Financial Instability and Delays in Access to Sexual and Reproductive Health Care Due to COVID-19

Abstract

Objective: To identify prevalence of, and patient and clinic characteristics associated with, delays in access to sexual and reproductive health (SRH) care due to the COVID-19 pandemic across three states with varying COVID-19 context and state government response. Methods: We weighted data collected between May 2020 and May 2021 from monthly and biannual follow-up surveys of patients seeking family planning care at a publicly supported health center in Arizona ( N = 538), Iowa ( N = 341), and Wisconsin ( N = 568), who reported on experiences 6–18 months before the survey. We conducted multivariable logistic regression analyses to identify characteristics associated with delays in accessing SRH care due to COVID-19, with specific attention to associations between patients' financial instability and experiencing delays. Results: Between May 2020 and May 2021, over half of respondents in Arizona (57%), 38% in Iowa, and 30% in Wisconsin indicated that they were either unable to access or delayed accessing SRH care or a contraceptive method due to the COVID-19 pandemic. In Arizona and Wisconsin, in multivariable models, respondents who had experienced financial instability due to being out of work, having fallen behind on key life payments, or because of a job reduction or loss due to COVID-19 had increased odds of experiencing COVID-19-related SRH care delays (Arizona adjusted odds ratio [aOR] = 2.6, p = 0.01 and Wisconsin aOR = 6.0, p < 0.001). Conclusions: Access to contraception was curtailed during the COVID-19 pandemic, especially for those who experienced employment and financial instability. Individuals' and clinics' ability to mitigate these effects were likely dependent on state context and response to the pandemic, among other factors.

Birth Control Use and Access Including Pharmacist-Prescribed Contraception Services during COVID-19

“…The current literature on BC access during the pandemic reported challenges with obtaining refills, appointment availability, and affordability, which disproportionately affected minorities and those with financial instability. Our study confirmed emerging data that the pandemic increased worry about BC access [ 9 ] and some BC and reproductive health care access barriers existed [ 9 , 10 , 36 ].…”

“…The COVID-19 pandemic has prevented individuals from obtaining necessary reproductive health care [ 8 , 9 , 10 , 11 , 12 ]. Policies and practices enacted in response to the pandemic such as social distancing, stay-at-home orders, and limiting in-person care to “essential” procedures widened gaps in reproductive health access [ 13 ], disproportionately affecting underserved populations [ 8 , 9 , 14 ].…”

The Covid-19 Baby Bump: The Unexpected Increase in U.S. Fertility Rates in Response to the Pandemic

“…Affluent families also saw increases in the value of their assets as both stock markets and home prices soared (Cian and Rebillard, 2021). At the same time, access to reproductive health care and abortion was disrupted and, in some cases, completely shut down (Kavanaugh, 2022), which may have reduced fertility at older ages while also tending to increase unintended childbirth (Bailey et al, 2022). Also these differences make it important to examine fertility trends by demographic group in order to gain a better understanding of the role of these factors.…”

Disruptions and opportunities in sexual and reproductive health care: How COVID‐19 impacted service provision in three US states

“…While health inequities are a multi‐pronged systemic issue, determining ways to further reduce barriers to telehealth may be particularly important for Black and Latinx individuals, people of color, and people living on low‐incomes who use publicly supported health facilities for their health needs 4,5 . These groups have been more likely to experience delays in accessing SRH services during the pandemic 12 and, due to existing systemic inequities, have been disproportionately affected by COVID‐19 25,28 . Furthermore, telehealth allows increased access to health care for rural, geographically dispersed populations.…”