Gildner Theresa E, Thayer Zaneta M
Department of Anthropology, Dartmouth College, Hanover, NH, United States.
Department of Anthropology, Washington University in St. Louis, St. Louis, MO, United States.
Front Sociol. 2021 Feb 18;6:611407. doi: 10.3389/fsoc.2021.611407. eCollection 2021.
The COVID-19 pandemic has impacted maternity care decisions, including plans to change providers or delivery location due to pandemic-related restrictions and fears. A relatively unexplored question, however, is how the pandemic may shape future maternity care preferences post-pandemic. Here, we use data collected from an online convenience survey of 980 women living in the United States to evaluate how and why the pandemic has affected women's future care preferences. We hypothesize that while the majority of women will express a continued interest in hospital birth and OB/GYN care due to perceived safety of medicalized birth, a subset of women will express a new interest in out-of-hospital or "community" care in future pregnancies. However, factors such as local provider and facility availability, insurance coverage, and out-of-pocket cost could limit access to such future preferred care options. Among our predominately white, educated, and high-income sample, a total of 58 participants (5.9% of the sample) reported a novel preference for community care during future pregnancies. While the pandemic prompted the exploration of non-hospital options, the reasons women preferred community care were mostly consistent with factors described in pre-pandemic studies, (e.g. a preference for a natural birth model and a desire for more person-centered care). However, a relatively high percentage (34.5%) of participants with novel preference for community care indicated that they expected limitations in their ability to access these services. These findings highlight how the pandemic has potentially influenced maternity care preferences, with implications for how providers and policy makers should anticipate and respond to future care needs.
新冠疫情影响了孕产妇护理决策，包括因疫情相关限制和担忧而改变医疗服务提供者或分娩地点的计划。然而，一个相对未被探讨的问题是，疫情可能如何塑造疫情后未来的孕产妇护理偏好。在此，我们使用从对980名居住在美国的女性进行的在线便利调查中收集的数据，来评估疫情如何以及为何影响了女性未来的护理偏好。我们假设，虽然由于认为医疗化分娩安全，大多数女性会继续对医院分娩和妇产科护理表现出兴趣，但一部分女性会在未来怀孕时对院外或“社区”护理表现出新的兴趣。然而，当地医疗服务提供者和机构的可及性、保险覆盖范围以及自付费用等因素可能会限制获得此类未来首选护理选项的机会。在我们以白人为主、受过教育且高收入的样本中，共有58名参与者（占样本的5.9%）表示在未来怀孕时有对社区护理的新偏好。虽然疫情促使人们探索非医院选项，但女性偏好社区护理的原因大多与疫情前研究中描述的因素一致（例如，对自然分娩模式的偏好以及对更以人为本护理的渴望）。然而，对社区护理有新偏好的参与者中，相对较高比例（34.5%）的人表示，他们预计获得这些服务的能力会受到限制。这些发现凸显了疫情如何潜在地影响了孕产妇护理偏好，对医疗服务提供者和政策制定者应如何预测和应对未来的护理需求具有启示意义。
