Pregnancy for trans and non-binary parents

We have produced this information in collaboration with trans and non-binary people. We are using these terms but recognise that there are many ways people describe their identity. 

Some of the pages that we signpost to from this information may use gendered language. Our language is under constant review as we understand more about our audience’s needs. 

Becoming pregnant as a trans man or non-binary person

There are different ways that trans and non-binary people choose to become pregnant. They may choose to become pregnant by having sex, through using a fertility clinic or by using at-home fertility treatment. Whether you have a partner or not, you also have the option of sperm donation. 

If you are thinking about trying for a baby, you can find information and read others’ experiences on the Trans Fertility website. 

If you have started hormonal transition, you will need to stop testosterone therapy (T) if you are trying to get pregnant. You may choose to do this by yourself or with the support of healthcare providers. If you pause testosterone and have no other underlying fertility issues, new research suggests that your chances of becoming pregnant are equal to cisgender women. 

You’ll need to arrange your antenatal care when you get pregnant. You can self-refer to some NHS hospitals – look at their website to see if that’s possible. Your GP can also refer to you for care.

Speak to your GP straight away if you become pregnant unexpectedly while taking testosterone. They can advise you about your testosterone medication. 

Getting support from your healthcare team

“I guarantee that you are not alone and that there will be advice and community out there for you, even if it’s hard to find at first.”

Freddy

When you begin your antenatal care, you will see a midwife at your first appointment. This is called the booking appointment. This should happen before you are 10 weeks pregnant. 

Some people may feel nervous and worry about things like their healthcare team’s use of language. This is natural but there are things your team can do to support you and to help you feel comfortable. 

Many NHS trusts have had training on how to deliver appropriate care to pregnant people who identify as trans or non-binary. 

Don’t be afraid to speak to your hospital about how they can support you during pregnancy. Your team are there to take care of you and your baby. 

Using inclusive language, that is personal to your individual situation, is crucial in helping you feel recognised and respected. 

Your midwife or doctor may need your guidance on what language you would prefer them to use that suits you best. You may wish to write down a list of preferred language terms that you can give to your midwife to keep with your antenatal notes. You may be cared for by several healthcare professionals throughout your pregnancy and this may prevent you having to repeat your needs during appointments.  

You can also ask your midwife or doctor to review the current Brighton and Sussex University Hospital (BSUH) guidelines on caring for trans and non-binary people during pregnancy, birth and the postnatal period.

Your pregnancy care rights

Every pregnant person deserves the best standard of care.

Your midwife and doctor should provide you with all the information you need to help you make informed choices about your care. They should listen to you and respect what you say. They should help you to get the care you choose during pregnancy.

The Nursing and Midwifery Code says that all midwives must treat people as individuals and respect and uphold their rights. Your midwife is your advocate and should support you in any decision you make about your pregnancy care. 

Asking for another midwife

It’s important to have a good relationship with your midwife because you should feel able to talk to them about any issues or concerns you have during your pregnancy. You can always ask if you can change midwives if you feel something isn’t right. You can also give feedback through PALS so services can improve (see below).

Using the PALS (Patient Advice and Liaison Service)

If you need any more support, you can also speak to the Patient Advice and Liaison Service (PALS).

PALS can:

• help you with health-related questions
• help resolve concerns or problems when you're using the NHS
• tell you how to get more involved in your own healthcare
• tell you about the NHS complaints procedure, including how to get independent help if you want to make a complaint.

You can find your nearest PALS office on the NHS website. 

Continuity of carer

Some trusts can offer continuity of carer from their midwives. This means you can see the same midwife throughout your antenatal care. This can help you establish a relationship and feel comfortable with the person caring for you. This isn’t available in every area. 

You may still find it helpful to do things such as calling ahead before appointments. This means you can check that your midwife is aware of your language requests and can help you feel more comfortable in their care.  

Midwives only want what is best for you and your baby and to give you the best possible care. It’s important to communicate your needs and preferences.

