Contraceptive and pregnancy concerns in the UK during the first COVID-19 lockdown: A rapid study

Hammond, Natalie; Steels, Stephanie; King, G

doi:10.1016/j.srhc.2022.100754

Cited by 5 publications

(8 citation statements)

References 29 publications

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“…165-167 195 196 Increased use of online recruitment and data collection was identified following the onset of the COVID-19 pandemic. [145][146][147][148][149][150] Developments in RCT design were also seen over this period. 173 174 176-179 At later stages of the evaluation process we identified continuous or contemporaneous data collection or data analyses as a means to increase rapidity of evaluation in RCTs and other quantitative study designs.…”

Section: Adaptation Of Part Of a Standard Evaluation Methodsmentioning

confidence: 97%

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Approaches to enabling rapid evaluation of innovations in health and social care: a scoping review of evidence from high-income countries

et al. 2022

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ObjectiveThe COVID-19 pandemic increased the demand for rapid evaluation of innovation in health and social care. Assessment of rapid methodologies is lacking although challenges in ensuring rigour and effective use of resources are known. We mapped reports of rapid evaluations of health and social care innovations, categorised different approaches to rapid evaluation, explored comparative benefits of rapid evaluation, and identified knowledge gaps.DesignScoping review.Data sourcesMEDLINE, EMBASE and Health Management Information Consortium (HMIC) databases were searched through 13 September 2022.Eligibility criteria for selecting studiesWe included publications reporting primary research or methods for rapid evaluation of interventions or services in health and social care in high-income countries.Data extraction and synthesisTwo reviewers developed and piloted a data extraction form. One reviewer extracted data, a second reviewer checked 10% of the studies; disagreements and uncertainty were resolved through consensus. We used narrative synthesis to map different approaches to conducting rapid evaluation.ResultsWe identified 16 759 records and included 162 which met inclusion criteria.We identified four main approaches for rapid evaluation: (1) Using methodology designed specifically for rapid evaluation; (2) Increasing rapidity by doing less or using less time-intensive methodology; (3) Using alternative technologies and/or data to increase speed of existing evaluation method; (4) Adapting part of non-rapid evaluation.The COVID-19 pandemic resulted in an increase in publications and some limited changes in identified methods. We found little research comparing rapid and non-rapid evaluation.ConclusionsWe found a lack of clarity about what ‘rapid evaluation’ means but identified some useful preliminary categories. There is a need for clarity and consistency about what constitutes rapid evaluation; consistent terminology in reporting evaluations as rapid; development of specific methodologies for making evaluation more rapid; and assessment of advantages and disadvantages of rapid methodology in terms of rigour, cost and impact.

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Section: Adaptation Of Part Of a Standard Evaluation Methodsmentioning

confidence: 97%

“…Joseph and Goddard, Demeulemeester et al, Banga et al 140-142 Using an online survey Survey hosted on webpage and/or social media sites. Attal et al, Daviskiba et al, Elsawy et al, Hammond et al; Khubchandani et al, Talati et al, Petrella et al[145][146][147][148][149][150]…”

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confidence: 99%

Approaches to enabling rapid evaluation of innovations in health and social care: a scoping review of evidence from high-income countries

et al. 2022

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“…Although aiming for equitable access,4 5 rapid adaptions during the pandemic had the potential to exacerbate inequalities, particularly if these required digital access and literacy 6 7. Service users might also interpret adaptations as de-prioritising contraceptive services,8 and we know that some patients self-censored their needs or were anxious about COVID-19 risk if accessing services in person 9. Overall, people in the UK and globally struggled to access contraception during lockdowns,1 10–14 and prescribing data for the UK showed substantial drops in LARCs fitted in 2020 versus 2019 15.…”

Section: Introductionmentioning

confidence: 99%

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)

Baxter

Geary

Dema

et al. 2023

BMJ Sex Reprod Health

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BackgroundContraceptive services were significantly disrupted during the COVID-19 pandemic in Britain. We investigated contraception-related health inequalities in the first year of the pandemic.MethodsNatsal-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.ResultsOf 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.ConclusionsJust 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.

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“…Although aiming for equitable access, 4,5 rapid adaptions during the pandemic had the potential to exacerbate inequalities, particularly if these required digital access and literacy. 6,7 Service users might also interpret adaptations as de-prioritising contraceptive services, 8 and we know that some patients self-censored their needs or were anxious about COVID-19 risk if accessing services in person. 9 Overall, people in the UK and globally struggled to access contraception during lockdowns, 1,10–14 and prescribing data for the UK showed substantial drops in LARCs fitted in 2020 versus 2019.…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies have indicated difficulties accessing contraception, alongside changing sexual risk behaviours, however these often used small convenience samples in the early stages of the pandemic. 8,14,17,18 The Natsal-COVID study, a large national survey of sexual and reproductive health, was set up to address gaps in representativeness of studies and a lack of detailed information about the ongoing effects of the pandemic. Wave 1 findings (conducted four months after the first UK national lockdown) suggested young women were most likely to switch contraceptive and face barriers to sexual health service access.…”

Section: Introductionmentioning

confidence: 99%

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)

Baxter

Geary

Dema

et al. 2022

Preprint

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Background Reproductive health 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 6,658 adults aged 18-59 between March-April 2021, using quotas and weighting to achieve quasi-representativeness. Our analysis included sexually active participants aged 18-44, described as female at birth. We analysed contraception use and switching, contraceptive service access, and pregnancy plannedness in the year from March 2020. Findings Amongst all participants (n=1,488), 14.3% (12.5%-16.3%) reported switching or stopping contraception due to the pandemic. Of participants at risk of unplanned pregnancy (n=1,169), 54.1% (51.0%-57.1%) reported routinely using effective contraception in the past year. 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. Stopping/switching was more likely amongst participants of younger age, non-white ethnicity, and lower social grade. 29.3% of at-risk participants (26.9%-31.8%) reported trying to access contraceptive services; of whom 16.4% (13.0%-20.4%) reported their needs went unmet. Unmet need was associated with younger age, diverse sexual identities and anxiety symptoms. Of 199 pregnancies, 6.6% (3.9%-11.1%) were scored as 'unplanned'; less planning was associated with younger age, lower social grade and unemployment. Interpretation Although many participants reported accessing contraceptive services during the pandemic, one-in-six of these reported an unmet need. Inequalities in unmet need and risk of unplanned pregnancy - related to age, ethnicity, social disadvantage and mental health - potentially exacerbated existing reproductive health inequalities. These should be addressed in the post-pandemic period and beyond.

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Contraceptive and pregnancy concerns in the UK during the first COVID-19 lockdown: A rapid study

Cited by 5 publications

References 29 publications

Approaches to enabling rapid evaluation of innovations in health and social care: a scoping review of evidence from high-income countries

Approaches to enabling rapid evaluation of innovations in health and social care: a scoping review of evidence from high-income countries

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)

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)

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