title: Service use and gaps in services for lesbian and bisexual women during donor insemination, pregnancy, and the postpartum period.
abstract: OBJECTIVE
  Increasing numbers of lesbian and bisexual women are choosing to have children. This qualitative study investigated the degree to which a sample of Canadian lesbian and bisexual women were satisfied with the health and social services that they received during the process of trying to conceive, during pregnancy, and during the early postpartum weeks and months.
  
  
  METHODS
  Three focus groups were conducted: (1) women who were themselves, or whose partners were, in the process of trying to conceive (n = 6); (2) biological parents of young children (n = 7); and (3) women who were non-biological parents of young children or whose partners were currently pregnant (n = 10). Participants were asked to discuss their positive and negative experiences with health and social services during their efforts to conceive and through the perinatal period.
  
  
  RESULTS
  Participants were very satisfied with the care they received from midwives, doulas, and public health nurses. Services directed specifically to lesbian, gay, and bisexual parents were also perceived to be important sources of information and support. Many participants perceived fertility services to be unsupportive or unable to address their different health care needs.
  
  
  CONCLUSIONS
  Participants expressed satisfaction with pregnancy-related services provided by non-physicians and dissatisfaction with services provided by physicians and fertility clinics. There is a strong desire for fertility services specific to lesbian and bisexual women, but even minor changes to existing services could improve the satisfaction of lesbian and bisexual patients.
authors.affiliation: Women's Mental Health and Addiction Research Section, Centre for Addiction and Mental Health, Toronto ON.
authors.forename: Lori E
authors.initials: LE
authors.lastname: Ross
authors.affiliation: Department of Family and Community Medicine, St. Michael's Hospital, University of Toronto, Toronto ON.
authors.forename: Leah S
authors.initials: LS
authors.lastname: Steele
authors.affiliation: LGBT Parenting Network, Family Service Association of Toronto, Toronto ON.
authors.forename: Rachel
authors.initials: R
authors.lastname: Epstein
mesh_terms: D001291:Attitude of Health Personnel; D001727:Bisexuality / Q000523:psychology*; D002170:Canada; D005260:Female; D017144:Focus Groups; D018452:Homosexuality, Female / Q000523:psychology*; D006801:Humans; D007315:Insemination, Artificial; D008427:Maternal Health Services / Q000592:standards*; D008880:Midwifery / Q000592:standards; D017060:Patient Satisfaction; D010820:Physicians / Q000523:psychology*; D049590:Postpartum Period; D011247:Pregnancy; D011637:Public Health Nursing / Q000592:standards; D012938:Social Perception