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Contexts of Reproductive Loss in Lesbian Couples

Black, Beth Perry PhD, RN; Fields, Wendy Smith MSN, APRN, FNP-C

MCN: The American Journal of Maternal/Child Nursing: May/June 2014 - Volume 39 - Issue 3 - p 157–162
doi: 10.1097/NMC.0000000000000032
Feature: CE Connection

Lesbian couples seek to become parents in a heteronormative world and in the context of complex biological, social, and legal challenges that may constrain same-sex parenting. Because of these constraints and challenges, lesbian couples experiencing a reproductive loss may encounter issues that heterosexual couples typically will not. Prior to pregnancy, lesbians may experience loss and grief because they cannot conceive a child together without the assistance of a third party. Same-sex families are marginalized; simply deciding to become parents leaves them open to criticism and negative judgment. If pregnancy is not achieved or does not end in a live birth, lesbian couples face decisions about how, whether, and who to conceive a subsequent pregnancy. Although laws vary by state, the social (nonbiological) mother may not have legal status as the child's parent; therefore, the decision of which partner to become pregnant is especially significant. In the event of a reproductive loss, the grief of the social mother might not be acknowledged. Lesbian couples will benefit from the care of a nurse who understands and is accepting of the complex contexts within which they face the challenges of reproductive loss.

Our country is finally making some progress toward greater acceptance of non-traditional families, but the very special needs of lesbian couples who experience a perinatal loss has rarely been tackled in the literature before this.

Beth Perry Black is an Assistant Professor, University of North Carolina at Chapel Hill, School of Nursing. She can be reached via e-mail at

Wendy Smith Fields is a Family Nurse Practitioner.

The authors and planners have disclosed no potential conflicts of interest, financial or otherwise.

Authors are currently receiving a grant (Reproductive Loss in Lesbian Couples) from the Gay and Lesbian Medical Association/Lesbian Health Fund.

For 17 additional continuing nursing education activities on reproductive health topics, go to

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