling 4,427 postpartum people, of whom 5.1% self-identified as LGBTQ+.
The researchers found:
- LGBTQ+ people were significantly more likely to report delaying needed care (14.6%), cost-related nonadherence (8.3%), any primary care (11.8%), any specialist care (15.3%), any emergency department (ED) use (12.4%), and low care quality (10.7%) compared with non-LGBTQ+ people in the postpartum year.
- LGBTQ+ people were less likely to report any dental care (−14.4%) compared with non-LGBTQ+ people.
- There were no significant differences in postpartum health insurance or health care visits.
“Despite similar access to health insurance, LGBTQ+ people had large inequities in unmet health care needs and cost-related medication nonadherence in the postpartum year,” the researchers emphasized. “Results suggested LGBTQ+ people receive lower-quality care in the postpartum period. Although use of pregnancy-related care was comparable, LGBTQ+ individuals used more primary and specialist care and were nearly twice as likely to use the ED compared with non-LGBTQ+ people.”
The findings actually backed prior literature documenting higher health care needs, more financial barriers, and negative health care experiences among LGBTQ+ people.3
For the researchers, therefore, there is a need for “multilevel approaches to mitigating LGBTQ+-related inequities in access to and quality of care in the postpartum period” including “policies that institutionalize LGBTQ+ equality, clinician training for LGBTQ+-inclusive care, and clinician understanding of unique experiences of LGBTQ+ childbearing people.”
