Queer birthing parents in the Pacific Northwestern United States have multifaceted and variable paths when it comes to conceiving a family. With the innovations in assisted reproductive technology accompanying the wider acceptance and recognition of gender and sexual difference in mainstream society, a greater number of queer birthing parents are interfacing with the dominant biomedical obstetric complex than ever before. Using data collected from open-ended, semi-structured interviews with a voluntary sample (n=15) of individuals living in the Pacific Northwest of the United States, the purpose of this project was to identify and bring to light the birth experiences of queer-identified parents. In the pages that follow, I question: how does the predominantly heterosexual and cisgender culture of US birth affect the pregnancy, birth and early parenting experiences of queer, trans and non-binary birthing people? Specifically, I aim: 1) to better understand the role that queer identity negotiation plays in participants’ experiences of conception, provider choice, place of birth, and psychosocial support needs during labor; and 2) to examine how narratives of queer birthing parents “trouble” (Haraway 2016) what birth means and looks like outside of dominant biomedical paradigm. This research examines the costs and benefits of interfacing with medical providers in all birth settings along the path to biological parenthood, and provides applications of the research themes to maternity care that can help guide providers and birth workers serving this community. Ultimately, we argue that queer experiences of conception, pregnancy, and giving birth differ from more traditional US birth narratives in two key ways: 1) the path to conception is not as simple; queer parents-to-be spend much of their birth stories emphasizing how their conception, fertility methods, and provider options affected their experiences and outcomes, and 2) experiences of dysphoria and gender and sexual identity visibility/invisibility both within their communities and when interacting with healthcare providers are compounded by lack of continuity of care.