Parental Identity and Lived Experiences when Parenting a LGBTQIA+2 Child: A Critical Narrative Synthesis of Current Evidence.

PURPOSE: Most LGBTQIA + 2 studies focus on the core sexually and gender diverse population without exploring the peripheral familial perspectives. Current research needs to explore parental experiences of parenting a LGBTQIA+2 child, since parents undergo an identity change after their child's disclosure. This parental identity change may affect parental well-being and add to the existing stress of parenting a LGBTQIA + 2 child. METHODS: This paper uses the identity process theory (IPT) to review 18 studies on parental narratives to highlight the change in parental identity. Databases were searched for first-hand parenting experiences and shortlisted articles were qualitatively synthesized. FINDINGS: We identified six main themes: I) Parental identity change is triggered by a child's disclosure. II) Parental identity change drives parental emotions that evolve from initial anger, shock, fear, concern, grief, etc. to eventual acceptance of their child. III) Parental identity and emotions change, as for any life change process, across assimilation, accommodation, adjustment, and evaluation phases of the IPT. IV) Parental identity change is motivated by continuity, coherence, self-efficacy, belongingness, distinctiveness, meaning and self-esteem principles of the IPT. V) Parental identity influences parental micro-individual, meso-interactional and macro-societal interactions of the IPT framework. VI) Parental mental well-being may be affected across the assimilation, accommodation, adjustment phases of the IPT before eventual acceptance of the child in the evaluation phase. CONCLUSIONS: Parental lived experiences require a stronger consideration today within the wider, non-white, contexts. The effect of identity change on parental mental well-being and its intergenerational effect needs to be explored within the context of the IPT. Parental narratives will contribute towards creating appropriate counselling toolkits and interventions for health care providers and parents of LGBTQIA + 2 children.

The Global Network Socioeconomic Status Index as a predictor of stillbirths, perinatal mortality, and neonatal mortality in rural communities in low and lower middle income country sites of the Global Network for Women's and Children's Health Research.

BACKGROUND: Globally, socioeconomic status (SES) is an important health determinant across a range of health conditions and diseases. However, measuring SES within low- and middle-income countries (LMICs) can be particularly challenging given the variation and diversity of LMIC populations. OBJECTIVE: The current study investigates whether maternal SES as assessed by the newly developed Global Network-SES Index is associated with pregnancy outcomes (stillbirths, perinatal mortality, and neonatal mortality) in six LMICs: Democratic Republic of the Congo, Guatemala, India, Kenya, Pakistan, and Zambia. METHODS: The analysis included data from 87,923 women enrolled in the Maternal and Newborn Health Registry of the NICHD-funded Global Network for Women's and Children's Health Research. Generalized estimating equations models were computed for each outcome by SES level (high, moderate, or low) and controlling for site, maternal age, parity, years of schooling, body mass index, and facility birth, including sampling cluster as a random effect. RESULTS: Women with low SES had significantly higher risks for stillbirth (p < 0.001), perinatal mortality (p = 0.001), and neonatal mortality (p = 0.005) than women with high SES. In addition, those with moderate SES had significantly higher risks of stillbirth (p = 0.003) and perinatal mortality (p = 0.008) in comparison to those with high SES. CONCLUSION: The SES categories were associated with pregnancy outcomes, supporting the validity of the index as a non-income-based measure of SES for use in studies of pregnancy outcomes in LMICs.