Where to have your appointments

Talk to your midwife about where you would feel most comfortable having your antenatal appointments. This could be at home instead of a children’s centre or GP surgery. 

Maternity care varies across the UK, but your healthcare team should make every effort possible to make sure you are comfortable. 

If you do have to go somewhere for your appointment, you could take someone with you for support. 

How to look after yourself during pregnancy 

Being healthy in pregnancy 

During pregnancy, there are some changes that you can make to your lifestyle that can help you have a healthy pregnancy. 

• Taking pregnancy supplements – there are two key supplements that are important to take during pregnancy, folic acid and vitamin D. These provide your baby with nutrients they need to grow and develop. 
• Try to stay active – being active during pregnancy will help support your physical and mental wellbeing, as well as prepare you for birth and recovery.
• Try to eat well by having a healthy, balanced diet and avoid certain foods that could be harmful during pregnancy.  
• If you smoke, giving up smoking is the best thing you can do to protect your baby.
• Avoid caffeine and keep your intake as low as possible under 200 mg a day.
• Always check before taking any medication when pregnant including painkillers.
• Avoid alcohol as there is no known safe level of drinking during pregnancy. 

It can be hard to find gender-neutral pregnancy wear. If your usual wardrobe is starting to feel uncomfortable, some people find that things like tracksuits or dungarees comfortable.

You may find it useful to look for trans-inclusive services such as hypnobirthing or antenatal classes, doula services or parent groups. These can support you with your wellbeing throughout pregnancy. We have listed some useful organisations at the bottom of this page. 

Mental health and wellbeing

Pregnancy can be a very emotional time. Hormones can contribute to a mix of highs and lows and you’re also thinking about how life is about to change. If you are pausing testosterone and becoming pregnant, this can also increase feelings of gender dysphoria during and after pregnancy. This experience will be different for every person, but it’s important to make sure that you feel supported at this time. Try to let your midwife know if you are struggling to manage any difficult emotions. 

If you are having bad feelings all the time and are finding it hard to cope, this could be a sign of something more serious. Mental health difficulties, such as low mood, anxiety and depression are common during pregnancy and up to a year after giving birth. 

Studies have also shown that trans and non-binary people may be less likely to seek support for their mental health, particularly form a health professional. Try to reach out to friends or family who may be able to offer some encouragement and support. There are also lots of organisations you can contact that can provide mental health support. 

Keeping your baby safe

When it comes to taking care of yourself and your baby, it’s important to listen to your instincts. If you feel something isn’t right, always contact your midwife, GP or local maternity unit for support. You can use our symptom checker to find out more about what to look out for and when to seek help. 

This is particularly important when it comes to your baby's movements. There is no set number of normal movements you should be feeling – every baby is different. Contact your midwife or maternity unit immediately if you think your baby’s movements have slowed down, stopped or changed.

In the third trimester, advice is to go to sleep on your side as this has been shown to be the safest thing for you and your baby.

Giving birth as trans man or non-binary person

Think about where you would like to give birth

Where you can give birth will depend on what you feel comfortable with, where you live, or if you’ve had any complications during this pregnancy or any previous pregnancies.

Possible places include:

• in hospital
• in a midwife-led birth unit or centre
• at home.

Your midwife can discuss your options with you and help you decide the best location for you. Find out more about where you can give birth.

If you are going to give birth in hospital or midwife-led birthing centre, speak to your midwife about what will make you feel most comfortable. For example, you can request to have a private room. You may be able to arrange a tour of the hospital facilities where you may choose to have your baby. You can also explore the option of other facilities such as midwife-led birthing centres. 

If you have a straightforward pregnancy, and both you and the baby are well, you might choose to give birth at home. If you think you may feel more comfortable giving birth in your own home, speak to your midwife or doctor who can advise and arrange your care. Find out more about having a home birth. 

