Pregnancy During the COVID-19 Pandemic: Communicated Narrative Sense-Making and Resilience

Early-Pregnancy Resilience Characteristics before versus during the COVID-19 Pandemic

“…In particular, the stress, uncertainty and isolation has yielded major mental health concerns across populations 1 . During pregnancy and the first year postpartum, herein referred to as the 'perinatal' period, people were uniquely vulnerable to the negative effects of the pandemic, and multiple studies have identified worsening mental health among those delivering during the pandemic [2][3][4] . Mental health conditions are already the most common pregnancy-related complication, impacting up to one in five pregnant people, 5 and are associated with long and short term maternal morbidity, 6,7 as well as impaired maternal-child attachment 8,9 .…”

Editorial: Meeting the Needs of Federally Qualified Health Center Patients Following the Public Health Emergency Unwinding

“…For example, temporary policies enabled FQHCs to facilitate patient access to care via telehealth. Billions of dollars in federal grant funding were used to improve infrastructure, increase staff capacity, and assist FQHCs in maintaining financial protection when service utilization and revenues substantially decreased (Horstman, 2023). Furthermore, the pause on Medicaid redeterminations enabled millions of patients to maintain access to health insurance coverage, while ensuring that FQHCs were reimbursed for patient visits.…”

“…As such, FQHCs, which often operate within tight financial margins and heavily rely on Medicaid revenue, will likely see increases in uncompensated care as patients lose health insurance coverage. It is estimated that Medicaid redeterminations could lead to a loss of up to $2.5 billion in revenue for FQHCs (Horstman, 2023; Ku et al, 2023). Medicaid redeterminations not only threaten FQHCs' ability to invest in new resources (eg, technology, staffing, enabling services) but can also potentially impact their ability to deliver ongoing health services.…”

“…Although telehealth flexibilities for Medicaid were not tied to the federal PHE and vary by state, most state Medicaid programs have ended at least some of their telehealth-related flexibilities that were present during the pandemic. Going forward, inadequate payer reimbursement for telehealth services—including the types of services covered, the modalities covered, and the level of reimbursement—may result in declines in FQHC access following the PHE unwinding to the extent that telehealth improved access to FQHC services, as suggested by the literature (Cole, Lee et al, 2022; Horstman, 2023; Kim et al, 2020; Tierney et al, 2023).…”

“…In addition, it is possible that following the PHE unwinding and Medicaid redetermination, some FQHC patients may lack financial protection due to health insurance loss, leading to increases in patient-reported unmet social needs. Although there are many challenges to screening for social risk factors and addressing patient unmet social needs in clinical settings, staffing shortages stemming from federal funding cliffs and reductions in Medicaid reimbursement, in particular, will limit FQHCs' abilities to provide these supportive services (Cole, Nguyen et al, 2022; Horstman, 2023; Kaiser Family Foundation, 2022).…”