1
|
Congdon JL, Vittinghoff E, Dehlendorf C. Comparison of a person-centered pregnancy prevention question and One Key Question to assess postpartum contraceptive needs. Contraception 2024; 135:110465. [PMID: 38636583 DOI: 10.1016/j.contraception.2024.110465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 04/04/2024] [Accepted: 04/10/2024] [Indexed: 04/20/2024]
Abstract
OBJECTIVES To explore the relevance of pregnancy intention as a screen for contraceptive needs among postpartum individuals. STUDY DESIGN We surveyed 234 postpartum individuals to assess the alignment between pregnancy intentions in the next year and current desire to prevent pregnancy. RESULTS Most individuals (87%) desired pregnancy prevention now, including 73% of individuals who desired or were ambivalent about pregnancy in the next year. CONCLUSION A majority of individuals considering pregnancy in the next year desired pregnancy prevention now. Directly assessing current desire to prevent pregnancy may be more specific for contraceptive needs in postpartum individuals. IMPLICATIONS Our ability to ensure that all individuals who want to prevent pregnancy have access to contraception depends on the use of effective screening questions. These findings prompt consideration of broader clinical implementation of screening for desire to prevent pregnancy in lieu of questions about pregnancy intention in the next year.
Collapse
Affiliation(s)
- Jayme L Congdon
- Department of Pediatrics and Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, CA, United States.
| | - Eric Vittinghoff
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, United States.
| | - Christine Dehlendorf
- Department of Family and Community Medicine, University of California, San Francisco, CA, United States.
| |
Collapse
|
2
|
Lu Y, He Y, Wang Y, Zhu Q, Qi J, Li X, Ding Y, Huang J, Ding Z, Xu Y, Yang Y, Lindheim SR, Wei Z, Sun Y. Effects of SARS-COV-2 infection during the frozen-thawed embryo transfer cycle on embryo implantation and pregnancy outcomes. Hum Reprod 2024; 39:1239-1246. [PMID: 38604654 DOI: 10.1093/humrep/deae068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 02/29/2024] [Indexed: 04/13/2024] Open
Abstract
STUDY QUESTION Does severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection during the frozen-thawed embryo transfer (FET) cycle affect embryo implantation and pregnancy rates? SUMMARY ANSWER There is no evidence that SARS-CoV-2 infection of women during the FET cycle negatively affects embryo implantation and pregnancy rates. WHAT IS KNOWN ALREADY Coronavirus disease 2019 (COVID-19), as a multi-systemic disease, poses a threat to reproductive health. However, the effects of SARS-CoV-2 infection on embryo implantation and pregnancy following fertility treatments, particularly FET, remain largely unknown. STUDY DESIGN, SIZE, DURATION This retrospective cohort study, included women who underwent FET cycles between 1 November 2022 and 31 December 2022 at an academic fertility centre. PARTICIPANTS/MATERIALS, SETTING, METHODS Women who tested positive for SARS-CoV-2 during their FET cycles were included in the COVID-19 group, while those who tested negative during the same study period were included in the non-COVID-19 group. The primary outcome was ongoing pregnancy rate. Secondary outcomes included rates of implantation, biochemical pregnancy, clinical pregnancy, early pregnancy loss, and ongoing pregnancy. Multivariate logistic regression models were applied to adjust for potential confounders including age, body mass index, gravidity, vaccination status, and endometrial preparation regimen. Subgroup analyses were conducted by time of infection with respect to transfer (prior to transfer, 1-7 days after transfer, or 8-14 days after transfer) and by level of fever (no fever, fever <39°C, or fever ≥39°C). MAIN RESULTS AND THE ROLE OF CHANCE A total of 243 and 305 women were included in the COVID-19 and non-COVID-19 group, respectively. The rates of biochemical pregnancy (58.8% vs 62.0%, P = 0.46), clinical pregnancy (53.1% vs 54.4%, P = 0.76), implantation (46.4% vs 46.2%, P = 0.95), early pregnancy loss (24.5% vs 26.5%, P = 0.68), and ongoing pregnancy (44.4% vs 45.6%, P = 0.79) were all comparable between groups with or without infection. Results of logistic regression models, both before and after adjustment, revealed no associations between SARS-CoV-2 infection and rates of biochemical pregnancy, clinical pregnancy, early pregnancy loss, or ongoing pregnancy. Moreover, neither the time of infection with respect to transfer (prior to transfer, 1-7 days after transfer, or 8-14 days after transfer) nor the level of fever (no fever, fever <39°C, or fever ≥39°C) was found to be related to pregnancy rates. LIMITATIONS, REASONS FOR CAUTION The retrospective nature of the study is subject to possible selection bias. Additionally, although the sample size was relatively large for the COVID-19 group, the sample sizes for certain subgroups were relatively small and lacked adequate power, so these results should be interpreted with caution. WIDER IMPLICATIONS OF THE FINDINGS The study findings suggest that SARS-CoV-2 infection during the FET cycle in females does not affect embryo implantation and pregnancy rates including biochemical pregnancy, clinical pregnancy, early pregnancy loss, and ongoing pregnancy, indicating that cycle cancellation due to SARS-CoV-2 infection may not be necessary. Further studies are warranted to verify these findings. STUDY FUNDING/COMPETING INTEREST(S) This study was supported by the National Key Research and Development Program of China (2023YFC2705500, 2019YFA0802604), National Natural Science Foundation of China (82130046, 82101747), Shanghai leading talent program, Innovative research team of high-level local universities in Shanghai (SHSMU-ZLCX20210201, SHSMU-ZLCX20210200, SSMU-ZLCX20180401), Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital Clinical Research Innovation Cultivation Fund Program (RJPY-DZX-003), Science and Technology Commission of Shanghai Municipality (23Y11901400), Shanghai Sailing Program (21YF1425000), Shanghai's Top Priority Research Center Construction Project (2023ZZ02002), Three-Year Action Plan for Strengthening the Construction of the Public Health System in Shanghai (GWVI-11.1-36), and Shanghai Municipal Education Commission-Gaofeng Clinical Medicine Grant Support (20161413). The authors have no conflicts of interest to declare. TRIAL REGISTRATION NUMBER N/A.
Collapse
Affiliation(s)
- Yao Lu
- Department of Reproductive Medicine, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
| | - Yaqiong He
- Department of Reproductive Medicine, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
| | - Yuan Wang
- Department of Reproductive Medicine, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
| | - Qinling Zhu
- Department of Reproductive Medicine, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
| | - Jia Qi
- Department of Reproductive Medicine, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
| | - Xinyu Li
- Department of Reproductive Medicine, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
| | - Ying Ding
- Department of Reproductive Medicine, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
| | - Jiaan Huang
- Department of Reproductive Medicine, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
| | - Ziyin Ding
- Department of Reproductive Medicine, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
| | - Yurui Xu
- Department of Reproductive Medicine, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
| | - Yanan Yang
- Department of Reproductive Medicine, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
| | - Steven R Lindheim
- Department of Reproductive Medicine, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
- Department of Obstetrics and Gynecology, Baylor Scott & White, Temple, TX, USA
| | - Zhe Wei
- Department of Reproductive Medicine, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
| | - Yun Sun
- Department of Reproductive Medicine, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
- Shanghai Immune Therapy Institute, Shanghai Jiao Tong University School of Medicine-Affiliated Renji Hospital, Shanghai, China
| |
Collapse
|
3
|
Yarger J, Hopkins K, Elmes S, Rossetto I, Van Liefde D, De La Melena S, Harper CC. Use of telemedicine to obtain contraception among young adults: Inequities by health insurance. Contraception 2024; 134:110419. [PMID: 38467325 DOI: 10.1016/j.contraception.2024.110419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 12/19/2023] [Accepted: 03/06/2024] [Indexed: 03/13/2024]
Abstract
OBJECTIVES The objective of this study was to describe the use of telemedicine for contraception in a sample of young adults and examine differences by health insurance coverage. STUDY DESIGN We analyzed survey data collected from May 2020 to July 2022 from individuals at risk of pregnancy aged 18 to 29 recruited at 29 community colleges in California and Texas. We used multivariable mixed-effects logistic regression models with random effects for site and individual to compare the use of telemedicine to obtain contraception by insurance status, sociodemographic characteristics, and state. RESULTS Our analytic sample included 6465 observations from 1630 individuals. Participants reported using a contraceptive method obtained through telemedicine in just 6% of observations. Uninsured participants were significantly less likely than those privately insured to use contraception obtained through telemedicine (adjusted odds ratio [aOR], 0.54; 95% confidence interval [CI], 0.31-0.97), as were participants who did not know their insurance status (aOR, 0.54; 95% CI, 0.29-0.99). Texas participants were less likely to use contraception obtained via telemedicine than those in California (aOR, 0.42; CI: 0.25-0.69). CONCLUSIONS Few young people in this study obtained contraception through telemedicine, and insurance was crucial for access in both states. IMPLICATIONS Although telemedicine holds promise for increasing contraceptive access, we found that few young adults were using it, particularly among the uninsured. Efforts are needed to improve young adults' access to telemedicine for contraception and address insurance disparities.
Collapse
Affiliation(s)
- Jennifer Yarger
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, CA, United States; Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, United States; Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, CA, United States.
| | - Kristine Hopkins
- Population Research Center, University of Texas at Austin, Austin, TX, United States
| | - Sarah Elmes
- Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, CA, United States
| | - Irene Rossetto
- Population Research Center, University of Texas at Austin, Austin, TX, United States
| | - Danielle Van Liefde
- Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, CA, United States
| | - Stephanie De La Melena
- Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, CA, United States
| | - Cynthia C Harper
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, CA, United States; Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, CA, United States
| |
Collapse
|
4
|
Abualsaud RM, Aldhubabian NA, Alharthi AM, Alzahrani MA, Balto GE, Malak MM. The impact of the COVID-19 pandemic on reproductive intentions and contraceptive use among females in Jeddah, Saudi Arabia. Int J Gynaecol Obstet 2024. [PMID: 38634286 DOI: 10.1002/ijgo.15542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 03/31/2024] [Accepted: 04/02/2024] [Indexed: 04/19/2024]
Abstract
OBJECTIVE Pandemics have affected many people's social and emotional lives. Conception planning, contraceptive usage, and pregnancy intentions are activities with minimal research. This study is the first to evaluate how the COVID-19 pandemic influenced reproductive plans and contraceptive use among women during the pandemic in Jeddah, Saudi Arabia, in 2022. METHODS A cross-sectional survey was conducted by sending an online questionnaire to married women from Jeddah, Saudi Arabia. The questionnaire included demographics, personal obstetrics information, changes in pregnancy intentions owing to the COVID-19 pandemic, and questions about contraceptive usage. Qualitative data were presented as frequencies, and a χ2 test was performed to determine the relationships among the variables. RESULTS A total of 639 women enrolled in the study; most participants were 25-34 years old, and most indicated they changed their reproductive intentions during the pandemic (49%). Family planning accounted for 25.8% of participants who changed their reproductive intentions. Only 17.5% changed their choices because of fear of the COVID-19 impact. The percentage of women using contraception was significantly reduced during the lockdown, to 36.8%. Oral contraceptive pills were the most frequently used method during the curfew period (17.5%). CONCLUSION The COVID-19 lockdown affected the reproductive intentions of most women in Jeddah, and it significantly reduced contraceptive use.
Collapse
Affiliation(s)
- Renad M Abualsaud
- Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | | | | | | | - Mohammed M Malak
- Department of Obstetrics and Gynecology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| |
Collapse
|
5
|
Tilstra AM, Polizzi A, Wagner S, Akimova ET. Projecting the long-term effects of the COVID-19 pandemic on U.S. population structure. Nat Commun 2024; 15:2409. [PMID: 38499539 PMCID: PMC10948855 DOI: 10.1038/s41467-024-46582-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 03/04/2024] [Indexed: 03/20/2024] Open
Abstract
The immediate, direct effects of the COVID-19 pandemic on the United States population are substantial. Millions of people were affected by the pandemic: many died, others did not give birth, and still others could not migrate. Research that has examined these individual phenomena is important, but fragmented. The disruption of mortality, fertility, and migration jointly affected U.S. population counts and, consequently, future population structure. We use data from the United Nations World Population Prospects and the cohort component projection method to isolate the effect of the pandemic on U.S. population estimates until 2060. If the pandemic had not occurred, we project that the population of the U.S. would have 2.1 million (0.63%) more people in 2025, and 1.7 million (0.44%) more people in 2060. Pandemic-induced migration changes are projected to have a larger long-term effect on future population size than mortality, despite comparable short-term effects.
Collapse
Affiliation(s)
- Andrea M Tilstra
- Leverhulme Centre for Demographic Science, Nuffield Department of Population Health, Nuffield College, University of Oxford, Oxford, OX1 1JD, UK.
- Department of Sociology, University of Oxford, Oxford, OX1 1JD, UK.
| | - Antonino Polizzi
- Leverhulme Centre for Demographic Science, Nuffield Department of Population Health, Nuffield College, University of Oxford, Oxford, OX1 1JD, UK
- Department of Sociology, University of Oxford, Oxford, OX1 1JD, UK
| | - Sander Wagner
- Leverhulme Centre for Demographic Science, Nuffield Department of Population Health, Nuffield College, University of Oxford, Oxford, OX1 1JD, UK
| | - Evelina T Akimova
- Leverhulme Centre for Demographic Science, Nuffield Department of Population Health, Nuffield College, University of Oxford, Oxford, OX1 1JD, UK
| |
Collapse
|
6
|
Mooi-Reci I, Wooden M, Zilio F. Baby Bump or Baby Slump? COVID-19, Lockdowns, and their Effects on Births in Australia. SSM Popul Health 2024; 25:101604. [PMID: 38292050 PMCID: PMC10825770 DOI: 10.1016/j.ssmph.2024.101604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 01/03/2024] [Accepted: 01/04/2024] [Indexed: 02/01/2024] Open
Abstract
This study examines changes in birth rates in Australia during the COVID-19 pandemic and the extent to which such changes were influenced by lockdowns. We use natality data at State and small regional area levels spanning the period from 2011 to 2022. In our empirical approach, we first take advantage of a unique quasi-experimental setting that arose in Victoria, Australia's second most populous State, during the first year of the pandemic. Victoria imposed a 111-day stay-at-home lockdown while other States and Territories enforced milder restrictions on social and economic activities. We then exploit lockdowns that lasted more than three months in Victoria and New South Wales in the second year of the pandemic. Within these quasi-experimental settings, our empirical approach was to first use monthly data at the State-level and estimate birth rate deviations from secular trends for the months affected by COVID-19 policies. We also estimate separate models to examine variations in births across regional areas with different compositions of Indigenous population, unemployment, low-income, and non-English speaking residents. Our findings reveal a nationwide fertility increase in 2021, but Victoria exhibited slower growth, especially in areas with higher unemployment, lower income, and more non-English speaking residents. In 2022, we find evidence of a gradual return of birth rates to pre-pandemic trends, though this is mainly concentrated in the major cities. While the second-year lockdowns had limited impacts, language-diverse areas still mostly experienced lower rates of growth in birth rates.