Making a birth plan

A birth plan is a way for you to tell your healthcare team what you would like to happen during the birth of your baby. For example, if you’d like pain relief or if you want a birth partner with you. It’s also a great place to explain what language is right for you in case the midwives or doctors at the birth haven’t met you before. 

For anyone who is trans or non-binary, a birth plan can help you have a positive birth experience. You can make sure that your healthcare professionals are aware of any actions regarding your body that you feel uncomfortable with or might trigger feelings of dysphoria. 

Breast or chestfeeding your baby

If you have not had chest surgery, you should be able to breast or chestfeed your baby with a full milk supply. If you have had surgery, your milk supply may be greatly or partially reduced, but it could still be an option for feeding your baby. 

There are known benefits to breast or chest feeding your baby, including protecting them from future infections. However, choosing whether to breast or chestfeed your baby is a personal decision. Some people who experience dysphoria with breast or chestfeeding may choose to express milk and bottle feed their babies. 

Some people use a supplemental nursing system (SNS). There are different feeding options, including milk donation you can explore, and you may need to seek support from a breast or chest feeding specialist. 

It is still recommended that people who breast or chestfeed stay off testosterone until they decide to stop. 

Support for partners who are transitioning

Becoming a parent can be a challenging time, whether you are the person carrying the baby or not. It’s important that trans or non-binary non-birthing parents feel able to reach out for support too if they are find finding it difficult to manage.

When your partner begins antenatal care, have a discussion as a couple about how your healthcare team can best support you. Make them aware of any language preferences you have and anything that may trigger any difficult feelings.

You may have questions about how you may be able to feed your baby, whether that involves things like induced lactation or supplemental nursing systems (SNS). 

More information and support

Here is a list of organisations and networks that can provide support to you as you go through your pregnancy. 

CliniQ is a Community Interest Company that offers a holistic sexual health, mental health and wellbeing service for all trans people, partners and friends

Trans Unite is a UK directory of support groups for gender-variant people. They list groups campaigning for, supporting or assisting trans and gender diverse people. You will be able to find your nearest trans support group or services using their search tool. 

Gendered Intelligence is a registered charity that exists to increase understandings of gender diversity and improve trans people's quality of life. They have a directory of private therapists and counsellors for trans people.

Switchboard provides an information, support and referral service for people from the trans community.

LGBT Foundation provide a wide range of services to support lesbian, gay, bisexual and trans people. They also provide a range of support groups, face-to-face counselling and a helpline and email service.

Spectra is a London-based organisation that offers social groups, 121 support, counselling and workshops. 

The LGBT Mummies Tribe have lots of support for LGBTQ+ women and people on the path to motherhood or parenthood.  

Chestfeeding support

Birthing and Breast or Chestfeeding Trans People and Alliesis a Facebook groupintended for sharing information and experiences about pregnancy, birth and nursing amongst trans and genderfluid/gender neutral people anywhere on the gender spectrum, at any point in transition (or pre-transition).

Hearts Milkbank provides screened donor milk so babies everywhere can benefit from human milk. It works as part of the Human Milk Foundation.  

Paid-for services

The Positive Birth Company provides resources and support to empower birthing people and birth partners to create positive experiences. 

The Queer Parenting Partnership offers a range of services and support including a complete antenatal and postnatal education programme. 

The Queer Doula. Nanny Kimbo offers a range of doula services and more through to the postnatal period. 

Birthkeeper Doula. AJ Silver offers a doula service that involves birth and postnatal expertise. AJ is passionate about inclusivity and also runs workshops for birth workers. 

Further reading

The following reading has been suggested by some of our supporters.

Public Health England, Ensuring pregnant trans men get equal quality care

The Leeds University Trans Pregnancy Project, 

GenderGP, Trans Pregnancy and fertility

AJ Silver, Supporting Queer Birth: A Book for Birth Professionals and Parents

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If you have any comments, feedback or suggestions about how to improve this information, please email us at [email protected]