Cultural competency is a process that is learned and requires self-awareness, reflective practices, and knowledge of cultural issues (Ball et al., 2019).  Healthcare providers need to learn to be sensitive to a patient’s heritage, sexual preferences, socioeconomic situation, and ethnicity (Ball et al., 2019).  The purpose of this discussion is to explain the specific socioeconomic, spiritual, lifestyle, and cultural factors of a 32-year-old lesbian pregnant female, and to describe the issues that I would need to be sensitive too when interacting with this patient.

Lifestyle and Cultural Factors

 The specific socioeconomic factors for the 32-year-old lesbian pregnant female is unknown; however, there is a chance that the patient is at least in the middle class standing as she was able to provide a sperm donor for her pregnancy.  On the other hand, female couples are also usually on their own financially and medically regarding labs, ultrasounds, sperm, and professional expertise (Singer, 2012).  The spiritual factor is also hard to determine with this patient, but asking questions such as “Is there religion or faith which you partake in?” can be helpful in determining spiritual affiliation (Ball et al., 2019).  One lifestyle factor that is associated with this patient is that she is a pregnant lesbian.  I think that creating a comfortable environment and also learning new patterns of behavior and effectively applying them in the correct settings can help patients with trust (CDC, 2015).  According to Singer (2012), for lesbian women, trust is received when a healthcare professional has the philosophy to maintain inclusion and cultural sensitivity.

Sensitive Issues

 The two main sensitive issues to keep in mind with this 32-year-old lesbian pregnant women is her sexual orientation and pregnancy.  Both categories are considered to be sensitive because oftentimes, health care providers are usually considered heterosexisms, which means that they tend to see the world in the view of heterosexual terms and ignore homosexuality (Singer, 2012).  Therefore, as a medical provider, I need to remember to do the opposite of heterosexism and ask questions such as “Tell me the story of how you became pregnant, this question takes the providers assumptions out of the equation and allows for a deeper understanding” (Singer, 2012, p. 38).  The provider also needs to avoid hetero-assumptive dialogue and utilize open-ended questions, which allows the patient to open up about their sexual identity and family construct (Singer 2012). 

Five Targeted Questions

Tell me the story of how you became pregnant?

Is this your first pregnancy?

Any specific illnesses or problems regarding your current pregnancy?

Tell me family history regarding pregnancies?

When was your most recent pap smear and HPV test, and have you had any gynecologic abnormalities?

References

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to

 physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier

Mosby.

Centers for Disease and Control and Prevention (CDC). (2015). Cultural competence. Retrieved

            from https://npin.cdc.gov/pages/cultural-competence

Singer, B. R. (2012). Improving prenatal care for pregnant lesbians. International

Journal of Childbirth Education, 27(4), 37–40. Retrieved from https://search-ebscohost-

com.ezp.waldenulibrary.org/login.aspx?direct=true&db=rzh&AN=104424834&site=eds-live&scope=site.

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