Lack of policy consideration for breastfeeding co-mothers in maternity services
This article reports on two cases of lesbian non-gestational mothers whose breastfeeding intentions were disrupted by the postnatal ward visitor restrictions imposed by NHS trusts during the COVID-19 lockdowns in the UK. One case came to the attention of the author as part of a wider study using an online survey to examine experiences of birth during the first COVID-19 lockdown in April 2020. In the second case, the author was approached by the non-gestational mother for support in her capacity as a doula in April 2021. In both cases, the non-gestational mothers intended to breastfeed their babies and had taken steps to ensure they were lactating, but the heterosexist restrictions for partners in the early postnatal period created complications that impacted their breastfeeding intentions. In the second case, perinatal mental health care for previous birth trauma was also potentially indicated. Both non-gestational mothers also reported that they were not receiving antenatal support to overcome these difficulties, as they were mothers-to-be who were not pregnant.
Perinatal services are organised around the assumption that there will be one pregnant parent, who is a woman, and that the other parent will be a man, who lives with the woman, and is the father of the baby (Spidsberg, 2007). These heteronormative assumptions can cause difficulties for all families who fall outside of this model, including single women, pregnant trans men and non-binary people, and pregnant women whose partner is also a woman. The literature shows that pregnant women of a minority sexuality using perinatal services face both direct and indirect homophobia (Dahl et al, 2013). Indirect homophobia can include inappropriate forms that only refer to one father and one mother (Röndahl et al, 2009). Direct homophobia can include everything from refusing assisted conception services to lesbians (Spidsberg, 2007), to physically rough vaginal examinations while in labour (Spidsberg, 2007). Among women of a minority sexuality, co-mothers may also be affected by heterosexism and homophobia. The literature shows that similarly to sexual minority birth mothers, they may face exclusion either because organisational structures are heterocentric or because of professional incompetence and homophobic attitudes from perinatal healthcare providers (Cherguit et al, 2013). Pandemics reinforce existing inequities within societies (Dingwall et al, 2013). This case report demonstrates how the pandemic reinforced inequality for co-mothers in perinatal care.
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