Original Article

Secondary Effects of the COVID-19 Pandemic on Pregnancy Intention

Authors: Rebecca Grace, MD, Savannah Cotter, MD, Lauren Taylor, MD, Di Miao, PhD, Sabeena Rahman, MD, Bani M. Ratan, MD, EdD

Abstract

Objectives: The coronavirus disease 2019 (COVID-19) pandemic had many downstream effects, including, for some women, altering the wish to become pregnant. This study examines the effects on pregnancy intention and Edinburgh Postnatal Depression Scale (EPDS) score at the initiation of prenatal care in a low-income population during the COVID-19 pandemic.

Methods: A retrospective review of cohorts of women initiating prenatal care at two large Medicaid clinics between May and November 2019 and May and November 2020 was performed. Women entering prenatal care before 20 weeks and carrying pregnancies to term were included. Charts were abstracted for pregnancy intention, demographics, medical history, and EPDS score. Multivariate logistical regression analysis was used to analyze pregnancy intention pre- and pandemic. EPDS scores were compared by unpaired t test in the unplanned pregnancies pre- and pandemic.

Results: There were 462 women in the prepandemic cohort and 477 patients in the COVID pandemic cohort. During the pandemic, 53.04% (253/477) of women reported unplanned pregnancies, a significant increase from a baseline of 42.86% (198/462) of pregnancies prepandemic (P < 0.01, odds ratio 1.62, 95% confidence interval 1.19–2.20) when controlling for all other factors. Analysis of unplanned pregnancies specifically showed no significant differences in the demographic makeup pre- and pandemic. There also was no significant change in EPDS scores in unplanned pregnancies between the two cohorts.

Conclusions: There was a significant increase in the number of unplanned pregnancies during the COVID-19 pandemic in a large Medicaid patient population, although the demographics of those having unplanned pregnancies and the average EPDS score did not change significantly.
Posted in: Infectious Disease146 Pregnancy34

This content is limited to qualifying members.

Existing members, please login first

If you have an existing account please login now to access this article or view purchase options.

Purchase only this article ($25)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.

References

1. Flynn AC, Kavanagh K, Smith AD, et al. The impact of the COVID-19 pandemic on pregnancy planning behaviors. Womens Health Rep 2021;2:71–77.
 
2. Lin TK, Law R, Beaman J, et al. The impact of the COVID-19 pandemic on economic security and pregnancy intentions among people at risk of pregnancy. Contraception 2021; 103:380–385.
 
3. Biaggi A, Conroy S, Pawlby S, et al. Identifying the women at risk of antenatal anxiety and depression: a systematic review. J Affect Disord 2016;191:62–77.
 
4. Cheng D, Schwarz EB, Douglas E, et al. Unintended pregnancy and associated maternal preconception, prenatal and postpartum behaviors. Contraception 2009;79:194–198.
 
5. Finer LB, Zolna MR. Unintended pregnancy in the United States: incidence and disparities, 2006. Contraception 2011;84:478–485.
 
6. Aly J, Haeger KO, Christy AY, et al. Contraception access during the COVID-19 pandemic. Contracept Reprod Med 2020;5:17.
 
7. Punia V, Nasr G, Zagorski V, et al. Evidence of a rapid shift in outpatient practice during the COVID-19 pandemic using telemedicine. Telemed E-Health 2020;26:1301–1303.
 
8. Becker NV, Moniz MH, Tipirneni R, et al. Utilization of women’s preventive health services during the COVID-19 pandemic. JAMA Health Forum 2021;2:e211408.
 
9. SharmaKA, Zangmo R, Kumari A, et al. Family planning and abortion services in COVID 19 pandemic. Taiwan J Obstet Gynecol 2020;59:808–811.
 
10. Kaller S, Muñoz MGI, Sharma S, et al. Abortion service availability during the COVID-19 pandemic: results from a national census of abortion facilities in the U.S. Contracept X 2021; 3:100067.
 
11. Tex SB 8. Texas Heartbeat Bill. https://capitol.texas.gov/tlodocs/87R/billtext/pdf/SB00008F.pdf. Published May 13, 2021. Accessed August 22, 2024.
 
12. Muskens L, Boekhorst MGBM, Kop WJ, et al. The association of unplanned pregnancy with perinatal depression: a longitudinal cohort study. Arch Womens Ment Health 2022;25:611–620.
 
13. Boden JM, Fergusson DM, Horwood LJ. Outcomes for children and families following unplanned pregnancy: findings from a longitudinal birth cohort. Child Indic Res 2015;8: 389–402.
 
14. Gipson JD, Koenig MA, Hindin MJ. The effects of unintended pregnancy on infant, child, and parental health: a review of the literature. Stud Fam Plann 2008;39:18–38.
 
15. Moreau C, Bohet A, Le Guen M, et al. Unplanned or unwanted? A randomized study of national estimates of pregnancy intentions. Fertil Steril 2014;102:1663–1670.