“The hope, anticipation and time spent on conceiving via donor sperm or surrogacy raises the stakes of the pregnancy” – Recognising the unique challenges faced by the LGBT+ community during ectopic pregnancy Loss
Advancements in fertility treatments have resulted in more lesbian, gay, bisexual and transgender couples becoming successful in their quest to create a family. This includes lesbian couples conceiving through use of a sperm donor, gay men through surrogacy or transgender men who have retained their reproductive organs to undertake a pregnancy.
But the complications of pregnancy, for example ectopic pregnancy and miscarriage, can carry additional complexities for families in the LGBT+ community. Dealing with ectopic pregnancy in particular can be extremely challenging, as couples face the grief of pregnancy loss as well as the cultural silence that often surrounds the topic.
Jenny, 29, suffered an ectopic pregnancy after conceiving through a sperm donor with her partner Amy.
“We had been using a sperm donor with many unsuccessful rounds,” she said. “After I had an ectopic pregnancy not only had there been a huge medical complication that threatened my life but I was left with financial stresses, and I felt there was little recognition of the significance of this loss.”
Eighty-four percent of heterosexual couples will become pregnant within a year – a possible 12 cycles1. The difficulties of conceiving via donor sperm or surrogacy mean a large amount of planning, hope, anticipation, negotiation, time and money has been spent which raises the stakes of the pregnancy.
Sarah, 34, was a surrogate for an LGBT+ couple and after experiencing an ectopic pregnancy, felt added grief in ‘disappointing’ the future parents.
She said: “I felt I had let down the couple I had chosen to carry a child for.”
“I had been trying so hard to be healthy: not drinking alcohol, taking daily supplements and fertility medications. I was doing everything I could to give this baby the best chance.”
Currently, most support services for ectopic pregnancy and loss target heterosexual couples; a lack of specialised support for LGBT+ couples results in poorer quality of care and feeling isolated, with no places to hear similar stories or make connections with others who have had similar experiences.
Daniel, 39, highlights the challenges of having no family support system:
“I didn’t feel like I could talk to anyone; many of my family thought I shouldn’t be able to be a parent in the first place – being a gay man,” he said. “It wasn’t me that had suffered the medical complications but I didn’t acknowledge the grief and loss I was suffering or the guilt that I had put our surrogate life at risk.”
Transgender pregnancies are not well documented but face unique challenges that come with stopping hormonal treatments to get pregnant. The social stigma around changing gender then suddenly being seen as female and receiving treatment in a gender specific way results in a delay to seeking medication attention, which for ectopic pregnancy could be fatal2. Medical professionals need to be aware of correct pronouns, terms and language when engaging with transgender individuals, to improve patient care.
As more LGBT+ individuals conceive with assisted fertility methods, better support should become available to improve equal support for all types of pregnancy. If you have been affected and are looking for additional support or a health care professional with a special interest in LGBT+ and pregnancy please get in touch via our website.
– Dr Lucy Moy
Obstetrics and Gynaecology Specialist Trainee