Exploring factors associated with pregnant women’s experiences of material hardship during COVID-19: a cross-sectional Qualtrics survey in the United States

Abstract

Background The COVID-19 pandemic has exacerbated the financial insecurity of women and their families globally. Some studies have explored the impact of financial strain among pregnant women, in particular, during the pandemic. However, less is known about the factors associated with pregnant women’s experiences of material hardship. Methods This cross-sectional study used a non-probability sample to examine the factors associated with pregnant women’s experiences of material hardship during the COVID-19 pandemic. In January 2021, 183 pregnant women living in the United States participated in an online Qualtrics panel survey. In addition to socio-demographic characteristics, individuals were asked about their finances and predictors of financial well-being, mental health symptoms, and intimate partner violence (IPV) experiences. Chi-square analysis and one-way ANOVA were used to examine whether women’s experiences with material hardship and associated factors differed by income level (i.e., less than $20,000; $20,000 to $60,000; more than $60,000). Ordinary least squares regression was used to calculate unadjusted and adjusted estimates. Results Study findings showed that the majority of women in the sample experienced at least one form of material hardship in the past year. Individuals with an annual household income less than $20,000 reported the highest average number of material hardships experienced (M = 3.7, SD = 2.8). Compared to women with household incomes less than $20,000, women with incomes of more than $60,000 reported significantly fewer material hardships, less financial strain, and higher levels of financial support, economic self-efficacy, and economic-self-sufficiency. Women with incomes of $60,000 or more also reported significantly lower levels of psychological abuse, and a smaller percentage met the cut-off for anxiety. Economic self-sufficiency, financial strain, posttraumatic stress disorder, and economic abuse were all significantly associated with material hardship. Conclusions A contribution of this study is that it highlights the significant, positive association between economic abuse, a unique form of IPV, and material hardship among pregnant women during the pandemic. These findings suggest the need for policy and practice interventions that help to ameliorate the financial insecurity experienced by some pregnant women, as well as respond to associated bidirectional vulnerabilities (e.g., mental health symptoms, experiences of IPV).

Financial Disruption and Psychological Underpinning During COVID-19: A Review and Research Agenda

“…The poor coverage of health insurance and financial problems forced people to postpone or avoid the institutional services related to pregnancy antenatal care ( Abufaraj et al, 2021 ; Johnson, 2021 ), child care ( Vance et al, 2021 ), and postponement of childbearing intentions ( Malicka et al, 2021 ). Rapid coverage of health insurance policies ( Abufaraj et al, 2021 ), counseling for childbearing and family planning, social security schemes, financial support for pregnant women ( Johnson, 2021 ), and neonatal care and improving public health facilities ( Letourneau et al, 2021 ) are some health-related measures to cope with these challenges. Healthcare workers struggled for better packages matching their efforts for defending COVID-19, especially nurses ( Akkuş et al, 2021 ; Cho et al, 2021 ); orthopedic surgeons ( Attarde et al, 2021 ); otorhinolaryngologists ( Dosemane et al, 2021 ); and dentists ( Kumar et al, 2021 ).…”

“…A study on Jordan related to the gender disparities and healthcare facilities during COVID-19 has found that the limited coverage of the health insurance coverage, reduced payments, denial of payment to women during the COVID-19, and job losses affected the financial wellbeing and the pregnant women were unable to undertake the antenatal care ( Abufaraj et al, 2021 ; Mecik et al, 2022 ; Stevenson et al, 2022 ). The financial challenges of pregnant women during COVID-19 were also identified in the study ( Johnson, 2021 ). Child care is another important segment affected by the financial distress by COVID-19 ( Vance et al, 2021 ).…”

“…The financial struggles of vulnerable sections through financial support ( Hahlweg et al, 2020 ); financial support or assistance through social security schemes can alleviate the financial and psychological distress due to the COVID-19 ( Jha et al, 2021 ). The challenges for the healthcare facilities due to financial issues in COVID can be through better healthcare coverages ( Abufaraj et al, 2021 ); publicly funded healthcare systems ( Letourneau et al, 2021 ); and financial support for pregnant women ( Johnson, 2021 ). Promoting the psychological health of entrepreneurs ( St-Jean and Tremblay, 2021 ).…”

Point prevalence and sex-specific associated factors of depression in Latvian general population

“…Previously, there were no studies on the level of financial abuse or elements of the patriarchal form of relationships in families in Latvia, but our theoretical assumption is that it is likely that financial dependence during periods of economic inactivity is an aggravating factor for the development of mental health problems. For example, one recent study during the COVID-19 pandemic in the United States found that the percentage of women who experienced at least one form of economic violence while on maternity leave was quite high (approximately 65%) ( 54 ).…”

Someone you can count on: Examining the mediating effect of social support on economic abuse and depression

“…A smaller body of research has looked specifically at the effects of economic abuse during pregnancy or postpartum. Among a sample of pregnant women, Johnson (2021) found that economic abuse was significantly associated with material hardship. Gürkan et al (2020) found that experiencing economic abuse during pregnancy was associated with increased reported tiredness/fatigue and mental health symptomology; Kapiga et al (2017) also found a significant association between economic abuse and poor mental health during pregnancy.…”