Birthing Relationships and Rural Health Practices: The Experiences of Queer Women and Their Perinatal Care Providers.

Queer birthing women experience social exclusion in the Canadian health system based on gender and sexual orientation. Yet little research has been conducted on the experiences of these women, even less in rural care. Homophobia, heterosexism and intolerance continue to be embedded in health care structures that are invisible and not well understood by perinatal providers. Heterosexist language and resources are especially pervasive outside of urban centers creating social and institutional conditions of exclusion. Likewise, providers often lack the necessary education to work productively with queer women during birth. Although providers often approach birthing with the intent of doing good, taking up a position of neutrality or attempting to treat everyone the same leaves providers ill equipped to account for the ways in which social conditions impact the birth experiences of queer women in rural life. Providers working with birthing women may unknowingly reinstate normative patterns resulting in homophobia and gender binaries. This is particularly salient in birthing contexts, where the standards of care have been heteronormatively constructed. There is an urgency to understand how perinatal practices contribute to health inequities in the lives of birthing women who are queer, in addition to the ways certain providers may challenge those patterns to maximize rural birthing care. This phenomenological study will examine how queer women experience birth across six rural sites in Nova Scotia, and how rural providers experience their work with queer birthing women. A total of 25-30 queer women, 15-20 nurses, 15-20 physicians, and 4-5 midwives will participate in interviews and focus groups. Findings from the study will articulate strategies for optimizing perinatal care in the context of social exclusion. The results will be useful for best practice guidelines and continuing education for providers working with queer birthing women in rural care