Association Between the Coronavirus Disease 2019 (COVID-19) Pandemic and National Disparities in Postpartum Visit Attendance

Abstract

This study used data from PRAMS (Pregnancy Risk Assessment Monitoring System) between 2016 and 2020 and found that postpartum visit attendance declined by 5.8 (95% CI -6.4 to -5.2) percentage points in the first 9 months of the coronavirus disease 2019 (COVID-19) pandemic. The greatest declines occurred among non-Hispanic Black individuals (-9.9, 95% CI -11.6 to -8.1 percentage points), individuals aged 19 years or younger (-9.9, 95% CI -13.5 to -6.2 percentage points), and individuals without postpartum insurance (-11.4, 95% CI -14.5 to -8.3 percentage points). Although the pandemic was associated with a decrease in reporting common barriers to attendance, including lack of transportation and not being able to leave work, it introduced new barriers that potentially contributed to widened disparities in postpartum care. A combination of health policy and health system approaches are needed to increase postpartum visit attendance and reduce disparities in use.

Fig. 1.

Change in postpartum visit attendance after the start of the coronavirus disease 2019 (COVID-19) pandemic in the overall sample of postpartum individuals and by subgroup, PRAMS (Pregnancy Risk Assessment Monitoring System), January 2016–December 2020. Responses from 45 states; Washington, DC; and New York City. Error bars represent 95% Cls. All P<001. *All non-Hispanic race groups aside from White, Asian, and Black. Bellerose. COVID-19 and Disparities in Postpartum Care Use. Obstet Gynecol 2023.

Fig. 2.

Change in reasons for not attending a postpartum visit after the start of the coronavirus disease 2019 (COVID-19) pandemic, PRAMS (Pregnancy Risk Assessment Monitoring System), January 2016–December 2020. Error bars represent 95% Cls. Responses are from the seven states (Arizona, Illinois, lowa, Maryland, Utah, Virginia, and Wisconsin) that asked respondents who reported that they did not attend a postpartum visit, “Did any of these things keep you from having a postpartum check?” (n=2,290). Bellerose. COVID-19 and Disparities in Postpartum Care Use. Obstet Gynecol 2023.