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Impact of the SARS-CoV-2 pandemic on access to contraception and pregnancy intentions: a national prospective cohort study of the UK population.
Balachandren, Neerujah; Barrett, Geraldine; Stephenson, Judith M; Yasmin, Ephia; Mavrelos, Dimitrios; Davies, Melanie; David, Anna; Hall, Jennifer Anne.
  • Balachandren N; Reproductive Medicine Unit, University College London Hospitals NHS Foundation Trust, London, UK.
  • Barrett G; EGA Institute for Womens Health, University College London Medical School, London, UK.
  • Stephenson JM; EGA Institute for Womens Health, University College London Medical School, London, UK.
  • Yasmin E; Reproductive Medicine Unit, University College London Hospitals NHS Foundation Trust, London, UK.
  • Mavrelos D; Reproductive Medicine Unit, University College London Hospitals NHS Foundation Trust, London, UK.
  • Davies M; Reproductive Medicine Unit, University College London Hospitals NHS Foundation Trust, London, UK.
  • David A; EGA Institute for Womens Health, University College London Medical School, London, UK.
  • Hall JA; EGA Institute for Womens Health, University College London Medical School, London, UK jennifer.hall@ucl.ac.uk.
BMJ Sex Reprod Health ; 48(1): 60-65, 2022 01.
Article in English | MEDLINE | ID: covidwho-1484040
ABSTRACT

OBJECTIVE:

Evaluate the impact of the COVID-19 pandemic on access to contraception and pregnancy intentions.

DESIGN:

Nationwide prospective cohort study.

SETTING:

United Kingdom.

PARTICIPANTS:

Women in the UK who were pregnant between 24 May and 31 December 2020. MAIN OUTCOME

MEASURES:

Access to contraception and level of pregnancy intentions, using the London Measure of Unplanned Pregnancy (LMUP) in women whose last menstrual period was before or after 1 April 2020. While the official date of the first UK lockdown was 23 March, we used 1 April to ensure that those in the post-lockdown group would have faced restrictions in the month that they conceived.

RESULTS:

A total of 9784 women enrolled in the cohort 4114 (42.0%) conceived pre-lockdown and 5670 (58.0%) conceived post-lockdown. The proportion of women reporting difficulties accessing contraception was higher in those who conceived after lockdown (n=366, 6.5% vs n=25, 0.6%, p<0.001) and continued to rise from March to September 2020. After adjusting for confounders, women were nine times more likely to report difficulty accessing contraception after lockdown (adjusted odds ratio (aOR) 8.96, 95% CI 5.89 to 13.63, p<0.001). There is a significant difference in the levels of pregnancy planning, with higher proportions of unplanned (n=119, 2.1% vs n=55, 1.3%) and ambivalent pregnancies (n=1163, 20.5% vs n=663, 16.1%) and lower proportions of planned pregnancies (n=4388, 77.4% vs n=3396, 82.5%) in the post-lockdown group (p<0.001). After adjusting for confounders, women who conceived after lockdown were still significantly less likely to have a planned pregnancy (aOR 0.88, 95% CI 0.79 to 0.98, p=0.025).

CONCLUSIONS:

Access to contraception in the UK has become harder during the COVID-19 pandemic and the proportion of unplanned pregnancies has almost doubled.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: SARS-CoV-2 / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Limits: Female / Humans / Pregnancy Language: English Journal: BMJ Sex Reprod Health Year: 2022 Document Type: Article Affiliation country: Bmjsrh-2021-201164

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Full text: Available Collection: International databases Database: MEDLINE Main subject: SARS-CoV-2 / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Limits: Female / Humans / Pregnancy Language: English Journal: BMJ Sex Reprod Health Year: 2022 Document Type: Article Affiliation country: Bmjsrh-2021-201164