Collapse
Affiliation(s)
- Irma Mooi-Reci
- School of Social and Political Sciences, Level 5, John Medley Bldg, The University of Melbourne, Victoria, 3010, Australia
| | - Mark Wooden
- Melbourne Institute: Applied Economic & Social Research, University of Melbourne, Victoria, 3010, Australia
| | - Federico Zilio
- Melbourne Institute: Applied Economic & Social Research, University of Melbourne, Victoria, 3010, Australia
| |
Collapse
|
7
|
Borges ALV, Roman Lay AA, Duarte LS, Chofakian CBDN, Hall JA, Barrett G. Changes in contraceptive use during the second COVID-19 lockdown in Brazil: A web-based survey. Contraception 2024; 131:110359. [PMID: 38159791 DOI: 10.1016/j.contraception.2023.110359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 12/18/2023] [Accepted: 12/22/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVE We assessed contraceptive use changes during the second lockdown due to COVID-19 in Brazil and their associated factors. STUDY DESIGN This was a longitudinal web-based study in which 725 non-pregnant Brazilian women aged 18 to 49 completed an online structured survey about their contraceptive practices in two rounds in 2021. Multivariate multinomial logistic regression was used to analyze factors associated with contraceptive use changes during COVID-19. RESULTS Sixty percent reported they changed their contraceptive use during COVID-19, especially starting to use a method or switching to a more effective one (32%). In adjusted analysis, women who were ambivalent about a future pregnancy were more likely to switch to a more effective method (adjusted odds ratio [aOR] 2.33, 95% CI 1.42-3.83) and to stop using contraceptive (aOR 3.64, 95% CI 1.91-6.91). Women with a partner were less likely to switch to a more effective method (aOR 0.61, 95% CI 0.39-0.93) and to stop using contraceptive (aOR 0.53, 95% CI 0.31-0.93), but more likely to switch to a less effective method (aOR 2.25, 95% CI 1.16-4.34). Age was also associated with contraceptive use changes. CONCLUSIONS Contraceptive use among Brazilian women during COVID-19 depended on their age and partnership status. During the period of the highest peak in the number of cases and deaths in the country, ambivalence towards a future pregnancy increased changes in contraceptive use. IMPLICATIONS Contraceptive changes were observed during a two-wave web-survey in Brazil depending on women's age and partnership status. Ambivalence towards a future pregnancy increased changes in contraceptive use and should be considered in future studies regarding sexual and reproductive health and COVID-19 as well as in family planning program implementation.
Collapse
Affiliation(s)
| | | | | | | | | | - Geraldine Barrett
- EGA Institute for Women's Health, University College London, London, UK
| |
Collapse
|
8
|
Cherinet A, Zemedkun A, Wudineh A, Molla W, Sisay D, Negassa B, Mebratu A, Gossaye A, Melaku G, Madoro D. Lesson Learned During a Pandemic: A Phenomenological Study of Pregnant Women's Experience in Resource-Limited Setting. J Multidiscip Healthc 2024; 17:325-337. [PMID: 38284117 PMCID: PMC10821727 DOI: 10.2147/jmdh.s448376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 01/18/2024] [Indexed: 01/30/2024] Open
Abstract
Introduction Pandemics like COVID-19 has strained healthcare systems globally, particularly in resource-limited settings where pre-existing healthcare gaps and constraints amplify the challenges faced by pregnant women. Having this lesson on pregnant women's experiences during COVID-19 offers invaluable insights into potential strategies and interventions needed to mitigate the impact of similar outbreaks in the future. Therefore, this phenomenological study aimed to uncover the experiences of pregnant women during the COVID-19 pandemic in Dilla town, Gedeo zone, southern Ethiopia. Method and Materials A descriptive phenomenological design was employed at Dilla University teaching hospital. A Purposive sampling technique was used and point of data saturation was declared at participant 16th. An in-depth interview was conducted in a private room after they received antenatal care services. The interviews were audiotaped, transcribed, and analysed using the open code software version 4.03. The interviews were transcribed verbatim to provide tick descriptions of data. Thematic analysis was employed using an inductive approach. Direct quotes from participants were included without any grammar editing to preserve their intended meaning. Results Our study found five predominant themes: mental health consequences of the COVID-19 pandemic, health impact of COVID-19, concerns over the economic impact of the COVID-19 pandemic, COVID-19 influence on social engagements, and challenge on getting reliable information. Conclusion and Recommendation This study identified that pregnant women experienced various challenges during the pandemic which includes psychological problems, health impact of COVID-19, economic problems, lack of reliable information and limited social support. Hence, implementing a customized approach by integrating psychosocial interventions with prenatal care services and conducting intensive health education sessions and economic empowerment are beneficial as mitigation strategies to better prepare for future pandemics.
Collapse
Affiliation(s)
- Aneleay Cherinet
- Department of Midwifery, College of Health Sciences and Medicine, Dilla University, Dilla, Ethiopia
| | - Abebayehu Zemedkun
- Department of Anesthesiology, College of Health Sciences and Medicine, Dilla University, Dilla, Ethiopia
| | - Aregahegn Wudineh
- Department of Midwifery, College of Health Sciences and Medicine, Dilla University, Dilla, Ethiopia
| | - Wondwosen Molla
- Department of Midwifery, College of Health Sciences and Medicine, Dilla University, Dilla, Ethiopia
| | - Daniel Sisay
- School of Public Health, College of Health Sciences and Medicine, Dilla University, Dilla, Ethiopia
| | - Belay Negassa
- Department of Environmental Health, College of Health Sciences and Medicine, Dilla University, Dilla, Ethiopia
| | - Andualem Mebratu
- Department of Midwifery, College of Health Sciences and Medicine, Dilla University, Dilla, Ethiopia
| | - Aschalew Gossaye
- Departments of Nursing, College of Health Sciences and Medicine, Dilla University, Dilla, Ethiopia
| | - Getnet Melaku
- Department of Midwifery, College of Health Sciences and Medicine, Dilla University, Dilla, Ethiopia
| | - Derebe Madoro
- Department of Psychiatry, College of Health Sciences and Medicine, Dilla University, Dilla, Ethiopia
| |
Collapse
|
9
|
Pickering S, Manze M, Losch J, Romero D. Delays in Obtaining Abortion and Miscarriage Care Among Pregnant Persons in New York State During the COVID-19 Pandemic: The CAP Study. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2024; 5:30-39. [PMID: 38249936 PMCID: PMC10797165 DOI: 10.1089/whr.2023.0128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/14/2023] [Indexed: 01/23/2024]
Abstract
Background We sought to investigate delays obtaining abortion and miscarriage care during the COVID-19 pandemic, compared with before the pandemic, among pregnant persons in New York State (NYS). Methods We administered a cross-sectional survey in June-July 2020 to NYS residents aged 18-44 years who identified as female or transgender male (N = 1,525). This analysis focused on a subsample who had an abortion or miscarriage during COVID-19, were seeking an abortion at the time of the survey, or had an abortion or miscarriage before COVID-19 (n = 116). We conducted bivariate analyses to determine differences in delays to seeking or obtaining an abortion or miscarriage during versus before the pandemic, as well as consideration of abortion among those pregnant during versus before the pandemic. We also asked open-ended questions about miscarriage and abortion experiences. Main Findings Of the 21 respondents who sought or were seeking an abortion during the COVID-19 pandemic, 76.2% (n = 16) reported experiencing a delay in obtaining abortion care, compared with 18.2% (n = 4) of those who experienced a delay before the pandemic (p < 0.001). A significantly higher proportion of respondents who were pregnant during the pandemic considered abortion, compared with those who gave birth before the pandemic (39.1% vs. 7.6%; p < 0.001). Of the 39 respondents who miscarried during the pandemic, 35.9% (n = 14) delayed care, compared with 5.9% (n = 2) before the pandemic (p < 0.01). Some respondents also commented on the difficulty of accessing miscarriage services during COVID-19 in open-ended responses. Principal Conclusions Those who sought abortion or miscarriage care during the COVID-19 pandemic experienced significant delays in getting care. These are essential services that must be available during public health emergencies, and yet access to these services is now severely limited in many states due to the Dobbs vs. Jackson Women's Health Organization decision.
Collapse
Affiliation(s)
- Sarah Pickering
- Department of Community Health and Social Sciences, City University of New York (CUNY) Graduate School of Public Health and Health Policy, New York, New York, USA
| | - Meredith Manze
- Department of Community Health and Social Sciences, City University of New York (CUNY) Graduate School of Public Health and Health Policy, New York, New York, USA
| | - Jessie Losch
- Department of Community Health and Social Sciences, City University of New York (CUNY) Graduate School of Public Health and Health Policy, New York, New York, USA
| | - Diana Romero
- Department of Community Health and Social Sciences, City University of New York (CUNY) Graduate School of Public Health and Health Policy, New York, New York, USA
| |
Collapse
|
10
|
Bhuptani PH, Hunter J, Goodwin C, Millman C, Orchowski LM. Characterizing Intimate Partner Violence in the United States During the COVID-19 Pandemic: A Systematic Review. TRAUMA, VIOLENCE & ABUSE 2023; 24:3220-3235. [PMID: 36321779 DOI: 10.1177/15248380221126187] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Intimate partner violence (IPV) is a significant global health concern. Numerous research studies document increases in IPV since the onset of the COVID-19 pandemic in March 2020. Despite this widespread recognition, research around the nature of this violence is still growing. This systematic review summarizes the existing literature documenting the prevalence and characteristics of IPV during the COVID-19 pandemic. Inclusion criteria are as follows: reported original data empirical study, assessed for IPV among adult population in the United States, and was published in English between December 2019 and March 2022. A total of 53 articles were then independently reviewed and sorted into four thematic subcategories: victimization, perpetration, articles addressing victimization and perpetration, and provider perspectives. Studies document consistent increases in the prevalence of IPV victimization and perpetration. Providers within agencies providing support to individuals impacted by IPV also documented increased strain on the agencies.
Collapse
Affiliation(s)
- Prachi H Bhuptani
- Rhode Island Hospital, Providence, USA
- Brown University, Providence, RI, USA
| | | | | | | | | |
Collapse
|
11
|
Golovina K, Nenko I, Marcinkowska UM. Childcare burden and changes in fertility desires of mothers during the COVID-19 pandemic. Front Psychol 2023; 14:1243907. [PMID: 38106382 PMCID: PMC10723901 DOI: 10.3389/fpsyg.2023.1243907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 10/26/2023] [Indexed: 12/19/2023] Open
Abstract
Objectives Previous studies have documented a decline in fertility desires and intentions following the COVID-19 outbreak, but the reasons for this decline are not well understood. This study examined whether childcare burden on mothers during the lockdown and quarantines, COVID-related stress, and COVID exposure were associated with a change in the desired number of children. Methods The survey was conducted online, in Poland from April to July 2021 on a sample of 622 non-pregnant mothers without diagnosed infertility. Results Associations were observed between childcare responsibilities during the quarantine and fertility desires: mothers who solely or mainly took care of their children during the quarantine(s) were more likely to decrease their desired number of children ([adjusted] aOR = 1.91, 95% CI = 1.16-3.15). Mothers with higher levels of COVID-related stress (aOR = 1.81, 95% CI = 1.48-2.22) and a greater COVID exposure index (aOR = 1.39, 95% CI = 1.12-1.72) were more likely to decrease their fertility desires. Conclusion Higher childcare burden during quarantines was related to a lower desired number of children among mothers. Both greater COVID-related stress and COVID exposure were associated with fertility desires, regardless of childcare responsibilities during the pandemic.
Collapse
Affiliation(s)
- Kateryna Golovina
- Helsinki Collegium for Advanced Studies, University of Helsinki, Helsinki, Finland
| | - Ilona Nenko
- Faculty of Health Sciences, Jagiellonian University Medical College, Kraków, Poland
| | | |
Collapse
|
12
|
Van Baak B, Powell A, Fricas J, Caupain Sanderson A. Essential Nursing Actions to Reduce Inequities for Black Women in the Perinatal Period. J Obstet Gynecol Neonatal Nurs 2023; 52:454-466. [PMID: 37597534 DOI: 10.1016/j.jogn.2023.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 07/10/2023] [Accepted: 07/12/2023] [Indexed: 08/21/2023] Open
Abstract
Perinatal nurses play a critical role in the care of, advocacy for, and research with Black women in the perinatal period. Despite awareness of inequities in the perinatal health care system that stem from racism in the United States, many nurses report feeling detached from the crisis. In this critical commentary, we provide a five-step nursing action guide to address this health disparity that is aligned with the Future of Nursing report and the American Nurses Association Code of Ethics. We recommend nursing activities in each step: understand drivers of health inequities among Black women, reflect on implicit bias, use respectful care frameworks with Black women, conduct ethical research, and advocate for change. The article includes a sharable and printable action sheet that can be used in the work environment to remind nurses of their roles in enacting change.
Collapse
|
13
|
Baxter AJ, Geary RS, Dema E, Bosó Pérez R, Riddell J, Willis M, Conolly A, Oakley LL, Copas AJ, Gibbs J, Bonell C, Sonnenberg P, Mercer CH, Clifton S, Field N, Mitchell K. Contraceptive use and pregnancy planning in Britain during the first year of the COVID-19 pandemic: findings from a large, quasi-representative survey (Natsal-COVID). BMJ SEXUAL & REPRODUCTIVE HEALTH 2023; 49:260-273. [PMID: 36958823 PMCID: PMC10579517 DOI: 10.1136/bmjsrh-2022-201763] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 03/12/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Contraceptive services were significantly disrupted during the COVID-19 pandemic in Britain. We investigated contraception-related health inequalities in the first year of the pandemic. METHODS Natsal-COVID Wave 2 surveyed 6658 adults aged 18-59 years between March and April 2021, using quotas and weighting to achieve quasi-representativeness. Our analysis included sexually active participants aged 18-44 years, described as female at birth. We analysed contraception use, contraceptive switching due to the pandemic, contraceptive service access, and pregnancy plannedness. RESULTS Of 1488 participants, 1619 were at risk of unplanned pregnancy, of whom 54.1% (51.0%-57.1%) reported routinely using effective contraception in the past year. Among all participants, 14.3% (12.5%-16.3%) reported switching or stopping contraception due to the pandemic. 3.2% (2.0%-5.1%) of those using effective methods pre-pandemic switched to less effective methods, while 3.8% (2.5%-5.9%) stopped. 29.3% (26.9%-31.8%) of at-risk participants reported seeking contraceptive services, of whom 16.4% (13.0%-20.4%) reported difficulty accessing services. Clinic closures and cancelled appointments were commonly reported pandemic-related reasons for difficulty accessing services. This unmet need was associated with younger age, diverse sexual identities and anxiety symptoms. Of 199 pregnancies, 6.6% (3.9%-11.1%) scored as 'unplanned'; less planning was associated with younger age, lower social grade and unemployment. CONCLUSIONS Just under a third of participants sought contraceptive services during the pandemic and most were successful, indicating resilience and adaptability of service delivery. However, one in six reported an unmet need due to the pandemic. COVID-induced inequalities in service access potentially exacerbated existing reproductive health inequalities. These should be addressed in the post-pandemic period and beyond.
