Perinatal care “unsafe” for trans and non-binary people, study finds
The findings, led by Te Herenga Waka—Victoria University of Wellington’s Dr George Parker, was launched by Independent MP Dr Elizabeth Kerekere in July.
Warming the Whare for Trans People and Whānau in Perinatal Care, was jointly funded by Manatū Hauora Ministry of Health and the Health Research Council (HRC) and sought to understand the need for inclusive perinatal care in Aotearoa and ways to achieve it.
The project team was made up of trans, non-binary, takatāpui and cisgender researchers and community members from Te Herenga Waka, Te Pūkenga|Otago Polytechnic, and the University of Waikato, with Dr Kerekere representing Tīwhanawhana Trust.
Speaking at the report launch at Parliament, Dr Kerekere says the “ground-breaking” research will lead the way for understanding and addressing the needs for takatāpui, trans, non-binary, intersex inclusive pregnancy and birth care.
“Although positive changes are being made, the system is clearly not delivering for trans, non-binary and gender-diverse people.”
Dr Parker, from Te Herenga Waka’s Te Kura Tātai Hauora—School of Health, says their findings show that transgender, non-binary, and takatāpui people experience significant disparities in perinatal care compared to the general population.
“Current issues include a lack of gender-inclusive language, lack of gender-inclusive bathrooms and other facilities, data systems that make it difficult or impossible to capture gender identity, and unwelcoming and transphobic attitudes from some perinatal providers.
“Participants typically had low expectations of the level of care they’d receive before even starting the process, and described feeling out of place or excluded, leading to a loss of trust and joy in the process.”
The findings of the report show that some providers and services are already implementing some inclusive care initiatives, but improvements are needed to ensure that trans people and whānau can anticipate care that is consistently affirming.
“Historically, the perinatal workforce has not been adequately prepared to provide trans affirming and inclusive care,” Dr Parker says. “But most providers are willing and open to engaging in education to support trans affirming and inclusive practice.”
Dr Parker says the report provides clear recommendations to perinatal health services in Aotearoa to alleviate disparities and inform future policy direction and educate health professionals to provide clinically and culturally safe care to trans people and whānau.
“During our study, we spoke with representatives from trans whānau, Royal Australian and NZ College of Obstetricians and Gynaecologists; NZ College of Midwives, Kahu Taurima|Maternity and Early Years policy teams at Te Whatu Ora and Te Aka Whai Ora, and perinatal community organisations. They were unified in their support for this research and the potential for transformational change in our health system.
“In Budget 2022, the Government committed $2.182 million over four years to improve the health system for trans and non-binary people. We need to see Te Whatu Ora and Te Aka Whai Ora working in collaboration with community to achieve this.”
HRC Chief Executive Professor Sunny Collings also acknowledged the importance of the study.
“This research is one of several projects supported through a joint funding initiative with the Ministry of Health to invest in projects that will help achieve equitable maternal and infant health outcomes in Aotearoa New Zealand.
“It may be a small research area, but it has the potential to make a huge difference for takatāpui and gender-diverse people seeking and accessing maternity care.”