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Clinical Trial
. 2022 May 24;17(5):e0268698.
doi: 10.1371/journal.pone.0268698. eCollection 2022.

Postpartum during a pandemic: Challenges of low-income individuals with healthcare interactions during COVID-19

Maria V Gomez-Roas  1 , Ka'Derricka M Davis  1 , Karolina Leziak  1   2 , Jenise Jackson  1 , Brittney R Williams  1 , Joe M Feinglass  3 , William A Grobman  1 , Lynn M Yee  1
Affiliations
Clinical Trial

Postpartum during a pandemic: Challenges of low-income individuals with healthcare interactions during COVID-19

Maria V Gomez-Roas et al. PLoS One. .

Abstract

Background: Changes to the healthcare system due to COVID-19 have altered care delivery during birth and the postpartum period, a transitional time that requires intensive healthcare support and that is complicated by well-established health disparities. Our objective was to identify additional challenges to healthcare interactions that emerged for low-income postpartum individuals during the pandemic.

Methods: This is a qualitative investigation of low-income postpartum individuals enrolled in a trial of postpartum care, who gave birth in the United States in the first three months of the COVID-19 pandemic. Participants completed in-depth semi-structured interviews that addressed healthcare experiences during and after birth, both for in-person and telemedicine encounters. Transcripts were analyzed using the constant comparative method.

Results: Of 46 eligible individuals, 87% (N = 40) completed an interview, with 50% identifying as non-Hispanic Black and 38% as Hispanic. Challenges were organized into three domains: unanticipated changes in the birth experience, delayed care, and perceived disadvantages of telemedicine. Changes in the birth experience addressed uncertainty about COVID-19 status, COVID-19 testing, separation from newborn, and visitor restrictions. Delayed care themes addressed logistical challenges, postpartum care, health maintenance, and pediatric care. Participants reported multiple telemedicine-related challenges, including difficulty establishing rapport with providers.

Conclusions: Understanding the challenges experienced by low-income peripartum individuals as the COVID-19 pandemic evolves is critical to informing guidelines and diminishing inequities in healthcare delivery. Potential solutions that may mitigate limitations to care in the pandemic include emphasizing shared decision-making in care processes and developing communication strategies to improve telemedicine rapport.

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Conflict of interest statement

The authors have declared that no competing interests exist.

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