An assessment of postpartum contraception rates with evolving care during the COVID-19 pandemic
Copyright © 2023 Elsevier B.V. All rights reserved..
OBJECTIVE: The COVID-19 pandemic presented new care delivery obstacles in the form of scheduling procedures and safe presentation to in-person visits. Contraception provision is an indispensable component of postpartum care that was not immune to these challenges. Given the barriers to care during the initial months of the pandemic, we sought to examine how postpartum contraception, sterilization, and visit attendance were affected during this period.
STUDY DESIGN: We performed a retrospective chart review to examine contraception initiation, sterilization, and postpartum virtual and in-person visit attendance rates during the first six months (March 15 to September 7, 2020) of the COVID-19 pandemic compared to the rates in the same period in the year prior at a single tertiary academic care center. We abstracted data from the first prenatal visit through twelve weeks postpartum.
RESULTS: With the initiation of virtual appointments, postpartum visit attendance significantly increased (94.6 % vs 88.4 %, p < 0.001) during the pandemic with no difference in overall contraception uptake (51 % vs 54.1 %, p = 0.2) or sterilization (11.0 % vs 11.5 %, p = 0.88). During the pandemic, contraception prescribed differed significantly with a trend towards patient-administered methods including pills, patches, and rings (21 % vs 16 %, p = 0.02). In both periods, there was a significantly younger mean age (p < 0.001), higher proportion of non-White and non-Asian race (p < 0.001), public insurance (p = 0.003, 0.004), and an established contraceptive plan prenatally (p < 0.001) in the group that received contraception.
CONCLUSION: As virtual postpartum visits were instituted, contraception initiation and sterilization were maintained at pre-pandemic rates and visit attendance rose despite the obstacles to care presented by the COVID-19 pandemic. Provision of virtual postpartum visits may be a driver to maintain contraception and sterilization rates at a time, such as early in the COVID-19 pandemic, when patient care is at risk to be disrupted by social distancing, isolation, and avoidance of medical campuses.
Medienart: |
E-Artikel |
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Erscheinungsjahr: |
2023 |
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Erschienen: |
2023 |
Enthalten in: |
Zur Gesamtaufnahme - volume:36 |
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Enthalten in: |
Sexual & reproductive healthcare : official journal of the Swedish Association of Midwives - 36(2023) vom: 01. Juni, Seite 100844 |
Sprache: |
Englisch |
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Beteiligte Personen: |
Lagon, Elena P [VerfasserIn] |
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Links: |
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Themen: |
COVID-19 |
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Anmerkungen: |
Date Completed 07.06.2023 Date Revised 07.06.2023 published: Print-Electronic Citation Status MEDLINE |
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doi: |
10.1016/j.srhc.2023.100844 |
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funding: |
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Förderinstitution / Projekttitel: |
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PPN (Katalog-ID): |
NLM355362031 |
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520 | |a Copyright © 2023 Elsevier B.V. All rights reserved. | ||
520 | |a OBJECTIVE: The COVID-19 pandemic presented new care delivery obstacles in the form of scheduling procedures and safe presentation to in-person visits. Contraception provision is an indispensable component of postpartum care that was not immune to these challenges. Given the barriers to care during the initial months of the pandemic, we sought to examine how postpartum contraception, sterilization, and visit attendance were affected during this period | ||
520 | |a STUDY DESIGN: We performed a retrospective chart review to examine contraception initiation, sterilization, and postpartum virtual and in-person visit attendance rates during the first six months (March 15 to September 7, 2020) of the COVID-19 pandemic compared to the rates in the same period in the year prior at a single tertiary academic care center. We abstracted data from the first prenatal visit through twelve weeks postpartum | ||
520 | |a RESULTS: With the initiation of virtual appointments, postpartum visit attendance significantly increased (94.6 % vs 88.4 %, p < 0.001) during the pandemic with no difference in overall contraception uptake (51 % vs 54.1 %, p = 0.2) or sterilization (11.0 % vs 11.5 %, p = 0.88). During the pandemic, contraception prescribed differed significantly with a trend towards patient-administered methods including pills, patches, and rings (21 % vs 16 %, p = 0.02). In both periods, there was a significantly younger mean age (p < 0.001), higher proportion of non-White and non-Asian race (p < 0.001), public insurance (p = 0.003, 0.004), and an established contraceptive plan prenatally (p < 0.001) in the group that received contraception | ||
520 | |a CONCLUSION: As virtual postpartum visits were instituted, contraception initiation and sterilization were maintained at pre-pandemic rates and visit attendance rose despite the obstacles to care presented by the COVID-19 pandemic. Provision of virtual postpartum visits may be a driver to maintain contraception and sterilization rates at a time, such as early in the COVID-19 pandemic, when patient care is at risk to be disrupted by social distancing, isolation, and avoidance of medical campuses | ||
650 | 4 | |a Journal Article | |
650 | 4 | |a COVID-19 | |
650 | 4 | |a Postpartum contraception | |
650 | 4 | |a Postpartum sterilization | |
650 | 4 | |a Reproductive justice | |
650 | 4 | |a Telehealth | |
650 | 4 | |a Virtual visits | |
700 | 1 | |a Mauney, Logan |e verfasserin |4 aut | |
700 | 1 | |a Onwuzurike, Chiamaka |e verfasserin |4 aut | |
700 | 1 | |a Shahawy, Sarrah |e verfasserin |4 aut | |
700 | 1 | |a Schaefer, Kimberly |e verfasserin |4 aut | |
700 | 1 | |a Starosta, Anabel |e verfasserin |4 aut | |
700 | 1 | |a Ye, Sonya |e verfasserin |4 aut | |
700 | 1 | |a Bartz, Deborah |e verfasserin |4 aut | |
700 | 1 | |a Schantz-Dunn, Julianna |e verfasserin |4 aut | |
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