Lesbian couples’ experiences of maternity care

Abstract

Purpose: Internationally, the increasing visibility of diverse family structures has drawn attention to the ways heteronormative assumptions continue to influence maternity care systems. Studies across various countries show that lesbian couples often encounter inconsistent recognition, exclusionary language, and variability in inclusive practices throughout pregnancy, childbirth, and the postnatal period. Although Malta has similarly experienced growing recognition of same-sex parenthood and significant legislative progress in LGBTQ+ rights, maternity services have been slower to adapt. Research exploring the maternity care experiences of lesbian couples in Malta is currently absent, limiting understanding of how global patterns of inclusion and exclusion manifest locally and how these couples navigate their interactions with healthcare professionals. Aim and Objectives: This study aimed to explore the maternity care experiences of lesbian couples in Malta. The research question guiding this study was: How do lesbian couples experience maternity care in Malta? The objectives were to explore their experiences during the antenatal, intrapartum and early postpartum period; to enquire into the feelings evoked while receiving care; to understand their specific needs and preferences; and to examine how they constructed meaning around these experiences. Methodology: A qualitative design informed by Interpretative Phenomenological Analysis (IPA) was used. Audio-recorded semi-structured interviews were conducted with five lesbian couples who were at least 18 years old, first-time parents, and had given birth in Malta within the past three years. I had no professional involvement in their care. Interviews were transcribed verbatim and analysed using IPA principles, with Queer Theory guiding interpretation. Results: Three overarching themes were identified. Navigating Maternity Care highlighted anticipatory concerns regarding disclosure, balanced with instances of affirming and inclusive care. Recognition as a Legitimate Family illustrated how co-mothers sought validation of their parental role and encountered both supportive care practices and institutional barriers, particularly in administrative and gatekeeping contexts. Language and Belonging captured how spoken and written language within healthcare settings signalled either inclusion or marginalisation, shaping how couples experienced visibility, legitimacy, and emotional safety. Conclusions: This study strengthens the limited body of recent international research on lesbian parenthood in maternity care and provides the first empirical insight from Malta. It offers an understanding of how lesbian couples navigate maternity services within a context of rapid social and legislative change. While some inclusive practices were evident, structural and linguistic heteronormativity persists, highlighting the need for institutional reform, staff training, and more inclusive documentation. The findings emphasise the importance of maternity environments that recognise diverse family forms and promote equitable care for all parents.