BACKGROUND: As many as 1 in 5 adults practise some type of consensual nonmonogamy such as polyamory; many are married, have children, or both. Polyamorous families face unique challenges when accessing care during pregnancy and birth, and qualitative descriptive studies are needed to understand their experiences and inform health care providers’ practice.
METHODS: Participants, who self-identified as polyamorous, had given birth in the last 5 years and received at least some prenatal care, were recruited through convenience sampling on social media. Any of the birthing individual’s partners were also invited to participate. All participants completed a short demographic questionnaire and participated in a semistructured interview. Interview transcripts were coded using Braun and Clarke’s iterative thematic analysis.
RESULTS: A total of 24 participants, 11 who had given birth and 13 partners, were interviewed. Of those who had given birth, 5 received midwifery care only, 4 received obstetric care exclusively and 2 received shared care. Polyamorous families described sharing many common experiences during pregnancy and birth that were affected by their polyamorous identity. Although participants reported both positive and negative experiences with health care providers, when accessing health care all had experienced some form of marginalization that was related to their polyamorous status. One particular challenge for families was with respect to disclosure of polyamorous identity in hospital environments. Participants offered suggestions for improving the health care of polyamorous families during pregnancy and birth, including creating nonjudgmental spaces, accommodating difference through minimizing administrative barriers and allying with patients by providing patient-led care.
INTERPRETATION: Polyamorous families face marginalization when accessing pregnancy and birth care. Care experiences for polyamorous families can be improved by nonjudgmental, open attitudes of health care providers, and modifications to hospital policies to support multiparent families.
See related article at www.cmaj.ca/lookup/doi/10.1503/cmaj.191246
Polyamory, a type of consensual nonmonogamy, is “characterized by simultaneous consensual romantic relationships with multiple partners.”
1 Prevalence estimates of polyamory are sparse and often subject to methodological limitations.
2 The most recent estimate suggests that 1 in 5 single Americans have engaged in some form of consensual nonmonogamy in their lifetime.
2 This estimate encompasses all forms of consensual nonmonogamy and does not account for married populations or alternatively arranged families who are engaging in the practice. A Canadian-based survey (
n = 547) reported that most polyamorous relationships contain at least 1 married couple.
3 This survey found that 75% of respondents were of child-bearing age and 23.2% of them had at least 1 child younger than 19 years living at home under the care of at least 1 parent or guardian.
3 It has been consistently reported that people who identify as gay, lesbian or bisexual are more likely to engage in consensual nonmonogamy.
2 Debate exists as to whether polyamory should be interpreted as part of one’s sexual orientation rather than as a relationship orientation or practice.
5 Many who practise polyamory describe being polyamorous as part of their identity.
5
Few studies have investigated the experiences of those practising polyamory, and much of the available literature is from the fields of psychology and sexuality.
4 Furthermore, few studies have investigated the experiences of polyamorous people in health care settings and no studies have investigated their experiences during pregnancy and birth.
Reports that do exist suggest that 1 in 4 polyamorous individuals have experienced some type of discrimination based on their polyamorous status.
6 As a result, legal arguments have been presented that conceptualize polyamory as a sexual orientation within antidiscrimination legislation.
7 Regardless of whether one agrees with this conceptualization, given the high proportion of polyamorous individuals who are of child-bearing age and the substantial potential for stigma, it is important to investigate polyamorous individuals’ experiences with reproductive care providers to better inform practice.
The objective of the Polyamorous Childbearing and Birth Experiences (POLYBABES) study was to gain an understanding of the experiences of polyamorous families during pregnancy and birth. This paper focuses on the health care experiences of polyamorous families when accessing reproductive health services.
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