Collapse
Affiliation(s)
- Andrew J Baxter
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Rebecca S Geary
- Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Emily Dema
- Institute for Global Health, University College London, London, UK
| | - Raquel Bosó Pérez
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Julie Riddell
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Malachi Willis
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Anne Conolly
- Institute for Global Health, University College London, London, UK
- NatCen Social Research, London, UK
| | - Laura L Oakley
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
- London School of Hygiene and Tropical Medicine, London, UK
| | - Andrew J Copas
- Institute for Global Health, University College London, London, UK
| | - Jo Gibbs
- Institute for Global Health, University College London, London, UK
| | | | - Pam Sonnenberg
- Institute for Global Health, University College London, London, UK
| | | | - Soazig Clifton
- Institute for Global Health, University College London, London, UK
- NatCen Social Research, London, UK
| | - Nigel Field
- Institute for Global Health, University College London, London, UK
| | - Kirsten Mitchell
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| |
Collapse
|
14
|
Roland N, Drouin J, Desplas D, Duranteau L, Cuenot F, Dray-Spira R, Weill A, Zureik M. Impact of coronavirus disease 2019 on contraception use in France. Therapie 2023; 78:593-603. [PMID: 36732137 PMCID: PMC9851715 DOI: 10.1016/j.therap.2023.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 11/24/2022] [Indexed: 01/21/2023]
Abstract
To limit the spread of the coronavirus disease 2019 (COVID 19), sanitary restrictions have been established since March 2020 in France. These restrictions and the waves of contamination may have had consequences on the use of health products in general, and on the use of contraceptives in particular. We aimed to assess the impact of COVID 19 pandemic from March 16th 2020 to April 30th 2021 in France on reimbursed contraceptives. We analyzed data from the French national health insurance database (SNDS) by extracting all oral contraception (OC), emergency contraception (EC), levonorgestrel-intrauterine system (LNG-IUS), copper-intrauterine device (C-IUD) and contraceptive implant dispensations in 2018, 2019, 2020 and to April 30th 2021. We computed the expected use of contraceptives in 2020 and 2021 without pandemic and its associated sanitary restrictions, by taking the annual trend into account. We assessed the evolution of dispensations by type of contraceptive and by age-groups (≤25 years old, between 25 and 35 and >35 years old) between observed and expected dispensations. After 15 months of pandemic, a decrease of all reimbursed contraceptives dispensations had been estimated, compared with what was expected: -2.0% for OC, -5.0% for EC, -9.5% for LNG-IUS, -8.6% for C-IUD, -16.4% for implant. Women under 25 years old were the most impacted by the decrease. This national study showed that the impact of the COVID 19 crisis was global on all reimbursed contraceptives, with different levels of impact depending on the type of contraceptive, the age-group and the severity of the restriction. OC dispensing decreased marginally compared with expectations. The decrease in long-acting contraceptives dispensing was more pronounced, especially for the implant. These results call for continued monitoring of contraceptive use over the long term and for prioritizing access to sexual health services during crises, especially among the youngest women who were most affected in this study.
Collapse
Affiliation(s)
- Noémie Roland
- EPI-PHARE, epidemiology of health products (French National Agency for Medicines and Health Products Safety, and French National Health Insurance), 93285 Saint-Denis cedex, France; University of Paris-Saclay, UVSQ, University Paris-Sud, Inserm, Anti-infective Evasion and Pharmacoepidemiology, CESP (Center for Research in Epidemiology and Population Health), 78180 Montigny le Bretonneux, France.
| | - Jérôme Drouin
- EPI-PHARE, epidemiology of health products (French National Agency for Medicines and Health Products Safety, and French National Health Insurance), 93285 Saint-Denis cedex, France
| | - David Desplas
- EPI-PHARE, epidemiology of health products (French National Agency for Medicines and Health Products Safety, and French National Health Insurance), 93285 Saint-Denis cedex, France
| | - Lise Duranteau
- Adolescent and Young Adult Gynaecology Unit and Reference Center for Rare, Diseases of Genital Development, AP.HP University of Paris Saclay, Bicêtre Hospital, 94270 Le Kremlin Bicêtre, France
| | - François Cuenot
- EPI-PHARE, epidemiology of health products (French National Agency for Medicines and Health Products Safety, and French National Health Insurance), 93285 Saint-Denis cedex, France
| | - Rosemary Dray-Spira
- EPI-PHARE, epidemiology of health products (French National Agency for Medicines and Health Products Safety, and French National Health Insurance), 93285 Saint-Denis cedex, France
| | - Alain Weill
- EPI-PHARE, epidemiology of health products (French National Agency for Medicines and Health Products Safety, and French National Health Insurance), 93285 Saint-Denis cedex, France
| | - Mahmoud Zureik
- EPI-PHARE, epidemiology of health products (French National Agency for Medicines and Health Products Safety, and French National Health Insurance), 93285 Saint-Denis cedex, France; University of Paris-Saclay, UVSQ, University Paris-Sud, Inserm, Anti-infective Evasion and Pharmacoepidemiology, CESP (Center for Research in Epidemiology and Population Health), 78180 Montigny le Bretonneux, France
| |
Collapse
|
15
|
Zimmerman ME, Hart LJ, Medrano P, Piccone C, Ramirez DM, Huggins LK, Sotres-Alvarez D, Fish LJ, Østbye T, Holliday KM. COVID-19 in the Community: Changes to Women's Mental Health, Financial Security, and Physical Activity. AJPM FOCUS 2023; 2:100095. [PMID: 37234692 PMCID: PMC10039779 DOI: 10.1016/j.focus.2023.100095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/28/2023]
Abstract
Introduction This study describes changes in the mental health, financial security, and physical activity levels of women in North Carolina during the COVID-19 pandemic. Methods Data were collected from women aged 20-40 years receiving primary care at 2 health centers in North Carolina during 2020-2022. Surveys (N=127) evaluated changes in mental health, financial security, and physical activity during the COVID-19 pandemic. These outcomes were analyzed both descriptively and for association with sociodemographic factors using logistic regression. A subset of participants (n=46) participated in semistructured interviews. Interview transcripts were reviewed and evaluated for recurring themes by primary and secondary coders using a rapid-coding technique. Analysis was conducted in 2022. Results Women surveyed were 28.4% non-Hispanic White, 38.6% non-Hispanic Black, and 33.1% Hispanic/Latina. Compared with reports before the pandemic, participants reported increased frustration or boredom (69.1%), loneliness (51.6%), anxiety (64.3%), depression (52.4%), and changed sleep patterns (68.3%). Increased alcohol and other recreational substance use were associated with race and ethnicity (p<0.05) after adjustment for other sociodemographic factors. Participants reported difficulty in paying for basic expenses (44.0%). Financial difficulties during COVID-19 were associated with non-Hispanic Black race and ethnicity, less education, and lower prepandemic household income. Data showed pandemic-associated reductions in mild (32.8%), moderate (39.5%), and strenuous (43.3%) exercise, with a correlation between increased depression and reduced mild exercise. Interviews identified themes including reduced activity while working remotely, lack of gym access, and reduced motivation for exercise. Conclusions This mixed-methods study is one of the first to evaluate the mental health, financial security, and physical activity challenges women aged between 20 and 40 years in the southern U.S. faced during the COVID-19 pandemic.
Collapse
Affiliation(s)
| | - Lauren J. Hart
- Department of Family Medicine & Community Health, Duke University School of Medicine, Durham, North Carolina
| | - Perla Medrano
- Duke Global Health Institute, Duke University, Durham, North Carolina
| | - Caitlin Piccone
- Department of Family Medicine & Community Health, Duke University School of Medicine, Durham, North Carolina
| | - Diana M. Ramirez
- Sanford School of Public Policy, Duke University, Durham, North Carolina
| | - Lenique K.L. Huggins
- Duke Global Health Institute, Duke University, Durham, North Carolina
- Department of Biology, Trinity College of Arts and Sciences, Duke University, Durham, North Carolina
| | - Daniela Sotres-Alvarez
- Department of Biostatistics, Gillings School of Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Laura J. Fish
- Department of Family Medicine & Community Health, Duke University School of Medicine, Durham, North Carolina
| | - Truls Østbye
- Department of Family Medicine & Community Health, Duke University School of Medicine, Durham, North Carolina
- Duke Global Health Institute, Duke University, Durham, North Carolina
| | - Katelyn M. Holliday
- Department of Family Medicine & Community Health, Duke University School of Medicine, Durham, North Carolina
| |
Collapse
|
16
|
Bailey MJ, Currie J, Schwandt H. The COVID-19 baby bump in the United States. Proc Natl Acad Sci U S A 2023; 120:e2222075120. [PMID: 37582121 PMCID: PMC10450661 DOI: 10.1073/pnas.2222075120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 07/12/2023] [Indexed: 08/17/2023] Open
Abstract
We use natality microdata covering the universe of US. births for 2015 to 2021 and California births from 2015 through February 2023 to examine childbearing responses to the COVID-19 pandemic. We find that 60% of the 2020 decline in US fertility rates was driven by sharp reductions in births to foreign-born mothers although births to this group comprised only 22% of all US births in 2019. This decline started in January 2020. In contrast, the COVID-19 recession resulted in an overall "baby bump" among US-born mothers, which marked the first reversal in declining fertility rates since the Great Recession. Births to US-born mothers fell by 31,000 in 2020 relative to a prepandemic trend but increased by 71,000 in 2021. The data for California suggest that US births remained elevated through February 2023. The baby bump was most pronounced for first births and women under age 25, suggesting that the pandemic led some women to start families earlier. Above age 25, the baby bump was most pronounced for women aged 30 to 34 and women with a college education. The 2021 to 2022 baby bump is especially remarkable given the large declines in fertility rates that would have been projected by standard statistical models.
Collapse
Affiliation(s)
- Martha J. Bailey
- Department of Economics, University of California, Los Angeles, CA90024
- National Bureau of Economic Research, Cambridge, MA02138
| | - Janet Currie
- National Bureau of Economic Research, Cambridge, MA02138
- Center for Health and Wellbeing, Princeton University, Princeton, NJ08544
| | - Hannes Schwandt
- National Bureau of Economic Research, Cambridge, MA02138
- School of Education and Social Policy, Northwestern University, Evanston, IL60208
| |
Collapse
|
17
|
Mitchell KR, Willis M, Dema E, Baxter AJ, Connolly A, Riddell J, Bosó Pérez R, Clifton S, Gibbs J, Tanton C, Geary R, Ratna N, Mohammed H, Unemo M, Bonell C, Copas A, Sonnenberg P, Mercer CH, Field N. Sexual and reproductive health in Britain during the first year of the COVID-19 pandemic: cross-sectional population survey (Natsal-COVID-Wave 2) and national surveillance data. Sex Transm Infect 2023; 99:386-397. [PMID: 36973042 PMCID: PMC10447381 DOI: 10.1136/sextrans-2022-055680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 01/03/2023] [Indexed: 03/29/2023] Open
Abstract
OBJECTIVES To assess sexual behaviour, and sexual and reproductive health (SRH) outcomes, after 1 year of the COVID-19 pandemic in Britain. METHODS 6658 participants aged 18-59 and resident in Britain completed a cross-sectional web-panel survey (Natsal-COVID-Wave 2, March-April 2021), 1 year after the first lockdown. Natsal-COVID-2 follows the Natsal-COVID-Wave 1 survey (July-August 2020) which captured impacts in the initial months. Quota-based sampling and weighting resulted in a quasi-representative population sample. Data were contextualised with reference to the most recent probability sample population data (Natsal-3; collected 2010-12; 15 162 participants aged 16-74) and national surveillance data on recorded sexually transmitted infection (STI) testing, conceptions, and abortions in England/Wales (2010-2020). The main outcomes were: sexual behaviour; SRH service use; pregnancy, abortion and fertility management; sexual dissatisfaction, distress and difficulties. RESULTS In the year from the first lockdown, over two-thirds of participants reported one or more sexual partners (women 71.8%; men 69.9%), while fewer than 20.0% reported a new partner (women 10.4%; men 16.8%). Median occasions of sex per month was two. Compared with 2010-12 (Natsal-3), we found less sexual risk behaviour (lower reporting of multiple partners, new partners, and new condomless partners), including among younger participants and those reporting same-sex behaviour. One in 10 women reported a pregnancy; pregnancies were fewer than in 2010-12 and less likely to be scored as unplanned. 19.3% of women and 22.8% of men were distressed or worried about their sex life, significantly more than in 2010-12. Compared with surveillance trends from 2010 to 2019, we found lower than expected use of STI-related services and HIV testing, lower levels of chlamydia testing, and fewer conceptions and abortions. CONCLUSIONS Our findings are consistent with significant changes in sexual behaviour, SRH, and service uptake in the year following the first lockdown in Britain. These data are foundational to SRH recovery and policy planning.
Collapse
Affiliation(s)
- Kirstin R Mitchell
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Malachi Willis
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Emily Dema
- Institute for Global Health, University College London, London, UK
| | - Andrew J Baxter
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Anne Connolly
- Institute for Global Health, University College London, London, UK
- NatCen Social Research, London, UK
| | - Julie Riddell
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Raquel Bosó Pérez
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Soazig Clifton
- Institute for Global Health, University College London, London, UK
- NatCen Social Research, London, UK
| | - Jo Gibbs
- Institute for Global Health, University College London, London, UK
| | - Clare Tanton
- Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Rebecca Geary
- Institute of Population Health, University of Liverpool, Liverpool, Merseyside, UK
| | - Natasha Ratna
- Blood Safety, Hepatitis, Sexually Transmitted Infections (STI) and HIV Division, UK Health Security Agency, London, UK
| | - Hamish Mohammed
- Blood Safety, Hepatitis, Sexually Transmitted Infections (STI) and HIV Division, UK Health Security Agency, London, UK
| | - Magnus Unemo
- Department of Laboratory Medicine, Örebro University Hospital, Örebro, Sweden
| | - Christopher Bonell
- Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Andrew Copas
- Institute for Global Health, University College London, London, UK
| | - Pam Sonnenberg
- Institute for Global Health, University College London, London, UK
| | | | - Nigel Field
- Institute for Global Health, University College London, London, UK
| |
Collapse
|
18
|
Moreno-Louzada L, Menezes-Filho N. The relationship between staying at home during the pandemic and the number of conceptions: A national panel data analysis. PLoS One 2023; 18:e0289604. [PMID: 37566617 PMCID: PMC10420359 DOI: 10.1371/journal.pone.0289604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 07/21/2023] [Indexed: 08/13/2023] Open
Abstract
hether the COVID-19 pandemic has changed fertility patterns is still an open question, as social isolation for long periods can impact the number of conceptions in many ways. We combine administrative data on all recent births in Brazil with daily data on individual location to estimate the relationship between the share of individuals staying close to their homes in each week and the number of conceptions in that same week, comparing municipalities with different social isolation patterns during the first semester of 2020. We find that conceptions unequivocally decline when social isolation increases. The effect is stronger for women who are between 21 and 25 years old and more educated, as well as for richer, larger, and more urban municipalities. COVID-19 is likely to change fertility across countries depending on the behavior of the population and on the lock-down measures implemented to fight the pandemic.
