Online maternity information seeking among lesbian, bisexual, and queer women

OBJECTIVE: recent research has concluded that barriers to maternity health care exist for lesbian, bisexual, and queer women. This mixed methods study aims to understand patterns in seeking and sharing online health information for LBQ women attempting conception. DESIGN: researchers performed a qualitative content analysis of 400 discussions in lesbian-oriented Facebook groups, containing 1764 total instances of text. 400 discussions from heterosexual-oriented conception and parenting Facebook groups were examined for comparison purposes, though they will not be the focus of this analysis. This paper also presents descriptive statistics on posts observed. SETTING: posts were drawn from a representative sample of lesbian-oriented conception, pregnancy, and parenting Facebook groups. Posts examined for comparison purposes were drawn from groups that appeared to primarily serve heterosexual women. MEASUREMENTS AND FINDINGS: many participants in lesbian-oriented Facebook groups sought and provided medical information. Their queries focused on the insemination process, and frequently related to posters\u27 specific situations, while heterosexual women tended to seek general advice about the conception and pregnancy process. The accuracy of the content of responses varied, and group members seemed to view the prevalence of contradictory information as positive evidence of diverse perspectives. Even when information was technically correct, posters did not always apply it properly to the question at hand. KEY CONCLUSIONS: barriers to maternity care, or a lack of education and initiative among primary care providers, may drive lesbian, bisexual, and queer women to seek health information from peers on the Internet when trying to become pregnant. These exchanges may contribute to misinformation, which may negatively affect lesbian, bisexual, and queer women\u27s fertility outcomes and overall health. IMPLICATIONS FOR PRACTICE: clinicians should be conscious of online health information seeking as both a symptom of and cause of sexuality-based disparities

Making it work: Successful collaborative practice

There are three major examples of collaborative programs between certified nurse-midwives (CNMs) and obstetrician-gynecologists at Baystate Medical Center in Springfield, Massachusetts, within the Department of Obstetrics and Gynecology. One program is a midwifery practice that serves a diverse population in a hospital-based office, four neighborhood health centers, and a correctional facility. Another program provides a triage function for patients who present to the hospital with obstetric or gynecologic problems. The third program introduces a team approach to the education of residents with a CNM having primary responsibility for teaching normal obstetrics to first-year residents and medical students in collaboration with attending physicians. Keys to success include an understanding of the principles of collaborative practice, the use of a detailed practice agreement between midwives and attending physicians, keeping open lines of communication, understanding and accepting differing philosophies of practice, and, most importantly, maintaining trust across all levels of providers