When Baby Makes Four

When Baby Makes Four

When people in non-monogamous relationships decide to have a baby, they may find that hospitals are not ready to handle their childbirth needs, a new study suggests.

The study is among the first to look into the health care experiences of people in "polyamorous" relationships.

While the term might sound exotic, it's estimated that 20% of adults have willingly been in a non-monogamous relationship. Meanwhile, small surveys suggest many of those relationships involve at least one married couple.

"I think this is more common than many people think," said Sharon Flicker, an assistant professor of psychology at California State University, Sacramento.

But while polyamory might be fairly common, there are many misperceptions about it, according to Flicker, who wrote an editorial published with the study.

Some see it as an aberrant behavior. However, Flicker said, "there is nothing inherently pathological about these relationships."

Another misperception is that polyamorous relationships are strictly casual - in the vein of "swinging," said Elizabeth Darling, the senior researcher on the study.

But, in fact, many people build "stable family units" where there are simply more than two adults taking care of the kids, explained Darling, an associate professor at McMaster University, in Hamilton, Ontario, Canada.

Darling said studies have only begun to look into the health care experiences of people in polyamorous relationships. But there is evidence that they can face stigma and feel judged by health care providers.

So, her team decided to look at polyamorous families' experiences with childbirth -- which can present some unique challenges.

The researchers interviewed 24 polyamorous individuals: 11 had given birth in the past five years, and 13 were their partners. The majority identified as heterosexual or bisexual, but they reported a range of sexual orientations.

In general, participants reported both positive and negative childbirth experiences. Some of the obstacles were of the logistical variety: Hospital forms do not accommodate non-traditional families -- asking only for the mother's and father's name, for example. Rooms on the maternity ward often lacked space for the family, and there were only enough newborn ID bracelets for two people.

One participant brought up the fact that hospitals are ready to handle the birth of multiple babies instead of one, but multiple parents throw them off: "The hospital freaks because they're like, 'Crap, we can't make three bracelets for the [parents]!'… It's become this huge ordeal about who is getting bracelets."

Flicker said that some simple changes could help, including edits to the language on those standard hospital forms. "They could ask, 'Who's involved in the birth?' instead of asking for the names of the mom and dad," she said.

That, Flicker noted, would make things easier for all birth scenarios, not just those involving polyamorous families.

Study participants also pointed to the fact that in hospitals, families deal with multiple health care providers, and end up having to explain their family situation "over and over again," Darling said.
Said one participant: "I was just, like, I don't want to have this conversation five times."

Others said health care providers did not always use the right term for all parents in the family, referring to some as a "friend" or "aunt," for example.

Some spoke of broader health care experience, such as a participant who wanted to get more frequent testing for sexually transmitted diseases after starting a polyamorous relationship: "(My doctor) was willing to help me get the testing I needed, but he had only slightly veiled comments on the situation. Definitely not approving and also assuming that I would be settling down eventually. It was uncomfortable talking to him about it."

The findings were published Oct. 15 in the CMAJ.

According to Darling, the goal of a small study like this is to talk to people in polyamorous families and get a sense of what their experiences have been.

"We can't make any broad comments about how often they face stigma in accessing health care," she said.

But based on the research to date, Flicker said, it's clear that health care providers can do some things - including using "more inclusive" language - to make polyamorous patients feel more comfortable.

That starts with the basic recognition that not all relationships are of the traditional monogamous sort, she said.

Sources: Elizabeth Darling, Ph.D., associate professor, obstetrics and gynecology, and assistant dean, midwifery, McMaster University, Hamilton, Ontario, Canada; Sharon Flicker, Ph.D., assistant professor, psychology, California State University, Sacramento; Oct. 15, 2019, CMAJ.

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