Collapse
|
19
|
Diniz BP, Grisi SJFE, de Souza DM, Ferrer APS. Mother-infant bonding and postpartum depression during the COVID-19 pandemic - a risk for nurturing care and child development. REVISTA PAULISTA DE PEDIATRIA : ORGAO OFICIAL DA SOCIEDADE DE PEDIATRIA DE SAO PAULO 2023; 42:e2022151. [PMID: 37436245 PMCID: PMC10332442 DOI: 10.1590/1984-0462/2024/42/2022151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 02/07/2023] [Indexed: 07/13/2023]
Abstract
OBJECTIVE The COVID-19 pandemic Increased the risk of impairing the mother-infant bonding. The objectives of this study were to evaluate the early bond established between mother and infant and postpartum depression (PPD) in pregnancies that occurred during the pandemic period, to identify the factors that may have influenced these outcomes and to verify if there was an association between bonding and probable PPD. METHODS This is a cross-sectional study of postpartum women from a public maternity hospital in the city of São Paulo conducted from February to June 2021, involving 127 mother-baby dyads. The initial data were collected in the immediate postpartum period and between 21-45 days after birth, using a semi-structured questionnaire on sociodemographic characteristics, gestational and birth conditions, and baby characteristics; the Edinburgh Postnatal Depression Scale (EPDS) and Postpartum Bonding Questionnaire (PBQ) were used to evaluate PPD and bonding, respectively. RESULTS The presence of probable PPD and unplanned pregnancies were associated with higher PBQ score and risk to impaired bonding (p = 0.001 and p = 0.004, respectively). EPDS showed a high prevalence of PPD (29.1%) and was not associated with any Studied variable. Probably, this high prevalence of probable PPD was due to the context of insecurity secondary to the pandemic. CONCLUSIONS We observed an increase in the prevalence of probable PPD and unplanned pregnancies during the first 18 months of the pandemic, which were associated with worse scores in mother-infant bonding. The impaired bond can affect the future development of children born during this period.
Collapse
|
20
|
Rezaei F, Amiri-Farahani L, Haghani S, Pezaro S, Behmanesh F. The impact of the COVID-19 pandemic on contraceptive methods, abortion, and unintended pregnancy: a cross-sectional study. BMC Womens Health 2023; 23:357. [PMID: 37403093 DOI: 10.1186/s12905-023-02512-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 06/27/2023] [Indexed: 07/06/2023] Open
Abstract
BACKGROUND AND AIM By creating an international emergency, the COVID-19 pandemic may have led to compromised reproductive health care, including family planning services, and thus increased unintended pregnancies and unsafe abortions. This study was conducted to compare methods of contraception, abortion, and unintended pregnancies in those served by the health centers of Babol city in Iran, both before and during the COVID-19 pandemic. METHODS A cross-sectional study was conducted including 425 participants registered to the health centers of Babol city, Mazandaran province, Iran. Using a multi-stage method, 6 urban health centers and 10 rural centers were selected for inclusion. Proportional allocation method was used for sampling those who met the inclusion criteria. A questionnaire was used to collect data in relation to individual characteristics and reproductive behaviors via 6 questions focused upon methods and preparation of contraception, number and type of abortions, and number and causes of unintended pregnancy from July to November 2021. The data were analyzed using SPSS software version 26. Significance level was considered to be p < 0.05 in all tests. RESULTS Most participants aged between 20 and 29 years old had a diploma level of education, were housewives and lived in the city. Prior to the pandemic, 32.0% used modern contraceptive methods and 31.6% used these during the pandemic. No change in the combination of contraceptive methods used was observed between these two periods. Approximately two-thirds used the withdrawal method in both periods. The majority of participants in both periods purchased their contraceptives from a pharmacy. Unintended pregnancy increased from 20.4% prior to the pandemic to 25.4% during the pandemic. Abortions increased from 19.1% prior to the pandemic to 20.9% during the pandemic, although these findings were not found to be statistically significant. Contraceptive methods had a statistically significant relationship with age, education, spouse's education, spouse's occupation, and place of residence. The number of unintended pregnancies had a significant relationship with age, the educational level of both participants and their spouses and socio-economic status, and the number of abortions had a statistically significant relationship with the age and education level of the spouse (p > 0.05). CONCLUSION Despite there being no change in contraceptive methods compared to the pre-pandemic period, an increase in the number of unintended pregnancies, abortions and illegal abortions was observed. This may be indicative of an unmet need for family planning services during the COVID-19 pandemic.
Collapse
Affiliation(s)
- Fatemeh Rezaei
- MSc in Midwifery, Department of Reproductive Health and Midwifery, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Leila Amiri-Farahani
- Department of Reproductive Health and Midwifery, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran.
| | - Shima Haghani
- Department of Biostatistics, Nursing and Midwifery Care Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Sally Pezaro
- PhD in Midwifery, The Research Centre for Healthcare and Communities, Coventry University, Coventry, UK
- The University of Notre Dame, Fremantle, Australia
| | - Fereshteh Behmanesh
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| |
Collapse
|
21
|
Rokicki S, Reichman NE, McGovern ME. Association of Increasing the Minimum Wage in the US With Experiences of Maternal Stressful Life Events. JAMA Netw Open 2023; 6:e2324018. [PMID: 37462972 PMCID: PMC10354676 DOI: 10.1001/jamanetworkopen.2023.24018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 06/04/2023] [Indexed: 07/21/2023] Open
Abstract
Importance Exposure to stressful life events (SLEs) before and during pregnancy is associated with adverse health for pregnant people and their children. Minimum wage policies have the potential to reduce exposure to SLEs among socioeconomically disadvantaged pregnant people. Objective To examine the association of increasing the minimum wage with experience of maternal SLEs. Design, Setting, and Participants This repeated cross-sectional study included 199 308 individuals who gave birth between January 1, 2004, and December 31, 2015, in 39 states that participated in at least 2 years of the Pregnancy Risk Assessment Monitoring Survey between 2004 and 2015. Statistical analysis was performed from September 1, 2022, to January 6, 2023. Exposure The mean minimum wage in the 2 years prior to the month and year of delivery in an individual's state of residence. Main Outcomes and Measures The main outcomes were number of financial, partner-related, traumatic, and total SLEs in the 12 months before delivery. Individual-level covariates included age, race and ethnicity, marital status, parity, educational level, and birth month. State-level covariates included unemployment, gross state product, uninsurance, poverty, state income supports, political affiliation of governor, and Medicaid eligibility levels. A 2-way fixed-effects analysis was conducted, adjusting for individual and state-level covariates and state-specific time trends. Results Of the 199 308 women (mean [SD] age at delivery, 25.7 [6.1] years) in the study, 1.4% were American Indian or Alaska Native, 2.5% were Asian or Pacific Islander, 27.2% were Hispanic, 17.6% were non-Hispanic Black, and 48.8% were non-Hispanic White. A $1 increase in the minimum wage was associated with a reduction in total SLEs (-0.060; 95% CI, -0.095 to -0.024), financial SLEs (-0.032; 95% CI, -0.056 to -0.007), and partner-related SLEs (-0.019; 95% CI, -0.036 to -0.003). When stratifying by race and ethnicity, minimum wage increases were associated with larger reductions in total SLEs for Hispanic women (-0.125; 95% CI, -0.242 to -0.009). Conclusions and Relevance In this repeated cross-sectional study of women with a high school education or less across 39 states, an increase in the state-level minimum wage was associated with reductions in experiences of maternal SLEs. Findings support the potential of increasing the minimum wage as a policy for improving maternal well-being among socioeconomically disadvantaged pregnant people. These findings have relevance for current policy debates regarding the minimum wage as a tool for improving population health.
Collapse
Affiliation(s)
- Slawa Rokicki
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, New Jersey
| | - Nancy E. Reichman
- Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
- Child Health Institute of New Jersey, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
- Department of Economics, Princeton University, Princeton, New Jersey
| | - Mark E. McGovern
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, New Jersey
| |
Collapse
|
22
|
Qiao S, Wilcox S, Olatosi B, Li X. COVID-19 challenges, responses, and resilience among rural Black women: a study protocol. Front Public Health 2023; 11:1156717. [PMID: 37333566 PMCID: PMC10275362 DOI: 10.3389/fpubh.2023.1156717] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 05/12/2023] [Indexed: 06/20/2023] Open
Abstract
Despite the aggregated burdens and challenges experienced by rural Black women during the COVID-19 pandemic, many likely also demonstrated strength and resilience to overcome challenges. A mixed methodology and a community-based participatory approach will be used to collect multilevel data on challenges, responses, resilience, and lessons during the pandemic from Black women, community health workers, and community leaders in rural areas in South Carolina (SC). Specifically, the unique circumstances and lived experiences of rural Black women during the COVID-19 pandemic will be documented to understand their needs regarding effective management of social, physical, and mental health challenges through focus group discussions and in-depth interviews with Black women, community health workers, and local community leaders recruited from rural SC communities. Barriers, facilitators, and potential impacts of multilevel resilience development will be identified through a survey administered among rural Black women recruited from 11 rural counties (with one as site for a pilot testing of the questionnaire). A report for public health practice will be developed, including recommended strategies to optimize health systems' emergency preparedness and responses through triangulation of qualitative and quantitative data from multiple sources. Findings in the proposed study will provide valuable references in terms of addressing social determinants of health factor challenges during the pandemic, fostering resilience, and informing evidence-based decision-making for policymakers. The study will contribute to the development of public health emergency preparedness plans, which can promote the resilience of women, their families, and local communities as well as optimize effective preparedness and response of health systems for rural Black women and their families during infectious disease outbreaks and other public health emergencies.
Collapse
Affiliation(s)
- Shan Qiao
- Department of Health Promotion Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
- South Carolina SmartState Center for Healthcare Quality, University of South Carolina, Columbia, SC, United States
| | - Sara Wilcox
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
- Prevention Research Center, University of South Carolina, Columbia, SC, United States
| | - Bankole Olatosi
- South Carolina SmartState Center for Healthcare Quality, University of South Carolina, Columbia, SC, United States
- Department of Health System Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Xiaoming Li
- Department of Health Promotion Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
- South Carolina SmartState Center for Healthcare Quality, University of South Carolina, Columbia, SC, United States
| |
Collapse
|
23
|
Adelman S, Charifson M, Seok E, Mehta-Lee SS, Brubaker SG, Liu M, Kahn LG. State-specific fertility rate changes across the USA following the first two waves of COVID-19. Hum Reprod 2023; 38:1202-1212. [PMID: 37038265 PMCID: PMC10233281 DOI: 10.1093/humrep/dead055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 03/02/2023] [Indexed: 04/12/2023] Open
Abstract
STUDY QUESTION How did the first two coronavirus disease 2019 (COVID-19) waves affect fertility rates in the USA? SUMMARY ANSWER States differed widely in how their fertility rates changed following the COVID-19 outbreak and these changes were influenced more by state-level economic, racial, political, and social factors than by COVID-19 wave severity. WHAT IS KNOWN ALREADY The outbreak of the COVID-19 pandemic contributed to already declining fertility rates in the USA, but not equally across states. Identifying drivers of differential changes in fertility rates can help explain variations in demographic shifts across states in the USA and motivate policies that support families in general, not only during crises. STUDY DESIGN, SIZE, DURATION This is an ecological study using state-level data from 50 US states and the District of Columbia (n = 51). The study period extends from 2020 to 2021 with historical data from 2016 to 2019. We identified Wave 1 as the first apex for each state after February 2020 and Wave 2 as the second apex, during Fall/Winter 2020-2021. PARTICIPANTS/MATERIALS, SETTING, METHODS State-level COVID-19 wave severity, defined as case acceleration during each 3-month COVID-19 wave (cases/100 000 population/month), was derived from 7-day weekly moving average COVID-19 case rates from the US Centers for Disease Control and Prevention (CDC). State-level fertility rate changes (change in average monthly fertility rate/100 000 women of reproductive age (WRA)/year) were derived from the CDC Bureau of Vital Statistics and from 2020 US Census and University of Virginia 2021 population estimates 9 months after each COVID-19 wave. We performed univariate analyses to describe national and state-level fertility rate changes following each wave, and simple and multivariable linear regression analyses to assess the relation of COVID-19 wave severity and other state-level characteristics with fertility rate changes. MAIN RESULTS AND THE ROLE OF CHANCE Nationwide, fertility dropped by 17.5 births/month/100 000 WRA/year following Wave 1 and 9.2 births/month/100 000 WRA/year following Wave 2. The declines following Wave 1 were largest among majority-Democrat, more non-White states where people practiced greater social distancing. Greater COVID-19 wave severity was associated with steeper fertility rate decline post-Wave 1 in simple regression, but the association was attenuated when adjusted for other covariates. Adjusting for the economic impact of the pandemic (hypothesized mediator) also attenuated the effect. There was no relation between COVID-19 wave severity and fertility rate change following Wave 2. LIMITATIONS, REASONS FOR CAUTION Our study harnesses state-level data so individual-level conclusions cannot be inferred. There may be residual confounding in our multivariable regression and we were underpowered to detect some effects. WIDER IMPLICATIONS OF THE FINDINGS The COVID-19 pandemic initially impacted the national fertility rate but, overall, the fertility rate rebounded to the pre-pandemic level following Wave 2. Consistent with prior literature, COVID-19 wave severity did not appear to predict fertility rate change. Economic, racial, political, and social factors influenced state-specific fertility rates during the pandemic more than the severity of the outbreak alone. Future studies in other countries should also consider whether these factors account for internal heterogeneity when examining the impact of the COVID-19 pandemic and other crises on fertility. STUDY FUNDING/COMPETING INTEREST(S) L.G.K. received funding from the National Institute of Environmental Health Sciences (R00ES030403), M.C. from the National Science Foundation Graduate Research Fellowship Program (20-A0-00-1005789), and M.L. and E.S. from the National Institute of Environmental Health Sciences (R01ES032808). None of the authors have competing interests. TRIAL REGISTRATION NUMBER N/A.
