Volume 49, Issue 4
Pages 213 - 221

Sexual Orientation Concordance And (Un)Happiness About Births


A woman's happiness about a pregnancy and birth has implications for her child's health and her own well-being. Sexual orientation and, particularly, the extent of concordance across its dimensions (sexual identity, behavior and attraction) may be related to happiness about these events, but research on this relationship has been lacking.


Data on 5,744 pregnancies ending in births among women aged 15–44 in three waves of the National Survey of Family Growth (2006–2015) were examined. Weighted linear regression models examined the relationship between sexual orientation concordance and women's happiness about a birth. Analyses also explored whether birth intention and male partnership characteristics mediated the relationship, and whether it varied by intention status.


Women who identified as heterosexual but reported same-sex attraction or behavior (categorized as “heterosexual-identified discordant”) were less happy about their births than were women who were exclusively heterosexual (or “heterosexual-identified concordant”). The difference was more than half a point on a scale of 0–10 (coefficient, –0.7). This association was partially explained by the fact that births were less likely to be intended, and that relationships with male partners were less favorable for births, among discordant than among concordant women. Moreover, the happiness gap between concordant and discordant women was larger when births were unwanted (predicted score, 4.9 vs. 4.1) than when they were intended (9.3 vs. 9.1).


To help ensure optimal reproductive health care for all women, research should explore whether providers take into account all dimensions of individuals’ sexual orientation.

Authors' Affiliations

Caroline Sten Hartnett is assistant professor, Department of Sociology; Katrina M. Walsemann is associate professor, Department of Health Promotion, Education, and Behavior; and Daniela V. Negraia is a graduate student—all at the University of South Carolina, Columbia. Lisa Lindley is associate professor, Department of Global and Community Health, George Mason University, Fairfax, VA.

The views expressed in this publication do not necessarily reflect those of the Guttmacher Institute.

Perspectives on Sexual and Reproductive Health

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