Perinatal health care access, childbirth concerns, and birthing decision-making among pregnant people in California during COVID-19.
Perinatal health care access, childbirth concerns, and birthing decision-making among pregnant people in California during COVID-19.
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DOI：
10.1186/s12884-021-03942-y
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发表时间：
2021-07-02
影响因子：
3.1
通讯作者：
Simmons LA
中科院分区：
文献类型：
--
作者：
Whipps MDM;Phipps JE;Simmons LA
在包括COVID-19疫情在内的突发公共卫生事件期间，获得充足的医疗服务对保障家庭健康和福祉至关重要。在研究医疗保健服务时，孕妇和产后妇女是一个特别脆弱的群体。围产期人群不仅可能因COVID-19感染而患病、死亡和发病的风险更高，而且由于延迟或无法充分获得常规护理，他们也面临更高的负面结果风险。我们调查了加州的820名孕妇，调查了COVID-19大流行的两波：（1）“非激增”波（2020年6月，n = 433），以及（2）病例“激增”期间（2020年12月，n = 387），以描述目前获得围产期保健的情况，以及随着时间的推移对分娩的担忧和决策。我们还研究了现有的结构性脆弱性--包括严重的金融不安全和种族/民族少数化--是否与这两波浪潮中的准入、关切和决策有关。与2020年夏季COVID-19“平静期”期间的受访者相比，尽管COVID-19病例和住院人数激增，但加州孕妇在2020年至2021年冬季普遍享有更多围产期医疗保健服务，对围产期医疗保健的担忧减少。然而，在“激增”和“非激增”的大流行情况下，边缘化的怀孕人群的情况继续恶化----特别是那些面临严重经济困难的人，以及被认为是黑人或土著的种族少数群体。重要的是，临床医生，研究人员和政策制定者要了解社区传播和感染率的变化是否以及如何影响围产期保健的获得。针对少数民族和经济不安全的社区增加上游围产期医疗保健支持是减轻COVID-19大流行对加州孕妇的负面影响的有希望的途径。在线版本包含补充材料，可通过10.1186/s12884-021-03942-y获得。
During public health emergencies, including the COVID-19 pandemic, access to adequate healthcare is crucial for providing for the health and wellbeing of families. Pregnant and postpartum people are a particularly vulnerable subgroup to consider when studying healthcare access. Not only are perinatal people likely at higher risk for illness, mortality, and morbidity from COVID-19 infection, they are also at higher risk for negative outcomes due to delayed or inadequate access to routine care. We surveyed 820 pregnant people in California over two waves of the COVID-19 pandemic: (1) a ‘non-surge’ wave (June 2020, n = 433), and (2) during a ‘surge’ in cases (December 2020, n = 387) to describe current access to perinatal healthcare, as well as concerns and decision-making regarding childbirth, over time. We also examined whether existing structural vulnerabilities – including acute financial insecurity and racial/ethnic minoritization – are associated with access, concerns, and decision-making over these two waves. Pregnant Californians generally enjoyed more access to, and fewer concerns about, perinatal healthcare during the winter of 2020–2021, despite surging COVID-19 cases and hospitalizations, as compared to those surveyed during the COVID-19 ‘lull’ in the summer of 2020. However, across ‘surge’ and ‘non-surge’ pandemic circumstances, marginalized pregnant people continued to fare worse – especially those facing acute financial difficulty, and racially minoritized individuals identifying as Black or Indigenous. It is important for clinicians, researchers, and policymakers to understand whether and how shifting community transmission and infection rates may impact access to perinatal healthcare. Targeting minoritized and financially insecure communities for increased upstream perinatal healthcare supports are promising avenues to blunt the negative impacts of the COVID-19 pandemic on pregnant people in California. The online version contains supplementary material available at 10.1186/s12884-021-03942-y.
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影响因子：
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作者：
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通讯作者：
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影响因子：
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作者：
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通讯作者：
Elovitz MA
影响因子：
2.3
作者：
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通讯作者：
Schwartz, David A.