Collapse
Affiliation(s)
- Sarah Adelman
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA
| | - Mia Charifson
- Vilcek Institute of Biomedical Graduate Sciences, New York University Grossman School of Medicine, New York, NY, USA
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Eunsil Seok
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Shilpi S Mehta-Lee
- Department of Obstetrics and Gynecology, New York University Grossman School of Medicine, New York, NY, USA
| | - Sara G Brubaker
- Department of Obstetrics and Gynecology, New York University Grossman School of Medicine, New York, NY, USA
| | - Mengling Liu
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Linda G Kahn
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| |
Collapse
|
24
|
Rezaei F, Amiri-Farahani L, Haghani S, Pezaro S, Behmanesh F. Comparing reproductive intentions before and during the COVID-19 pandemic: a cross-sectional study. BMC Health Serv Res 2023; 23:545. [PMID: 37231470 DOI: 10.1186/s12913-023-09551-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 05/15/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND AND AIM Reproductive behaviors and intentions are affected by several factors, including the COVID-19 pandemic crisis. This study was conducted with the aim of comparing the intention to reproduce and its causes in Iran during the period prior to and during the COVID-19 pandemic. METHODS This descriptive-comparative study included 425 cisgender women from 6 urban health centers and 10 rural centers in Babol city, Mazandaran province, Iran. Urban and rural health centers were selected using a multi-stage approach with proportional allocation. A questionnaire was used to collect data in relation to individual characteristics and reproductive intentions. RESULTS Most participants aged between 20 and 29 years had a diploma level of education, were housewives and lived in the city. The intention to reproduce decreased from 11.4% before the pandemic to 5.4% during the pandemic (p = 0.006). The most common reason for wanting to have children prior to the pandemic was not having children (54.2%). During the pandemic, a desire to reach the ideal number of children was the most common reason to want to have children (59.1%), though no statistically significant difference was observed between the two periods (p = 0.303). The most common reason for not wanting to have children in both periods was having enough children already (45.2% before and 40.9% during the pandemic). The reasons for not wanting to have children had a statistically significant difference between the two periods (p < 0.001). Reproductive intentions had a statistically significant relationship with the variables of age (p < 0.001), the education level of both participants (p < 0.001) and spouses (p = 0.006), occupation (p = 0.004), and socio-economic status (p < 0.001). CONCLUSION Despite restrictions and lockdowns, the COVID-19 pandemic had a negative impact on people's desire to reproduce in this context. Economic problems caused by the sanctions which increased during the COVID-19 crisis may be one of the reasons for a reduction in people's intentions to become parents. Future research could usefully investigate whether this decrease in the desire to reproduce will lead to significant changes in population level and future birth rates.
Collapse
Affiliation(s)
- Fatemeh Rezaei
- Department of Reproductive Health and Midwifery, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Leila Amiri-Farahani
- Department of Reproductive Health and Midwifery, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, University of Medical Sciences, Tehran, Iran.
| | - Shima Haghani
- Department of Biostatistics, Nursing and Midwifery Care Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Sally Pezaro
- The Research Centre for Healthcare and Communities, Coventry University, Coventry, UK
- The University of Notre Dame, Notre Dame, Australia
| | - Fereshteh Behmanesh
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, I.R. of Iran
| |
Collapse
|
25
|
Zhou M, Guo W. Sooner, later, or never: Changing fertility intentions due to Covid-19 in China's Covid-19 epicentre. POPULATION STUDIES 2023; 77:123-140. [PMID: 36345982 DOI: 10.1080/00324728.2022.2134579] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Using survey data collected from Hubei province, China's Covid-19 epicentre, in August 2020, this study examines how fertility intentions of Chinese citizens changed during the Covid-19 pandemic. We consider not only whether people changed their fertility plans due to Covid-19 but also distinguish three types of change: bringing forward ('sooner'), postponing ('later'), and abandoning ('never') planned fertility. Over half of those who planned to have a child intended to change their fertility plans due to Covid-19. Younger individuals, those of non-Han ethnicities, urban residents, those with one child already, and those with ever-infected family members were more likely to change their fertility plans. While the effects of some characteristics seem to be short term, other characteristics such as age and number of children show more consequential influences. Older individuals and those planning their second child were particularly prone to abandoning their childbearing plans due to Covid-19. The pandemic may thus complicate China's latest efforts to boost its low fertility.
Collapse
|
26
|
Safdari-Dehcheshmeh F, Noroozi M, Memar S, Taleghani F. Childbearing decisions and related factors in the COVID-19 pandemic: A narrative review study. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:48. [PMID: 37113433 PMCID: PMC10127467 DOI: 10.4103/jehp.jehp_594_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 06/06/2022] [Indexed: 06/19/2023]
Abstract
The COVID-19 pandemic has had considerable consequences in many areas of life, including the social area and childbearing plans. The present narrative review aimed to examine the childbearing decisions and its related factors during the COVID-19 pandemic. This review was conducted by searching in scientific databases, including Web of Science, Science Direct, Google Scholar, Scopus, Cochrane, PubMed, ProQuest, Scientific Information Database (SID), Iranian Research Institute for Information Science and Technology (IranDoc) and Iranian Journal Database (Magiran) in June 2022. The search resulted in 111 sources, of which 16 were in line with the research objective. Couples have mainly cancelled or delayed their previous plans related to childbearing decisions. There are two groups of direct and indirect factors related to childbearing decisions during the COVID-19 pandemic: The former includes (1) well-being-related factors such as economic conditions, interpersonal relationships and gender roles in terms of task division; and (2) health-related factors, including health emergencies and physical and psychological health. The latter includes factors such as social distancing and social media. Based on the results, governments should facilitate childbearing by adjusting existing policies, addressing economic insecurity and protecting the livelihoods of those affected by the crisis. Health policymakers and planners must also prioritize women's access to reproductive health services in a safe environment while promoting equity in access. It is also necessary to promote the quality and quantity of indirect care and virtual counseling based on the needs of women in crisis.
Collapse
Affiliation(s)
- Faranak Safdari-Dehcheshmeh
- Student Research Committee, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Mahnaz Noroozi
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Soraya Memar
- Department of Social Sciences, Isfahan University, Isfahan, Iran
| | - Fariba Taleghani
- Department of Adult Health Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| |
Collapse
|
27
|
Vazzano A, Briggs S, Kim L, Parekh J, Manlove J. Adapting Family Planning Service Delivery in Title X and School-Based Settings during COVID-19: Provider and Staff Experiences. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3592. [PMID: 36834286 PMCID: PMC9963328 DOI: 10.3390/ijerph20043592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 02/09/2023] [Accepted: 02/15/2023] [Indexed: 06/18/2023]
Abstract
The COVID-19 pandemic introduced urgent and unique challenges to family planning providers and staff in ensuring continued access to high-quality services, particularly for groups who experience greater barriers to accessing services, such as women with systemically marginalized identities and adolescents and young adults (AYA). While research has documented key adaptations made to service delivery during the early phase of the pandemic, limited studies have used qualitative methods. This paper draws on qualitative interview data from family planning providers and staff in Title-X-funded clinics and school-based clinics-two settings that serve populations that experience greater barriers to accessing care-to (a) describe the adaptations made to service delivery during the first year of the pandemic and (b) explore provider and staff experiences and impressions implementing these adaptations. In-depth interviews were conducted with 75 providers and staff between February 2020 and February 2021. Verbatim transcripts were analyzed via inductive content analysis followed by thematic analysis. Four key themes were identified: (1) Title-X- and school-based staff made multiple, concurrent adaptations to continue family planning services; (2) providers embraced flexibility for patient-centered care; (3) school-based staff faced unique challenges to reaching and serving youth; and (4) COVID-19 created key opportunities for innovation. The findings suggest several lasting changes to family planning service delivery and provider mindsets at clinics serving populations hardest hit by the pandemic. Future studies should evaluate promising practices in family planning service delivery-including telehealth and streamlined administrative procedures-and explore how these are experienced by diverse patient populations, particularly AYA and those in areas where privacy or internet access are limited.
Collapse
Affiliation(s)
- Andrea Vazzano
- Child Trends, 7315 Wisconsin Avenue, Suite 1200W, Bethesda, MD 20814, USA
| | | | | | | | | |
Collapse
|
28
|
Factors Associated with Fertility Intention among Chinese Married Youth during the COVID-19 Pandemic. Behav Sci (Basel) 2023; 13:bs13020184. [PMID: 36829413 PMCID: PMC9951887 DOI: 10.3390/bs13020184] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/13/2023] [Accepted: 02/15/2023] [Indexed: 02/22/2023] Open
Abstract
Using the childbearing survey data from Hubei Province in March 2022, this article empirically analyzed the status quo of fertility intention and its influencing factors among Chinese married youth during the COVID-19 pandemic. In our analysis, fertility intention was operationalized as the ideal number of children and short-term fertility plan. Statistical results showed that the average ideal number of children stood at 1.652, which was lower than the population replacement level, whilst only 16.4% of married youth had a short-term fertility plan. By utilizing a binary logit regression model and the sheaf coefficient technique, we found that COVID-19-induced factors (i.e., change in the marital relationship during the epidemic, delayed pregnancy preparation due to vaccination) had a more stable effect on fertility intention, especially on short-term fertility planning. Parenting perception characteristics exerted a great impact on the ideal number of children but a relatively small impact on short-term fertility planning. Meanwhile, married youth with stable jobs and a high family income did not necessarily show stronger fertility intentions than those with fewer socioeconomic resources. In addition, the findings also reveal that the relative importance of fertility-influencing factors could vary at different fertile stages, which have valuable implications for population policy in Chinese contexts.
Collapse
|
29
|
Yarger J, Hopkins K, Elmes S, Rossetto I, De La Melena S, McCulloch CE, White K, Harper CC. Perceived Access to Contraception via Telemedicine Among Young Adults: Inequities by Food and Housing Insecurity. J Gen Intern Med 2023; 38:302-308. [PMID: 35657468 PMCID: PMC9165539 DOI: 10.1007/s11606-022-07669-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 05/06/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Telemedicine expanded rapidly during the COVID-19 pandemic, including for contraceptive services. Data are needed to understand whether young people can access telemedicine for contraception, especially in underserved populations. OBJECTIVE To compare young people's perceived access to telemedicine visits for contraception during the COVID-19 pandemic by food and housing insecurity. DESIGN Supplementary study to a cluster randomized controlled trial in 25 community colleges in California and Texas. Online surveys were administered May 2020 to April 2021. Mixed-effects logistic regression models with random effects for site were used to examine differences in access to contraception through telemedicine by food and housing insecurity status, controlling for key sociodemographic characteristics, including race/ethnicity, non-English primary language, health insurance status, and state of residence, and contraceptive method used. PARTICIPANTS 1,414 individuals assigned female at birth aged 18-28. MAIN MEASURES Survey measures were used to capture how difficult it would be for a participant to have a telemedicine visit (phone or video) for contraception. KEY RESULTS Twenty-nine percent of participants were food insecure, and 15% were housing insecure. Nearly a quarter (24%) stated that it would be difficult to have a phone or video visit for contraception. After accounting for sociodemographic factors and type of method used, food insecure (adjusted odds ratio [aOR], 2.17; 95% confidence interval [CI], 1.62-2.91) and housing insecure (aOR, 1.62; 95% CI, 1.13-2.33) participants were significantly more likely to report that it would be difficult to use telemedicine for contraception during the pandemic. CONCLUSIONS Underserved patients are those who could benefit most from the expansion of telemedicine services, yet our findings show that young people experiencing basic needs insecurity perceive the greatest difficulty accessing these services for essential reproductive care. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03519685.
Collapse
Affiliation(s)
- Jennifer Yarger
- Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, 550 16th Street, San Francisco, CA, 94158, USA.
| | - Kristine Hopkins
- Population Research Center, University of Texas at Austin, Austin, TX, USA
| | - Sarah Elmes
- Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, 550 16th Street, San Francisco, CA, 94158, USA
| | - Irene Rossetto
- Population Research Center, University of Texas at Austin, Austin, TX, USA
| | - Stephanie De La Melena
- Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, 550 16th Street, San Francisco, CA, 94158, USA
| | - Charles E McCulloch
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Kari White
- Population Research Center, University of Texas at Austin, Austin, TX, USA
| | - Cynthia C Harper
- Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, 550 16th Street, San Francisco, CA, 94158, USA
| |
Collapse
|
30
|
Lindau ST, Jagai JS, Abramsohn EM, Fuller CM, Wroblewski KE, Pinkerton EA, Makelarski JA. Unwanted sexual activity among United States women early in the COVID-19 pandemic. Am J Obstet Gynecol 2023; 228:209.e1-209.e16. [PMID: 36241078 PMCID: PMC9553968 DOI: 10.1016/j.ajog.2022.09.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 09/07/2022] [Accepted: 09/25/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND Female sexual activity and, accordingly, birth rates tend to decline in times of stress, such as a pandemic. In addition, when resources are scarce or exogenous conditions are threatening, some women may engage in sexual activity primarily to maintain socioeconomic security. Having unwanted sex may indicate sexual activity in exchange for economic security. OBJECTIVE This study aimed to describe patterns and correlates of unwanted sex, defined as having sex more frequently than desired, among US women early in the COVID-19 pandemic. STUDY DESIGN The National US Women's Health COVID-19 Study was conducted in April 2020, using a nested quota sample design to enroll 3200 English-speaking women (88% cooperation rate) aged 18 to 90 years recruited from a research panel. The quota strata ensured sufficient sample sizes in sociodemographic groups of interest, namely, racial and ethnic subgroups. Patterns of sexual activity, including unwanted sex early in the pandemic, were described. To further elucidate the experiences of women reporting unwanted sex, open-ended responses to an item querying "how the coronavirus pandemic is affecting your sex life" were assessed using conventional content analysis. Logistic regression analyses-adjusting for sociodemographic characteristics, self-reported health, and prepandemic health-related socioeconomic risk factors, including food insecurity, housing instability, utilities and transportation difficulties, and interpersonal violence-were used to model the odds of unwanted sex by a pandemic-related change in health-related socioeconomic risk factors. RESULTS The proportion of women who were sexually active early in the pandemic (51%) was about the same as in the 12 months before the pandemic (52%), although 7% of women became active, and 7% of women became inactive. Overall, 11% of sexually active women were having unwanted sex in the early pandemic. The rates of anxiety, depression, traumatic stress symptoms, and each of the 5 health-related socioeconomic risk factors assessed were about 2 times higher among women having unwanted sex than other women (P<.001). Women having unwanted sex were also 5 times more likely than other women to report an increased frequency of sex since the pandemic (65% vs 13%; P<.001) and 6 times more likely to be using emergency contraception (18% vs 3%; P<.001). Women reporting unwanted sex commonly described decreased libido or interest in sex related to mood changes since the pandemic, having "more sex," fear or worry about the transmission of the virus because of sex, and having sex to meet the partner's needs. Among sexually active women, the odds of unwanted sex (adjusting for demographic, reproductive, and health factors) were higher among women with 1 prepandemic health-related socioeconomic risk factor (adjusted odds ratio, 2.0; 95% confidence interval, 1.1-3.8) and 2 or more prepandemic health-related socioeconomic risk factors (adjusted odds ratio, 6.0; 95% confidence interval, 3.4-10.6). Among sexually active women with any prepandemic health-related socioeconomic risk factor, those with new or worsening transportation difficulties early in the pandemic were particularly vulnerable to unwanted sex (adjusted odds ratio, 2.7; 95% confidence interval, 1.7-4.3). CONCLUSION More than 1 in 10 sexually active US women was having unwanted sex early in the COVID-19 pandemic. Socioeconomically vulnerable women, especially those with new or worsening transportation problems because of the pandemic, were more likely than others to engage in unwanted sex. Pandemic response and recovery efforts should seek to mitigate unwanted sexual activity and related health and social risks among women.
