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).

IF 3.4 3区 医学 Q1 FAMILY STUDIES
BMJ Sexual & Reproductive Health Pub Date : 2023-10-01 Epub Date: 2023-03-23 DOI:10.1136/bmjsrh-2022-201763
Andrew J Baxter, Rebecca S Geary, Emily Dema, Raquel Bosó Pérez, Julie Riddell, Malachi Willis, Anne Conolly, Laura L Oakley, Andrew J Copas, Jo Gibbs, Christopher Bonell, Pam Sonnenberg, Catherine H Mercer, Soazig Clifton, Nigel Field, Kirsten Mitchell
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引用次数: 0

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.

Abstract Image

新冠肺炎大流行第一年英国的避孕药具使用和怀孕计划:一项大型准代表性调查(Natsal-COVID)的结果。
背景:在英国新冠肺炎大流行期间,避孕服务受到严重干扰。我们调查了新冠疫情第一年与避孕相关的健康不平等现象。方法:Natsal COVID Wave 2在2021年3月至4月期间调查了6658名18-59岁的成年人,使用配额和权重来实现准代表性。我们的分析包括18-44岁的性活跃参与者,他们在出生时被描述为女性。我们分析了避孕药具的使用、因疫情而改变的避孕药具、避孕服务的可及性和妊娠计划。结果:在1488名参与者中,1619人有计划外怀孕的风险,其中54.1%(51.0%-57.1%)的人报告在过去一年中常规使用了有效的避孕措施。在所有参与者中,14.3%(12.5%至16.3%)的人报告称,由于疫情,他们改变或停止了避孕措施。3.2%(2.0%-5.1%)在疫情前使用有效方法的人转而使用效果较差的方法,3.8%(2.5%-5.9%)停止使用。29.3%(26.9%-31.8%)的高危参与者报告寻求避孕服务,其中16.4%(13.0%-20.4%)报告难以获得服务。据报道,诊所关闭和预约取消通常是与疫情相关的难以获得服务的原因。这种未满足的需求与年龄较小、性身份多样化和焦虑症状有关。在199例妊娠中,6.6%(3.9%-11.1%)被评为“计划外”;计划较少与年龄较小、社会等级较低和失业率有关。结论:不到三分之一的参与者在疫情期间寻求避孕服务,大多数都获得了成功,这表明服务提供的弹性和适应性。然而,六分之一的人报告说,由于疫情,需求没有得到满足。新冠肺炎引发的服务获取不平等可能加剧现有的生殖健康不平等。这些问题应在疫情后时期及以后加以解决。
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来源期刊
BMJ Sexual & Reproductive Health
BMJ Sexual & Reproductive Health Medicine-Reproductive Medicine
CiteScore
5.10
自引率
6.10%
发文量
38
期刊介绍: BMJ Sexual & Reproductive Health is a multiprofessional journal that promotes sexual and reproductive health and wellbeing, and best contraceptive practice, worldwide. It publishes research, debate and comment to inform policy and practice, and recognises the importance of professional-patient partnership.
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