Laura Lindberg (@lauralindberg.bsky.social)

New paper on the experiences of sexual and gender minority (SGM) students in midwifery clinical training, documenting how discrimination and hostile learning environments shape their experiences. Improving provider equity benefits both providers and patients. www.liebertpub.com/doi/full/10....

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Clinical Education Experiences of Sexual and Gender Minority Midwifery Students in the United States | Health Equity Introduction: Diversifying the midwifery workforce is a promising strategy for advancing perinatal health and reducing disparities. Clinical education is essential to midwifery training; yet, the experiences of sexual and gender minority (SGM) midwifery students in these settings remain underexplored. Methods: We conducted a national cross-sectional survey of certified nurse-midwives and certified midwives certified between 2019 and 2024 (n = 4117) about their clinical education experiences. Six hundred forty respondents completed the survey, with a 16% response rate. Multiple clinical education measures were self-reported: perceived competency, satisfaction with preceptorship, quality of interactions, and experiences of bias, harassment, bullying, or abuse. The primary exposure was SGM identity, defined as identifying as non-heterosexual and/or non-cisgender. Multivariable logistic regression models, adjusted for demographic and training characteristics, assessed the associations between SGM identity and clinical education outcomes. Results: One-fifth of the respondents identified as SGM. Across nearly all measures examined, SGM respondents reported significantly poorer experiences than non-SGM peers. In the descriptive results, they were less likely to report excellent interactions with preceptors (47.5% vs. 63.1%), other midwives (24.6% vs. 46.3%), and physicians (11.0% vs. 21.7%) and were less likely to report no gender- or sexual orientation-related bias (46.6% vs. 80.1%). SGM respondents were also more likely to experience bullying, harassment, or abuse during training. Fully adjusted models showed patterns consistent with these findings. Conclusion: SGM midwifery students experience lower-quality clinical education and higher exposure to bias and mistreatment. Addressing these inequities is critical for building a diverse midwifery workforce and broader efforts to advance perinatal health equity. https://www.liebertpub.com/doi/full/10.1177/24731242251405607