Collapse
Affiliation(s)
- Stacy T Lindau
- Departments of Obstetrics and Gynecology, The University of Chicago, Chicago, IL; Medicine Geriatrics, The University of Chicago, Chicago, IL.
| | - Jyotsna S Jagai
- Departments of Obstetrics and Gynecology, The University of Chicago, Chicago, IL
| | - Emily M Abramsohn
- Departments of Obstetrics and Gynecology, The University of Chicago, Chicago, IL
| | - Charles M Fuller
- Departments of Obstetrics and Gynecology, The University of Chicago, Chicago, IL
| | | | - El A Pinkerton
- Departments of Obstetrics and Gynecology, The University of Chicago, Chicago, IL
| | - Jennifer A Makelarski
- Departments of Obstetrics and Gynecology, The University of Chicago, Chicago, IL; College of Science and Health, Benedictine University, Lisle, IL
| |
Collapse
|
31
|
Mooi-Reci I, Trinh TA, Vera-Toscano E, Wooden M. The impact of lockdowns during the COVID-19 pandemic on fertility intentions. ECONOMICS AND HUMAN BIOLOGY 2023; 48:101214. [PMID: 36565491 PMCID: PMC9762099 DOI: 10.1016/j.ehb.2022.101214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 12/12/2022] [Accepted: 12/16/2022] [Indexed: 06/17/2023]
Abstract
Lockdown edicts during the COVID-19 pandemic have led to concerns about consequences for childbirth plans and decisions. Robust empirical research to either refute or confirm these concerns, however, is lacking. To evaluate the causal impact of lockdowns on fertility, we exploited a large sample of Australians (aged 18-45) from a nationally representative household panel survey and leveraged variation from a unique natural experiment that occurred in Australia in 2020: a lockdown imposed in the state of Victoria, but not elsewhere in Australia. Difference-in-differences models were estimated comparing changes in fertility intentions of persons who resided in Victoria during lockdown, or within four weeks of the lockdown being lifted, and those living elsewhere in Australia. Results revealed a significantly larger decline in reported intentions of having another child among women who lived through the protracted lockdown. The average effect was small, with fertility intentions estimated to fall by between 2.8% and 4.3% of the pre-pandemic mean. This negative effect was, however, more pronounced among those aged over 35 years, the less educated, and those employed on fixed-term contracts. Impacts on men's fertility intentions were generally negligible, but with a notable exception being Indigenous Australians.
Collapse
Affiliation(s)
- Irma Mooi-Reci
- School of Social and Political Sciences, University of Melbourne, Victoria 3010, Australia.
| | - Trong-Anh Trinh
- Melbourne Institute of Applied Economic and Social Research, University of Melbourne, Victoria 3010, Australia.
| | - Esperanza Vera-Toscano
- Melbourne Institute of Applied Economic and Social Research, University of Melbourne, Victoria 3010, Australia.
| | - Mark Wooden
- Melbourne Institute of Applied Economic and Social Research, University of Melbourne, Victoria 3010, Australia.
| |
Collapse
|
32
|
Horan C, Palmer M, Shrestha R, Erlank CP, Church K. The impact of COVID-19 lockdown on abortion care: a time series analysis of data from Marie Stopes Nepal. Sex Reprod Health Matters 2022; 30:2079185. [PMID: 35713504 PMCID: PMC9225672 DOI: 10.1080/26410397.2022.2079185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
The COVID-19 pandemic significantly impacted sexual and reproductive health and rights. Nepal implemented a nationwide lockdown in March 2020, limiting population movement and service access. The 36 clinics run by Marie Stopes Nepal (MSN) closed for varying periods at the beginning of lockdown. This study assesses the impact of lockdown and associated clinic closures on abortion services within MSN’s network. An interrupted time-series analysis of clinic-level MSN data compared abortion service use in the pre-closure and post-reopening periods, focusing on the following outcomes: number of abortion care visits, proportion of abortion-related visits, gestational age at time of abortion care and demographics of patients accessing abortion care. Subsequent meta-analyses combined clinic-level results to generate outcome-specific pooled effect estimates. As MSN clinics reopened, during ongoing wider lockdown, weekly visits for abortion care decreased by 37% on average, but abortion increased as a proportion of services post-reopening (OR: 1.53) compared with pre-closure, with no evidence of a change in the proportion of higher gestation abortions. The demographic profile of abortion care clients was altered, with post-reopening clients more likely to have completed primary education (OR: 1.54) and be aged 25 years or older (OR: 1.31) compared with pre-closure clients. COVID-19 lockdown and associated clinic closures reduced the absolute number of abortion services provided within MSN’s network, impacting the composition of service provision. Reductions in safe abortion and wider SRH access will have wide-ranging consequences, curtailing crucial reproductive rights. Policy-makers must ensure ongoing abortion access to protect rights and ensure access.
Collapse
Affiliation(s)
- Corrina Horan
- MSc Student in Reproductive and Sexual Health Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Melissa Palmer
- Assistant Professor, London School of Hygiene and Tropical Medicine, London, UK
| | - Raman Shrestha
- Evidence to Action Manager, Sunaulo Parivar Nepal, Kathmandu, Nepal
| | | | - Kathryn Church
- Independent Consultant & Honorary Assistant Professor, London School of Hygiene & Tropical Medicine, London, UK
| |
Collapse
|
33
|
Christian CS, Rossouw L. Scoping review of the impact of coronavirus disease 2019 on unplanned pregnancy. Afr J Prim Health Care Fam Med 2022; 14:e1-e8. [PMID: 36546497 PMCID: PMC9772756 DOI: 10.4102/phcfm.v14i1.3601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 09/09/2022] [Accepted: 10/06/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Increased pressure on the healthcare system because of coronavirus disease 2019 (COVID-19) along with national lockdown policies had consequences on the sexual and reproductive health of women. While the pandemic has resulted in changes in pregnancy intentions, child-bearing and fertility, the direction of this relationship is unclear and is likely to be impacted by each country's socio-economic status and stage of fertility transition. Understanding the fertility trajectory and the pandemic is important in understanding population structures and ageing, which have consequences for health policies, budgeting and economic activity. AIM This study aimed to conduct a scoping review of the impact of COVID-19 on unplanned pregnancy. METHODS A rapid review of available literature using Google Scholar, PubMed and Medical Literature Analysis and Retrieval System Online (MEDLINE), SocINDEX, Cumulative Index to Nursing and Allied Health Literature (CINAHL) Complete and Academic Search Ultimate. Articles in English from 2020 to 2021 were included. RESULTS Fifteen articles were included. These were mostly cross-sectional, primary data-collection surveys exploring the relationship between COVID-19 and child-bearing intentions. CONCLUSION Access to contraceptives, socio-economic status and uncertainty about the health impact of COVID-19 on pregnancy were major themes that emerged when considering child-bearing intentions. Evidence of changes in the number of unplanned pregnancies and abortions was not insignificant but should be explored further. Although the studies covered a range of countries, more studies are needed focusing on low- and middle-income countries where the socio-economic impact of child-bearing intention is greater. There is a need for causal analysis using country-level data and for longer studies using more robust methodologies. The pandemic will continue to influence birth rates.Contribution: This article revealed gaps in the current literature on the measurement of the quantitative and causal impact of the COVID-19 pandemic on fertility and child-bearing. Findings from our study may assist in setting the trajectory for future research.
Collapse
Affiliation(s)
- Carmen S. Christian
- Department of Economics, Faculty of Economic and Management Sciences, University of the Western Cape, Bellville, South Africa
| | - Laura Rossouw
- School of Economics and Finance, Faculty of Commerce, Law and Management, University of the Witwatersrand, Johannesburg, South Africa
| |
Collapse
|
34
|
Luppi F, Arpino B, Rosina A. Fertility plans in the early times of the COVID-19 pandemic: The role of occupational and financial uncertainty in Italy. PLoS One 2022; 17:e0271384. [PMID: 36480514 PMCID: PMC9731473 DOI: 10.1371/journal.pone.0271384] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 06/29/2022] [Indexed: 12/13/2022] Open
Abstract
This study investigates the association between objective and subjective indicators of economic uncertainty, generated by the COVID-19 health and economic crisis, and young Italians' fertility plans during the 2020. We use unique repeated cross-sectional data, collected at different time points during the pandemic (March and October/November 2020) together with pre-COVID data (2016). The data offer a standard fertility intention question pre- and during-COVID, and also a direct question on whether pre-COVID fertility plans have been confirmed, postponed or abandoned. In March 2020, individuals with more vulnerable occupations show a lower probability of intending to have a(nother) child in the short-term and a higher probability of abandoning their pre-COVID fertility plan; in October 2020 changes in fertility plans do not vary by employment condition. Instead, both in March and October, those who suffered from a negative income shock and those with negative expectations on their future income and occupation are more likely to abandon their pre-pandemic fertility plan compared to their better off counterparts. Overall, economic uncertainty seems to have similarly affected men and women's fertility intentions. Our findings point to the fact that the unequal economic consequences of the pandemic also produced and will produce heterogeneous effects on fertility intentions.
Collapse
Affiliation(s)
- Francesca Luppi
- Department of Statistics, Università Cattolica del Sacro Cuore, Milan, Italy
- * E-mail:
| | - Bruno Arpino
- Department of Statistics, Computer Science, Applications, University of Florence, Florence, Italy
| | - Alessandro Rosina
- Department of Statistics, Università Cattolica del Sacro Cuore, Milan, Italy
| |
Collapse
|
35
|
Burke KL, Sierra G, Lerma K, White K. Service delivery at Title X sites in Texas during the COVID-19 pandemic. PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH 2022; 54:198-207. [PMID: 36336334 DOI: 10.1363/psrh.12211] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
CONTEXT The important role of Title X sites in supporting publicly funded reproductive healthcare was elevated during the COVID-19 pandemic, as many people experienced economic uncertainty and changed their fertility preferences. In this study, we assessed changes in service delivery during the first year of the COVID-19 pandemic at Title X-supported sites in Texas, a large state with a high uninsured rate and a diverse Title X network. METHODS Using surveys of Title X-funded organizations in Texas from April and November 2020, we examined the percentage of organizations reporting service modifications. With administrative data on 507,947 client encounters between March 2019 and March 2021, we assessed change in client volume at the onset of the pandemic and evaluated the association between regional COVID-19 case rates and the provision of key Title X services. RESULTS In April 2020, most organizations (78%) limited in-person operations while implementing telehealth (74%) and contactless contraception (67%). Network-wide encounter volume declined by 26% at pandemic onset (incidence rate ratio [IRR] = 0.74, 95% confidence interval [CI] = 0.65, 0.84). Health departments experienced the steepest declines in encounter volume (IRR = 0.43, 95% CI = 0.36-0.50). Weekly encounters, particularly for long-acting reversible method placement/removal and sexually transmitted infection testing, decreased as COVID-19 rates increased. CONCLUSIONS Investment in public health infrastructure, including providing robust support to health departments as well as rebuilding and expanding the Title X network, is essential to safeguarding access to publicly funded reproductive healthcare during and after the pandemic.
Collapse
Affiliation(s)
- Kristen Lagasse Burke
- Population Research Center, University of Texas at Austin, Austin, Texas, USA
- Department of Sociology, University of Texas at Austin, Austin, Texas, USA
| | - Gracia Sierra
- Population Research Center, University of Texas at Austin, Austin, Texas, USA
| | - Klaira Lerma
- Population Research Center, University of Texas at Austin, Austin, Texas, USA
| | - Kari White
- Population Research Center, University of Texas at Austin, Austin, Texas, USA
- Department of Sociology, University of Texas at Austin, Austin, Texas, USA
- Steve Hicks School of Social Work, University of Texas at Austin, Austin, Texas, USA
| |
Collapse
|
36
|
Koenig LR, Smith Hughes C, Gemmill A, Diamond-Smith N. Unequal impacts of the COVID-19 pandemic on women's fertility preferences: Evidence from a longitudinal cohort in the United States. SSM Popul Health 2022; 20:101305. [PMID: 36467514 PMCID: PMC9705005 DOI: 10.1016/j.ssmph.2022.101305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 11/23/2022] [Accepted: 11/27/2022] [Indexed: 11/30/2022] Open
Abstract
•The COVID-19 pandemic suppressed fertility desires among US women.•Impacts on fertility preferences persisted from summer 2020 to early 2021.•The fertility preferences of younger women, women of color and those facing financial stress were most impacted.
Collapse
Affiliation(s)
- Leah R. Koenig
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Carolyn Smith Hughes
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Alison Gemmill
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, USA
| | - Nadia Diamond-Smith
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| |
Collapse
|
37
|
Tres J, Damaso EL, de Nadai MN. Impact of COVID-19 on the prescription of contraceptives in a city in São Paulo. Rev Assoc Med Bras (1992) 2022; 68:1765-1768. [PMID: 36449808 PMCID: PMC9779952 DOI: 10.1590/1806-9282.20220999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 07/31/2022] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE In the beginning of the pandemic, measures, such as social distancing, lockdown strategies, and restrictions on mobility, as well as the fear of transiting through health facilities, raised concerns about the impact of COVID-19 on women's ability to continue using contraceptives. METHODS This is a retrospective cohort study, which evaluated reports of medication distribution spreadsheets in Bauru - SP, from January 2019 to June 2021. RESULTS Our study showed that the municipal dispensation of contraceptives in the SUS was markedly impacted by the COVID-19 pandemic, suffering reductions that can impact on an increase in unplanned pregnancy rates. It is possible to note a significant decrease in the distribution of combined oral contraceptives (44.18%), combined injectable contraceptives (47.58% reduction), and medroxyprogesterone acetate (13.98%). This fact may be associated with the reduction in offers of face-to-face consultations in gynecology, due to the social isolation necessary at the time of the pandemic. CONCLUSION Ensuring access to contraceptives during health emergencies should be a public health policy priority. Thus, it is essential to draw up strategic plans to encourage full access to reproductive planning services even in times of health emergency, so that the occurrence of unplanned pregnancies can be adequately prevented.
Collapse
Affiliation(s)
- Julia Tres
- Universidade de São Paulo, Faculdade de Odontologia de Bauru – Bauru (SP), Brazil
| | - Enio Luis Damaso
- Universidade de São Paulo, Faculdade de Odontologia de Bauru – Bauru (SP), Brazil
| | - Mariane Nunes de Nadai
- Universidade de São Paulo, Faculdade de Odontologia de Bauru – Bauru (SP), Brazil.,Corresponding author:
| |
Collapse
|
38
|
Foti TR, Vereen S, Vamos C, Sappenfield W, Kirby RS. "A Lot of Things Stopped with COVID": Screening Pregnant Patients for Opioid Use and Related Conditions During the COVID-19 Pandemic. Womens Health Issues 2022; 33:242-249. [PMID: 36496340 PMCID: PMC9637513 DOI: 10.1016/j.whi.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 09/12/2022] [Accepted: 11/01/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVE We explored the impact of COVID-19 on universal screening programs for opioid use and related conditions among practicing clinicians or staff who work with pregnant patients. METHODS Semi-structured, in-depth qualitative interviews (n = 15) were conducted with practicing clinicians or staff in West-Central Florida between May and October 2020, representing both a range of professions and clinical settings that serve pregnant patients. Interviews were recorded, transcribed verbatim, and reviewed for accuracy. Independent coders conducted thematic content analysis iteratively in MaxQDA to identify emergent themes. RESULTS Four main themes were identified: worsening health and life conditions of pregnant patients, impaired patient-provider interactions, lack of priority and resources, and conducting opioid screening remotely. Pregnant patients often faced worsening mental health, lack of connection with health care providers, and socioenvironmental factors that increased the risk of overdose and intimate partner violence. Health care providers and facilities faced an infectious disease pandemic that simultaneously increased mental burden and reduced resources. Telehealth improved access to health care for many, but also came with implementation challenges such as inadequate technology, the need to address barriers to developing rapport with patients, and difficulty with certain social screens. CONCLUSION These themes describe facilitators of and barriers to implementing opioid and related screening programs during the COVID-19 pandemic, as well as the increasing urgency of screening because of socioenvironmental factors. Patients, health care providers, and health practices may benefit from emergency plans that anticipate screening challenges given their increased importance during times of heightened risk, including disasters and epidemics.
