Reproductive health history of lesbians: implications for care.

Abstract

Parity and hormonal contraceptives modify the risk of reproductive cancers and cardiovascular disease. However, clinicians may not obtain reproductive histories from patients who self-identify as lesbian. We report lifetime pregnancy-related outcomes and hormonal contraception for 392 women who reported sexual activity with another woman in the preceding year. Among self-referred volunteers, previous pregnancy, pregnancy outcome, contraceptive use, and sexual identity were assessed with self-administered questionnaire. One in 4 subjects had been pregnant, and more than 50% of the women had used oral contraceptives (mean duration, 40 months). Sixteen percent of all subjects and 63% of those who had been pregnant previously reported having 1 or more induced abortions. The most common pregnancy outcome for women younger than 25 years was induced abortion (59% of pregnancies). Identifying as "lesbian" or "bisexual" predicted neither the duration of oral contraceptive use nor a report of induced abortion. Previous pregnancy, induced abortion, and hormonal contraceptive use are common among women who report sex with women, regardless of self-identification as lesbian.