RT Journal Article
SR Electronic
T1 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)
JF BMJ Sexual & Reproductive Health
JO BMJ Sex Reprod Health
FD British Medical Journal Publishing Group
SP 260
OP 273
DO 10.1136/bmjsrh-2022-201763
VO 49
IS 4
A1 Baxter, Andrew J
A1 Geary, Rebecca S
A1 Dema, Emily
A1 Bosó Pérez, Raquel
A1 Riddell, Julie
A1 Willis, Malachi
A1 Conolly, Anne
A1 Oakley, Laura L
A1 Copas, Andrew J
A1 Gibbs, Jo
A1 Bonell, Christopher
A1 Sonnenberg, Pam
A1 Mercer, Catherine H
A1 Clifton, Soazig
A1 Field, Nigel
A1 Mitchell, Kirsten
YR 2023
UL http://jfprhc.bmj.com/content/49/4/260.abstract
AB Background Contraceptive 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 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.Results Of 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.Conclusions Just 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.Data are available in a public, open access repository. https://beta.ukdataservice.ac.uk/datacatalogue/studies/study?id=8865.