Collapse
Affiliation(s)
- Tara R. Foti
- Division of Research, Kaiser Permanente of Northern California, Oakland, California,University of South Florida College of Public Health, Tampa, Florida,Correspondence to: Tara R. Foti, PhD, MPH, Kaiser Permanente of Northern California, Division of Research, 2000 Broadway, Oakland, CA 94612. Tel.: (585) 746-3857
| | - Shanda Vereen
- University of South Florida College of Public Health, Tampa, Florida
| | - Cheryl Vamos
- University of South Florida College of Public Health, Tampa, Florida
| | | | - Russell S. Kirby
- University of South Florida College of Public Health, Tampa, Florida
| |
Collapse
|
39
|
Dorney E, Barrett G, Hall J, Black KI. Measures of Pregnancy Intention: Why Use Them and What Do They Tell Us? Semin Reprod Med 2022; 40:229-234. [PMID: 36746157 DOI: 10.1055/s-0042-1760118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Understanding pregnancy intention is an important public health measure that captures the ability of individuals to access information, resources, and services needed to plan the timing and spacing of pregnancies. Pregnancy intention is a complex construct impacted by social, emotional, financial, cultural, and contextual factors. In this review, we will examine the range of available tools for individuals and populations to evaluate pregnancy intention, the timing of the tools in relation to pregnancy, their interpretation, and use for policy and practice. Traditionally, pregnancy intention was only assessed in population health surveys; however, more sophisticated tools and measures have been developed. These tools can be used at several time points: before pregnancy, during pregnancy, or after the pregnancy has ended. It is important to appreciate the varied contexts globally for women and their partners when assessing pregnancy intention, and the ability of a given tool to capture this when used retrospectively or prospectively. These tools can inform targeted delivery of services for a person or couple before, during, and after pregnancy. This knowledge can inform strategies at an individual, community, and population level as an indicator of access to sexual and reproductive health information and knowledge and uptake of preconception health.
Collapse
Affiliation(s)
- Edwina Dorney
- Faculty of Medicine and Health, Central Clinical School, The University of Sydney, New South Wales, Australia
| | - Geraldine Barrett
- Department of Reproductive Health, UCL EGA Institute for Women's Health, University College London, London, United Kingdom
| | - Jennifer Hall
- Department of Reproductive Health, UCL EGA Institute for Women's Health, University College London, London, United Kingdom
| | - Kirsten I Black
- Faculty of Medicine and Health, Central Clinical School, The University of Sydney, New South Wales, Australia
| |
Collapse
|
40
|
Swan LE, Vu H, Higgins JA, Bui LM, Malecki K, Green TL. Exploring financial stress and resource deprivation as barriers to preferred contraceptive use in Wisconsin in 2021. Contraception 2022; 115:22-26. [DOI: https:/doi.org/10.1016/j.contraception.2022.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2023]
|
41
|
McCool-Myers M, Grasso D, Kozlowski D, Cordes S, Jean V, Gold H, Goedken P. The COVID-19 pandemic’s intersectional impact on work life, home life and wellbeing: an exploratory mixed-methods analysis of Georgia women’s experiences during the pandemic. BMC Public Health 2022; 22:1988. [PMCID: PMC9619013 DOI: 10.1186/s12889-022-14285-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 09/27/2022] [Indexed: 11/10/2022] Open
Abstract
Background Women have been especially impacted by the COVID-19 pandemic. This exploratory study aimed to characterize women’s adverse experiences related to their work, home lives, and wellbeing during the height of the COVID-19 pandemic and to describe demographic differences of those lived experiences. Methods Using the validated Epidemic-Pandemic Impacts Inventory, we collected data from reproductive-aged women in the state of Georgia about their exposure to adverse events during the pandemic. A latent class analysis (LCA) was performed to identify subgroups of women reporting similar adverse experiences and describe their sociodemographic characteristics. An optional open-ended question yielded qualitative data that were analyzed thematically and merged with subgroup findings. Data were collected from September 2020 to January 2021. Results 423 individuals aged 18–49 completed the survey with 314 (74.2%) providing qualitative responses. The LCA yielded 4 subgroups: (1) a “low exposure” subgroup (n = 123, 29.1%) with relatively low probability of adverse experiences across domains (e.g. financial insecurity, health challenges, barriers to access to healthcare, intimate partner violence (IPV)); (2) a “high exposure” subgroup (n = 46, 10.9%) with high probability of experiencing multiple adversities across domains including the loss of loved ones to COVID-19; (3) a “caregiving stress” subgroup (n = 104, 24.6%) with high probability of experiencing challenges with home and work life including increased partner conflict; and (4) a “mental health changes” subgroup (n = 150, 35.5%) characterized by relatively low probability of adverse experiences but high probability of negative changes in mental health and lifestyle. Individuals in subgroups 1 and 4, which had low probabilities of adverse experiences, were significantly more likely to be non-Hispanic white. Individuals in subgroup 2 were more likely to identify with a sexual or racial/ethnic minority population. Inductive coding of qualitative data yielded themes such as stress, mental health, financial impact, and adaptation/resilience, providing context for pandemic-related adversity. Conclusion Though many individuals in our sample experienced hardship, minority populations were unequally impacted by pandemic-related adversity in work life, home life, and wellbeing. Recovery and future emergency preparedness efforts in Georgia must incorporate support mechanisms for mental health and IPV, focusing especially on the intersectional needs of racial, ethnic, and sexual minorities. Supplementary information The online version contains supplementary material available at 10.1186/s12889-022-14285-4.
Collapse
Affiliation(s)
- Megan McCool-Myers
- grid.189967.80000 0001 0941 6502Department of Gynecology and Obstetrics, Emory University School of Medicine, 46 Armstrong St SE, 30303 Atlanta, GA USA
| | - Damion Grasso
- grid.63054.340000 0001 0860 4915Department of Psychiatry, University of Connecticut Health, Connecticut, USA
| | - Debra Kozlowski
- grid.189967.80000 0001 0941 6502Department of Gynecology and Obstetrics, Emory University School of Medicine, 46 Armstrong St SE, 30303 Atlanta, GA USA
| | - Sarah Cordes
- grid.189967.80000 0001 0941 6502Department of Gynecology and Obstetrics, Emory University School of Medicine, 46 Armstrong St SE, 30303 Atlanta, GA USA
| | - Valerie Jean
- grid.189967.80000 0001 0941 6502Department of Gynecology and Obstetrics, Emory University School of Medicine, 46 Armstrong St SE, 30303 Atlanta, GA USA
| | - Heather Gold
- grid.189967.80000 0001 0941 6502Department of Gynecology and Obstetrics, Emory University School of Medicine, 46 Armstrong St SE, 30303 Atlanta, GA USA
| | - Peggy Goedken
- grid.189967.80000 0001 0941 6502Department of Gynecology and Obstetrics, Emory University School of Medicine, 46 Armstrong St SE, 30303 Atlanta, GA USA
| |
Collapse
|
42
|
VanBenschoten H, Kuganantham H, Larsson EC, Endler M, Thorson A, Gemzell-Danielsson K, Hanson C, Ganatra B, Ali M, Cleeve A. Impact of the COVID-19 pandemic on access to and utilisation of services for sexual and reproductive health: a scoping review. BMJ Glob Health 2022; 7:bmjgh-2022-009594. [PMID: 36202429 PMCID: PMC9539651 DOI: 10.1136/bmjgh-2022-009594] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 08/13/2022] [Indexed: 11/15/2022] Open
Abstract
Introduction The COVID-19 pandemic has negatively impacted health systems globally and widened preexisting disparities. We conducted a scoping review on the impact of the COVID-19 pandemic on women and girls’ access to and utilisation of sexual and reproductive health (SRH) services for contraception, abortion, gender-based and intimate partner violence (GBV/IPV) and sexually transmitted infections (STIs). Methods We systematically searched peer reviewed literature and quantitative reports, published between December 2019 and July 2021, focused on women and girls’ (15–49 years old) access to and utilisation of selected SRH services during the COVID-19 pandemic. Included studies were grouped based on setting, SRH service area, study design, population and reported impact. Qualitative data were coded, organised thematically and grouped by major findings. Results We included 83 of 3067 identified studies and found that access to contraception, in-person safe abortion services, in-person services for GBV/IPV and STI/HIV testing, prevention and treatment decreased. The geographical distribution of this body of research was uneven and significantly less representative of countries where COVID-19 restrictions were very strict. Access was limited by demand and supply side barriers including transportation disruptions, financial hardships, limited resources and legal restrictions. Few studies focused on marginalised groups with distinct SRH needs. Conclusion Reports indicated negative impacts on access to and utilisation of SRH services globally, especially for marginalised populations during the pandemic. Our findings call for strengthening of health systems preparedness and resilience to safeguard global access to essential SRH services in ongoing and future emergencies.
Collapse
Affiliation(s)
- Hannah VanBenschoten
- Department of Bioengineering, University of Washington, Seattle, Washington, USA
| | | | - Elin C Larsson
- Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden,WHO Collaborating Center for Human Reproduction, Karolinska University Hospital, Stockholm, Sweden
| | - Margit Endler
- Department of Women and Children’s Health, Karolinska Institutet, Stockholm, Sweden,Department of Obsetrics and Gynecology, Stockholm South General Hospital, Stockholm, Sweden
| | - Anna Thorson
- Department of Sexual and Reproductive Health and Research, WHO, Geneve, Switzerland,Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | - Kristina Gemzell-Danielsson
- Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden,WHO Collaborating Center for Human Reproduction, Karolinska University Hospital, Stockholm, Sweden
| | - Claudia Hanson
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden,Department of Disease Control, London School of Hygiene & Tropical Medicine Faculty of Infectious and Tropical Diseases, London, UK
| | - Bela Ganatra
- Department of Sexual and Reproductive Health and Research, WHO, Geneve, Switzerland
| | - Moazzam Ali
- Department of Sexual and Reproductive Health and Research, WHO, Geneve, Switzerland
| | - Amanda Cleeve
- Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden,Department of Obsetrics and Gynecology, Stockholm South General Hospital, Stockholm, Sweden
| |
Collapse
|
43
|
Izdebski Z, Wąż K, Warzecha D, Mazur J, Wielgoś M. Factors Associated with Uptake of Effective and Ineffective Contraceptives among Polish Women during the First Period of the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12748. [PMID: 36232046 PMCID: PMC9564462 DOI: 10.3390/ijerph191912748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 10/01/2022] [Accepted: 10/03/2022] [Indexed: 06/16/2023]
Abstract
The COVID-19 pandemic has burdened the healthcare system and influenced individuals' health-related choices. The aim of the study was to estimate the prevalence and to identify the correlates of the use of more and less effective contraceptive methods among Poles in the initial period of the COVID-19 pandemic. The cross-sectional online study was conducted among the representative sample of 642 female respondents aged 18-49. Three groups of contraception choices (only effective methods-42.2%, mixed effective and ineffective methods-26.8%, none-31.0%) were distinguished and 11 potential determinants were considered. One in ten women declared having difficulty in accessing contraception during the first months of the pandemic. A multinomial logistic regression model explained 48.7% of the variation in contraceptive method choice. Both effective and ineffective methods were more often declared by young women, and less often in case of lower education, planning children or subjective no need for contraception. In addition, factors that reduced the chance of effective contraception were poor financial situation, already having children and a relatively higher degree of religiosity. The study confirmed that a significant share of Polish women do not opt for effective methods of contraception. Their choices had strong demographic, social and cultural determinants.
Collapse
Affiliation(s)
- Zbigniew Izdebski
- Department of Biomedical Aspects of Development and Sexology, Faculty of Education, Warsaw University, 00-561 Warsaw, Poland
- Department of Humanization in Medicine and Sexology, Collegium Medicum, University of Zielona Gora, 65-729 Zielona Gora, Poland
| | - Krzysztof Wąż
- Institute of Pedagogy, Faculty of Social Sciences, University of Zielona Gora, 65-729 Zielona Gora, Poland
| | - Damian Warzecha
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-015 Warsaw, Poland
| | - Joanna Mazur
- Department of Humanization in Medicine and Sexology, Collegium Medicum, University of Zielona Gora, 65-729 Zielona Gora, Poland
| | - Mirosław Wielgoś
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-015 Warsaw, Poland
| |
Collapse
|
44
|
Dennard E, Kristjansson E, Tchangalova N, Totton S, Winham D, O’Connor A. Food insecurity among African Americans in the United States: A scoping review. PLoS One 2022; 17:e0274434. [PMID: 36094921 PMCID: PMC9467341 DOI: 10.1371/journal.pone.0274434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 08/09/2022] [Indexed: 11/18/2022] Open
Abstract
In 2019, the estimated prevalence of food insecurity for Black non-Hispanic households was higher than the national average due to health disparities exacerbated by forms of racial discrimination. During the COVID-19 pandemic, Black households have experienced higher rates of food insecurity when compared to other populations in the United States. The primary objectives of this review were to identify which risk factors have been investigated for an association with food insecurity, describe how food insecurity is measured across studies that have evaluated this outcome among African Americans, and determine which dimensions of food security (food accessibility, availability, and utilization) are captured by risk factors studied by authors. Food insecurity related studies were identified through a search of Google Scholar, PubMed, CINAHL Plus, MEDLINE®, PsycINFO, Health Source: Nursing/Academic Edition, and Web of Science™ (Clarivate), on May 20, 2021. Eligible studies were primary research studies, with a concurrent comparison group, published in English between 1995 and 2021. Ninety-eight relevant studies were included for data charting with 37 unique measurement tools, 115 risk factors, and 93 possible consequences of food insecurity identified. Few studies examined factors linked to racial discrimination, behaviour, or risk factors that mapped to the food availability dimension of food security. Infrequently studied factors, such as lifetime racial discrimination, socioeconomic status (SES), and income insecurity need further investigation while frequently studied factors such as age, education, race/ethnicity, and gender need to be summarized using a systematic review approach so that risk factor impact can be better assessed. Risk factors linked to racial discrimination and food insecurity need to be better understood in order to minimize health disparities among African American adults during the COVID-19 pandemic and beyond.
