Abstract

BACKGROUND: Sexual and/or gender minority (SGM) people account for roughly 7.1% of the U.S. population, and an estimated one-third are parents. Little is known about SGM people who become pregnant, despite this population having documented health care disparities that may impact pregnancy.OBJECTIVES: Our objective was to describe parental structures among birth parents and the pre-pregnancy characteristics of parents giving birth in likely sexual and/or gender minority (SGM) parental structures from California birth certificates.STUDY DESIGN: We conducted a population-based study using birth certificate data from all live births in California from 2016 through 2020 (n?=?2,257,974). The state amended its birth certificate in 2016 to enable the recording of more diverse parental roles. Now, parents on birth certificates are classified as "parent giving birth" and "parent not giving birth" and people in either role can identify as "mother," "father," or "parent." We examined all potential combinations of parenting roles and grouped parental structures of "mother-mother" and all structures designating a "father" as the "parent giving birth" into likely SGM groups. We assessed the distribution of pre-pregnancy characteristics across parental structure groups ("mother-father," "SGM," "mother only," "unclassified," and "missing both parental roles").RESULTS: SGM parents accounted for 6,802 (0.3%) of live births in California over the 5-year study period. The most common SGM parental structures were "mother-mother" (n=4,310; 63% of the group) and "father-father" (n=1,486; 22% of the group). Compared with "parents giving birth" in the "mother-father" structure (n=2,055,038; 91%), a higher proportion of "parents giving birth" in the "SGM" group were 35 years or older, white, college-educated, and had commercial health insurance. In addition, a higher proportion had a high pre-pregnancy body mass index. Although likely underreported overall, the proportion who used assisted reproductive technology was much higher among those in the "SGM" group (1.4%) than in the "mother-father" group (0.05%). Cigarette smoking in the three months prior to pregnancy was similar in both groups.CONCLUSION: Changes to the California birth certificate have revealed a multiplicity of parental structures. Our findings suggest that SGM parents differ from other parental structures and from the general SGM population and warrant further research.

View details for DOI 10.1016/j.ajogmf.2022.100653

View details for PubMedID 35462057