A secondary mixed methods analysis examining midwives' responses regarding patient sexual orientation and gender identity (SOGI) disclosure

Jennifer M Goldberg; Jenny Gong; C J Blennerhassett; Lori E Ross

doi:10.1016/j.midw.2023.103648

A secondary mixed methods analysis examining midwives' responses regarding patient sexual orientation and gender identity (SOGI) disclosure

Midwifery. 2023 May:120:103648. doi: 10.1016/j.midw.2023.103648. Epub 2023 Feb 28.

Authors

Jennifer M Goldberg¹, Jenny Gong², C J Blennerhassett³, Lori E Ross⁴

Affiliations

¹ Division of Social and Behavioural Health Sciences, Dalla Lana School of Public Health, University of Toronto, College St., Toronto, Canada; Registered Midwife, Ontario 500-155, Canada. Electronic address: jen.goldberg@mail.utoronto.ca.
² National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK.
³ Master of Health Administration Candidate, School of Health Administration, Dalhousie University, Sir Charles Tupper Medical Building 2nd floor, 5850 College Street, PO Box 15000, Halifax, NS B3H 4R2, Canada; Registered Midwife, Nova Scotia, Canada.
⁴ Division of Social and Behavioural Health Sciences, Dalla Lana School of Public Health, University of Toronto, College St., Toronto, Canada.

PMID: 36871488
DOI: 10.1016/j.midw.2023.103648

Abstract

Objective: Recent research suggests that midwives generally have positive attitudes towards sexual and gender minority (SGM) clients; however, little research has examined whether and how these attitudes translate into specific clinical practices. In this study, we performed a secondary mixed methods analysis to examine midwives' beliefs and practices regarding the importance of asking and knowing their patients' sexual orientation and gender identity (SOGI).

Methods: A confidential, anonymous paper survey was mailed to all midwifery practice groups (n = 131) in Ontario, Canada. Participants were midwives who were members of the Association of Ontario Midwives who responded to the survey (n = 267). Sequential explanatory mixed methods analysis was employed: quantitative SOGI questions were analyzed first, followed by qualitative open response comments to explain and contextualize the quantitative findings.

Findings: Midwives' responses indicated that it was not important to know or ask about clients' SOGI because (1) it is not necessary to be able to provide the best care to everyone, and (2) the onus is on the client to disclose SOGI. Midwives indicated that they would like more training and knowledge to be able to confidently care for SGM.

Key conclusions and implications for practice: Midwives' hesitancy to ask or know SOGI demonstrates that positive attitudes do not necessarily translate into current best practices for obtaining SOGI data in the context of SGM care provision. Midwifery education and training programs should address this gap.

Keywords: Gender identity; LGBTQ+; Midwifery; SOGI disclosure; Sexual and gender minorities; Sexual orientation.

MeSH terms

Disclosure
Female
Gender Identity
Humans
Male
Midwifery*
Ontario
Pregnancy
Sexual Behavior
Sexual and Gender Minorities*