Collapse
Affiliation(s)
- Elizabeth Dennard
- Office of Applied Research and Safety Assessment, Food and Drug Administration, Laurel, Maryland, United States of America
- * E-mail:
| | | | - Nedelina Tchangalova
- STEM Library, University of Maryland, College Park, Maryland, United States of America
| | - Sarah Totton
- Department of Population Medicine, University of Guelph, Guelph, Ontario, Canada
| | - Donna Winham
- Food Science and Human Nutrition, Iowa State University, Ames, Iowa, United States of America
| | - Annette O’Connor
- College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, United States of America
| |
Collapse
|
45
|
Dozier JL, Sufrin C, Berger BO, Burke AE, Bell SO. COVID-19 impacts on abortion care-seeking experiences in the Washington, DC, Maryland, and Virginia regions of the United States. PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH 2022; 54:68-79. [PMID: 35790127 PMCID: PMC9349554 DOI: 10.1363/psrh.12202] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
CONTEXT Many people wanted to avoid or delay childbearing during the COVID-19 pandemic. This study sought to examine the extent COVID-19 influenced abortion care-seeking in a region that did not enact policy restricting abortion due to the pandemic, has high service availability, and few abortion-restrictive policies. METHODOLOGY We conducted telephone surveys with adults (n=72) requesting abortion appointments between September 2020 and March 2021 at five clinics in Washington, DC, Maryland, and Virginia. We used χ2 tests to compare sociodemographic, reproductive history, service delivery characteristics, and pandemic-related life changes by whether COVID-19 influenced abortion care-seeking. RESULTS Most respondents (93%) had an abortion at the time of the survey, 4% were awaiting their scheduled appointment, and 3% did not have an appointment scheduled. Nearly 40% of people reported COVID-19 influenced their decision to have an abortion. These individuals were significantly more likely to report "not financially prepared" (44% vs. 16%) as a reason for termination compared to people reporting no influence of COVID-19. They were also more likely to have lost or changed their health insurance due to pandemic-related employment changes (15% vs. 2%), report substantial money difficulties due to COVID-19 (59% vs. 33%), and report that paying for their abortion was "very difficult" (25% vs. 2%). CONCLUSION COVID-19 influenced many people to have an abortion, particularly those financially disadvantaged by the pandemic. Expansion of Medicaid abortion coverage in Washington, DC and Virginia could reduce financial barriers to care and help people to better meet their reproductive needs amid future crises.
Collapse
Affiliation(s)
- Jessica L. Dozier
- Department of Population, Family and Reproductive HealthJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Carolyn Sufrin
- Department of Gynecology and ObstetricsJohns Hopkins School of MedicineBaltimoreMarylandUSA
- Department of Health, Behavior, and SocietyJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Blair O. Berger
- Department of Population, Family and Reproductive HealthJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Anne E. Burke
- Department of Population, Family and Reproductive HealthJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
- Department of Gynecology and ObstetricsJohns Hopkins School of MedicineBaltimoreMarylandUSA
| | - Suzanne O. Bell
- Department of Population, Family and Reproductive HealthJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
| |
Collapse
|
46
|
McCool-Myers M, Kozlowski D, Jean V, Cordes S, Gold H, Goedken P. The COVID-19 pandemic's impact on sexual and reproductive health in Georgia, USA: An exploration of behaviors, contraceptive care, and partner abuse. Contraception 2022; 113:30-36. [PMID: 35489392 PMCID: PMC9042735 DOI: 10.1016/j.contraception.2022.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 04/18/2022] [Accepted: 04/20/2022] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Assessing access to sexual and reproductive health care during the COVID-19 pandemic, experiences with intimate partner violence (IPV), and exploring sociodemographic disparities STUDY DESIGN: From September 2020 to January 2021, we recruited 436 individuals assigned female at birth (18-49 years.) in Georgia, USA for an online survey. The final convenience sample was n = 423; a response rate could not be calculated. Survey themes included: sociodemographic and financial information, access to contraceptive services/care, IPV, and pregnancy. Respondents who reported a loss of health insurance, difficulty accessing contraception, barriers to medical care, or IPV were characterized as having a negative sexual and reproductive health experience during the pandemic. We explored associations between sociodemographic variables and negative sexual and reproductive health experiences. RESULTS Since March 2020, 66/436 (16%) of respondents lost their health insurance, and 45% (89/436) reported income loss. Of our sample, 144/436 people (33%) attempted to access contraception. The pandemic made contraceptive access more difficult for 38/144 (26%) of respondents; however, 106/144 (74%) said it had no effect or positive effect on access. Twenty-one respondents reported IPV (5%). COVID-19 amplified negative views of unplanned pregnancy. Seventy-six people (18%) reported at least 1 negative sexual and reproductive health experience during the pandemic; people in an urban setting and those identifying as homo/bisexual were more likely to report negative experiences (24%, 28% respectively). CONCLUSION Urban and sexual minority populations had negative sexual and reproductive health experiences during COVID-19 more than their counterparts. The pandemic has shifted perspectives on family planning, likely due to the diverse impacts of COVID-19, including loss of health insurance and income. IMPLICATION Females across Georgia reported varying impacts of the COVID-19's pandemic on their sexual and reproductive health care. These findings could be utilized to propose recommendations for care and intimate partner violence support mechanisms, tailored to urban and sexual minority populations.
Collapse
Affiliation(s)
- Megan McCool-Myers
- Department of Gynecology and Obstetrics, Jane Fonda Center for Adolescent Reproductive Health, Emory University School of Medicine, Atlanta GA, United States
| | - Debra Kozlowski
- Department of Gynecology and Obstetrics, Family Planning Division, Emory University School of Medicine, Atlanta GA, United States
| | - Valerie Jean
- Department of Gynecology and Obstetrics, Family Planning Division, Emory University School of Medicine, Atlanta GA, United States
| | - Sarah Cordes
- Department of Gynecology and Obstetrics, Family Planning Division, Emory University School of Medicine, Atlanta GA, United States
| | - Heather Gold
- Department of Gynecology and Obstetrics, Family Planning Division, Emory University School of Medicine, Atlanta GA, United States,Corresponding author at: Emory University School of Medicine, University Faculty Office Building, 49 Jesse Hill Jr Dr SE, Atlanta, GA 30303, United States. Phone: not available, Fax: not available
| | - Peggy Goedken
- Department of Gynecology and Obstetrics, Jane Fonda Center for Adolescent Reproductive Health, Emory University School of Medicine, Atlanta GA, United States,Department of Gynecology and Obstetrics, Family Planning Division, Emory University School of Medicine, Atlanta GA, United States
| |
Collapse
|
47
|
Schoenaker DAJM, Bennett C, Grieger JA, Harrison CL, Hill B, Enticott J, Moran LJ, Teede HJ, O’Reilly SL, Lim S. Association between pregnancy intention and psychological distress among women exposed to different levels of restrictions during the COVID-19 pandemic in Australia. PLoS One 2022; 17:e0273339. [PMID: 36006931 PMCID: PMC9409515 DOI: 10.1371/journal.pone.0273339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 08/06/2022] [Indexed: 11/19/2022] Open
Abstract
Background The COVID-19 pandemic has had a negative impact on the mental health of people globally. Significant concerns about health and access to services among women of reproductive age considering pregnancy may cause psychological distress, and in turn increase health risks during and after pregnancy for mothers and offspring. Objectives To examine the association between pregnancy intention and psychological distress during the COVID-19 pandemic in Australia, and explore if this association differed based on local viral transmission rates and corresponding levels of pandemic restrictions. Methods A nationwide online survey was completed by 849 non-pregnant women aged 18–50 years between 15 October and 7 November 2020. Women were asked about their intention to become pregnant, and psychological distress was assessed using the Kessler Psychological Distress Scale (K10). Multivariable regression analysis examined associations between pregnancy intention and psychological distress. An interaction term was added to the model to examine differences in associations by level of viral transmission rates and lockdown restrictions which was determined based on postcode. Results Pregnancy intention was not associated with experiencing (very) high psychological distress in the overall study population (odds ratio (OR) 1.42, 95% CI 0.94, 2.11). The interaction term (p = 0.09) suggested potential differences by level of restrictions and viral transmission rates. In stratified analysis among women living in a location with strict lockdown restrictions and high viral transmission rates leading up to and during the study, those planning to become pregnant were more likely to experience (very) high psychological distress (OR 3.39, 2.04, 5.65) compared with women not planning to become pregnant. Pregnancy intention was not associated with psychological distress among women exposed to lower levels of pandemic restrictions and viral transmission rates (OR 1.17, 0.74, 1.85). Conclusions Our findings highlight the need to identify and support women planning pregnancy during a public health crisis to mitigate potential short- and long-term intergenerational negative health outcomes associated with psychological distress.
Collapse
Affiliation(s)
- Danielle A. J. M. Schoenaker
- School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
- * E-mail:
| | - Christie Bennett
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC, Australia
| | - Jessica A. Grieger
- Robinson Research Institute, University of Adelaide, North Adelaide, SA, Australia
- Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
| | - Cheryce L. Harrison
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, VIC, Australia
| | - Briony Hill
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Joanne Enticott
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, VIC, Australia
- Department of Psychiatry, Southern Synergy, Monash University, Clayton, VIC, Australia
| | - Lisa J. Moran
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, VIC, Australia
| | - Helena J. Teede
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, VIC, Australia
| | - Sharleen L. O’Reilly
- UCD Institute of Food and Health, School of Agriculture and Food Science, University College Dublin, Belfield, Dublin, Ireland
| | - Siew Lim
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, VIC, Australia
| |
Collapse
|
48
|
Akinyemi JO, Dipeolu OI, Adebayo AM, Gbadebo BM, Ajuwon GA, Olowolafe TA, Adewoyin Y, Odimegwu CO. Social consequences of COVID-19 on fertility preference consistency and contraceptive use among Nigerian women: insights from population-based data. Contracept Reprod Med 2022; 7:14. [PMID: 35915478 PMCID: PMC9343223 DOI: 10.1186/s40834-022-00181-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 06/27/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Emerging evidence from high income countries showed that the COVID-19 pandemic has had negative effects on population and reproductive health behaviour. This study provides a sub-Saharan Africa perspective by documenting the social consequences of COVID-19 and its relationship to fertility preference stability and modern contraceptive use in Nigeria. METHOD We analysed panel data collected by Performance Monitoring for Action in Nigeria. Baseline and Follow-up surveys were conducted before the COVID-19 outbreak (November 2019-February 2020) and during the lockdown respectively (May-July 2020). Analysis was restricted to married non-pregnant women during follow-up (n = 774). Descriptive statistics and generalized linear models were employed to explore the relationship between selected social consequences of COVID-19 and fertility preferences stability (between baseline and follow-up) as well as modern contraceptives use. RESULTS Reported social consequences of the pandemic lockdown include total loss of household income (31.3%), food insecurity (16.5%), and greater economic reliance on partner (43.0%). Sixty-eight women (8.8%) changed their minds about pregnancy and this was associated with age groups, higher wealth quintile (AOR = 0.38, CI: 0.15-0.97) and household food insecurity (AOR = 2.72, CI: 1.23-5.99). Fertility preference was inconsistent among 26.1%. Women aged 30-34 years (AOR = 4.46, CI:1.29-15.39) were more likely of inconsistent fertility preference compared to 15-24 years. The likelihood was also higher among women with three children compared to those with only one child (AOR = 3.88, CI: 1.36-11.08). During follow-up survey, 59.4% reported they would feel unhappy if pregnant. This was more common among women with tertiary education (AOR = 2.99, CI: 1.41-6.33). The odds increased with parity. The prevalence of modern contraceptive use was 32.8%. Women aged 45-49 years (AOR = 0.24, CI: 0.10-0.56) were less likely to use modern contraceptives than those aged 15-24 years. In contrast, the odds of contraceptive use were significantly higher among those with three (AOR = 1.82, CI: 1.03-3.20), four (AOR = 2.45, CI: 1.36-4.39) and at least five (AOR = 2.89, CI: 1.25-6.74) children. Unhappy disposition towards pregnancy (AOR = 2.48, CI: 1.724-3.58) was also a significant predictor of modern contraceptive use. CONCLUSION Some social consequences of COVID-19 affected pregnancy intention and stability of fertility preference but showed no independent association with modern contraceptive use.
Collapse
Affiliation(s)
- Joshua O Akinyemi
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria. .,Infectious Diseases Institute, College of Medicine, University of Ibadan, Ibadan, Nigeria. .,Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa.
| | - Oluwafemi I Dipeolu
- Department of Health Promotion and Education, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Ayodeji M Adebayo
- Department of Community Medicine, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Babatunde M Gbadebo
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Grace A Ajuwon
- E.Latunde Odeku Medical Library, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Tubosun A Olowolafe
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Yemi Adewoyin
- Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa.,Department of Geography, University of Nigeria, Nsukka, Nigeria
| | - Clifford O Odimegwu
- Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa
| |
Collapse
|
49
|
Wright KQ. "It changed the atmosphere surrounding the baby I did have": Making sense of reproduction during the COVID-19 pandemic. JOURNAL OF MARRIAGE AND THE FAMILY 2022; 84:1105-1128. [PMID: 35935914 PMCID: PMC9347647 DOI: 10.1111/jomf.12851] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 04/13/2022] [Accepted: 05/02/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE This study examines the schemas that women employed during the COVID-19 pandemic to make sense of their reproductive desires. BACKGROUND Existing research on reproduction during epidemics suggests that there are variable population responses to periods of long-term social uncertainty. However, less is known about how individuals make sense of maintaining or adapting their reproductive desires during periods of social upheaval. METHOD Twenty-nine women aged 25-35 from a mid-sized Midwestern county in the United States were recruited and interviewed about their experiences during the first 8 months of the COVID-19 pandemic. They were asked about their daily lived experiences and their reproductive desires during in-depth interviews. These interviews were transcribed and analyzed using thematic coding. RESULTS Participants used three normative schemas to describe their reproductive desires during the COVID-19 pandemic. Heteronormative schemas were used by many participants to articulate their commitment to a heteronormative aged-staged timeline of life events. Schemas of social support around being pregnant and giving birth were used by participants, primarily those who were currently or recently pregnant, to express grief and loss over the relational experience of having a new baby. Medicalized schemas were expressed by most participants to describe feelings of fear and risk at real or imagined encounters with medical institutions. CONCLUSION The schemas that participants used to make sense of their reproductive desires demonstrate how sense-making during a profound event that affects everyday realities allows participants to (re)articulate commitments to existing narratives that reinforce heterosexual, social, and medicalized hierarchies in reproduction.
Collapse
Affiliation(s)
- Kelsey Q. Wright
- Department of Sociology, Center for Demography and EcologyUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| |
Collapse
|
50
|
Swan LE, Vu H, Higgins JA, Bui LM, Malecki K, Green TL. Exploring financial stress and resource deprivation as barriers to preferred contraceptive use in Wisconsin in 2021. Contraception 2022; 115:22-26. [DOI: 10.1016/j.contraception.2022.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 07/27/2022] [Accepted: 07/29/2022] [Indexed: 11/03/2022]
|