HOW TO USE THIS BOOK So, you want to make a baby. Or at least you're thinking about it. You've come to the right place! In this book, you will find everything you need to know about fertility and queer conception that was left out of your high school biology curriculum, and all the things your primary care doctor didn't know to tell you, that your fertility doctor overlooked, and that would have taken you months to glean off the internet, wading through cis/het centered information. Here, you'll find evidence-based information that actually applies to queer people building families via pregnancy. You might pick up this book at any point in the conception process, but no matter what, this book has something for you. If you are doing some exploratory research in hopes of someday building a family , please be sure to take a look at Chapter 1: Making Decisions & Creating a Timeline. This chapter will guide you in thinking about your options as well as when to get started, including the ideal time to cryopreserve your gametes if you know you want to make a baby someday, but you're not ready now. If you are ready to begin the process of seeking pregnancy , start with Chapters 1-3, which provide an overview of the options, help with initial decision-making, and assist in preparing for conception and pregnancy. This is foundational and will support you as you dive into the specifics covered in Chapters 4-6, including donor selection, surrogacy and insemination. For those conceiving via insemination, special attention is given to helping you feel confident about when you are ovulating so you can get the timing right, which is covered in chapter 6. If you plan to start inseminating within the next 3-6 months, don't wait to review this chapter. If you are considering IVF or reciprocal IVF, chapter 1 addresses success rates and costs, while chapter 8 will walk you through what to expect during treatment. If you are already in the process of inseminating when you pick up this book, be sure to take a look at the success rates and recommended timelines in the second half of Chapter 1. This will provide guidance for deciding how long to try and when to seek additional support if needed. It will also put your efforts to conceive into perspective with your age, assisting you in big picture thinking to support you in moving to the next level of care at the appropriate time, before your fertile window runs out. You might then skip to the list of checkpoints at the beginning of Chapter 7: Troubleshooting & Complicated Conceptions. You can use this list to guide where in the book you turn to next. If you find there is information on the checklist you have not yet considered, back up to the recommended chapter provided on the checklist. If you are about to dive in to the IVF process , start with Chapter 8: In-Vitro Fertilization & Embryo Transfer. This chapter is designed to demystify the IVF process and provide anticipatory guidance to help you stay grounded as you go through it. Be sure to also flip back to Chapter 2: Fertile Health for Every Body to make sure you are doing what you can to support your gametes and/or prepare your body for pregnancy. If you have been diagnosed with PCOS, fibroids or endometriosis , Chapter 7: Troubleshooting & Complicated Conceptions is for you. A detailed exploration of the evidence for supporting these conditions is included here. This chapter, as well as the rest of the book, is written from a body-positive, anti-fat-shaming perspective. If you've simply been told you need to lose weight to conceive, you will find a more nuanced approach here. If you are newly pregnant or your partner or surrogate is pregnant , turn directly to Chapter 11: Early Pregnancy & Lactation Induction. While this book is primarily focused on fertility and achieving pregnancy, this chapter is included for guidance in the early weeks after conception. Additionally, it contains information that is hard to find elsewhere, including protocols for inducing lactation, which ideally start 3-6 months before your babe arrives. Guidance is provided for choosing a care provider, caring for your mental health, getting the support you need, and queering pregnancy. Considerations for bonding and attachment, feeding after chest masculinization surgery, and ensuring that your baby gets a good latch are included as well. If you are a midwife or other health care provider who cares for conceiving queer and trans families, you will glean a great deal of information by witnessing the transmission of information provided for families in this book. There are notes for you at the end of each chapter to guide you in your practice. Consider this the preceptorship you never had. A NOTE FROM THE MIDWIFE Dear Reader, By way of introduction, I am a white, queer, nonbinary empty nester parent of 4 grown children, one of whom I gave birth to in a freestanding birth center in central Missouri in 1995. Not only did my own experience of pregnancy and birth under the care of midwives spark my desire to enter the midwifery profession, something my midwife said to me during pregnancy struck a chord that has influenced everything about the way I practice. She said to me, "We were never meant to do this alone." This sentiment motivated me to reach out and create community during a time that otherwise could have been extremely isolating for me as a new parent. It has also underscored the work I do with the families in my care. Once I decided to heed the call of becoming a midwife, I knew that creating space for new parents to connect with one another would be a core aspect of my practice. When I realized my calling was to serve queer and trans families, specifically, my drive to build community among the clients I serve became integral for providing affirmation and cultivating resiliency during a time that most of us experience rampant cis/heterosexism, if not outright transphobia and homophobia, in receiving health care and within the culture at large. My practice is therefore unique. I don't catch babies much any more. Instead, I focus my energy and attention on filling the gaps in care that exist for my community. This means providing queer and trans focused preconception care to local families as well as to families at a distance via telemedicine, and running an online program of education and support for queer and trans families throughout conception, pregnancy, and the early weeks of parenthood. Although my clinical practice may be focused on making babies, at its core, my midwifery practice is about making parents. In creating spaces and facilitating conversations where new parents feel safe enough to be vulnerable, people experience feeling deeply held by their community. The stories I have witnessed over the course of my role as an educator, protector and guide for new families are not covered in textbooks and are never witnessed by providers in models of care that are purely focused on clinical concerns and end within days after birth. Although I can share a great deal of knowledge, what truly informs my practice is the past 26 years I have spent listening. My work as a midwife is to utilize clinical knowledge and procedural skills alongside psychosocial aspects of care including counseling, education and community building. From my perspective, it takes all of these to truly nurture and protect each individual's transition to parenthood. That being said, my lens is limited by my experience walking through the world as a white person. While I take seriously my personal responsibility to undo the messages of white superiority I was raised with, and I actively engage in utilizing my privilege to address the impacts of racism wherever I can, I still move through a racist world under the protection of white privilege. Naming and acknowledging this is vital in claiming the limitations of my perspective. I would like to express sincere gratitude and appreciation for every Black, Indigenous, and POC client who has felt safe enough to share their experiences within the spaces of my practice, as well as the BIPOC colleagues and mentors who have been gracious enough to inform me by sharing their own experiences and engaging in conversations with me about racism. I am listening. Thank you for speaking your truth. In addition to my work with families, I also fill gaps in education for midwives and other care providers by providing online modules and training programs for queer/trans affirming preconception care, midwife-led IUI, and gender inclusivity, as well as speaking at conferences and educational institutions and providing consulting services from time to time. Although I experience marginalization within my profession because of my gender and outspokenness about the needs of my community, I keep working for change, and I continue to create space for and provide guidance to queer and trans midwives entering the profession. For you, dear reader, I offer this book as an ever present guide to support you through the creation or expansion of your family. Queer conception is any conception that occurs outside of cis/heterocentric norms. Being queer means we forge our own way when culturally prescribed norms don't suit us. This book is about conceiving differently, in ways that suit our personal needs, affirm our identity, and reflect the level of intention with which we conceive. It's a book about how we go about creating our families and crafting our lives. With big queer love, Kristin Excerpted from Queer Conception: The Complete Fertility Guide for Queer and Trans Parents-To-Be by Kristin Kali All rights reserved by the original copyright owners. Excerpts are provided for display purposes only and may not be reproduced, reprinted or distributed without the written permission of the publisher.
