背景:先前的研究表明,与异性恋女性相比,性少数群体女性(SMW)更有可能报告多种母婴健康结果,并且这些结果受政策环境的调节。鲜为人知,然而,关于产前护理使用差异或SMW产前护理使用的社会决定因素。
目的:研究赋予法律保护的针对性取向的政策之间的关系(例如,仇恨犯罪保护,住房歧视,同性婚姻)和使用前瞻性,基于人口的数据集。
方法:使用全国青少年对成人健康的纵向研究和逻辑回归,我们将国家政策的措施与活产妇女在孕早期使用产前保健联系起来.前瞻性数据的使用使我们能够调整与怀孕前使用孕前保健相关的协变量(n=586个单胎出生到SMW;n=4,539个单胎出生到异性恋妇女)。
结果:在SMW报告的妊娠中,赋予保护的针对性取向的特定政策与更多地使用产前护理相关(OR=1.86,95%CI1.16,2.96)。事实上,在零保护的州,我们发现不同性别少数群体的产前护理使用没有差异;然而,在有两个或更多保护政策的州,与异性恋女性相比,SMW在孕早期更有可能获得产前护理。异性恋妇女报告的怀孕中,针对性取向的政策环境与产前护理使用之间没有关系。
结论:最近的研究表明,SMW比异性恋者更可能有不良的围产期和产科结局。这些发现表明,女同性恋/男同性恋/双性恋特定的政策保护可能有助于在SMW中使用产前护理,改善该人群生殖健康的潜在重要途径。
先前的研究发现,性少数族裔女性(SMW)更有可能报告婴儿的不良结局。特别是对于没有生活在反歧视政策的州的妇女,同性恋,双性恋,Trugner,或酷儿(LGBTQ)人群。这是首次使用全国代表检查产前护理使用中的性取向差异,前瞻性数据集。此外,我们研究了预防基于性取向的歧视的国家层面政策的数量是否存在差异.我们的结果表明,在所有性取向的头三个月中,产前护理的使用率很高,然而,在有两个或两个以上政策防止性取向歧视的州,性少数女性在妊娠早期比异性恋女性更有可能获得产前保健.这些发现表明,更具包容性的州环境可以促进性少数群体妇女在怀孕期间寻求医疗保健的行为。
BACKGROUND: Previous research has shown sexual minority women (SMW) are more likely to report multiple maternal and infant health outcomes compared to heterosexual women and that these outcomes are moderated by the policy environment. Little is known, however, about prenatal care use disparities or the social determinants of prenatal care use for SMW.
OBJECTIVE: To examine the relationship between sexual orientation-specific policies that confer legal protections (e.g., hate crime protections, housing discrimination, same-sex marriage) and prenatal care use among women using a prospective, population-based data set.
METHODS: Using the National Longitudinal Study of Adolescent to Adult Health and logistic regression, we link measures of state policies to the use of prenatal care in the first trimester among women who had live births. The use of prospective data allows us to adjust for covariates associated with preconception care use prior to pregnancy (n = 586 singleton births to SMW; n = 4,539 singleton births to heterosexual women).
RESULTS: Sexual orientation-specific policies that conferred protections were associated with increased use of prenatal care among pregnancies reported by SMW (OR = 1.86, 95% CI 1.16, 2.96). In fact, in states with zero protections, we found no differences in prenatal care use by sexual minority status; however, in states with two or more protective policies, SMW were more likely to access prenatal care in the first trimester than heterosexual women. There was no relationship between sexual orientation-specific policy environments and prenatal care use among pregnancies reported by heterosexual women.
CONCLUSIONS: Recent research has documented that SMW are more likely to have adverse perinatal and obstetrical outcomes than their heterosexual peers. These findings suggest that Lesbian/Gay/Bisexual-specific policy protections may facilitate the use of prenatal care among SMW, a potentially important pathway to improve reproductive health among this population.
Previous studies have found that sexual minority women (SMW) are more likely to report adverse infant outcomes, particularly for women who do not live in states with anti-discrimination policies against lesiban, gay, bisexual, transgnder, or queer (LGBTQ) populations. This is the first to examine sexual orientation disparities in prenatal care use using a nationally representative, prospective data set. Additionally, we examined whether prenatal care use varied by the number of state-level policies that protect against discrimination based on sexual orientation. Our results show high rates of prenatal care use in the first trimester across all sexual orientations, however, in states with states with two or more policies that prevent discrimination by sexual orientation, sexual minority women were more likely to access prenatal care in the first trimester than heterosexual women. These findings suggest that more inclusive state-level environments promote healthcare-seeking behaviors during pregnancy for sexual minority women.