Experiences of Canadian perinatal care during the COVID-19 pandemic: Analysis of open-ended survey responses.

BACKGROUND

The COVID-19 pandemic caused significant socioeconomic and healthcare disruptions in Canada. COVID-19 healthcare policies and local infection rates varied considerably across Canada's geographically diverse, multijurisdictional healthcare system. Emergence of highly transmissible COVID-19 variants and widespread COVID-19 vaccination mandates in Fall 2021 further impacted life in Canada. The experiences of pregnant people, in particular, were challenged by COVID-19 outbreaks, Canadian hospital policies, and local public health restrictions.

OBJECTIVE

This study explored experiences of Canadian perinatal care in the context of the COVID-19 pandemic.

DESIGN

Online, cross-sectional survey with qualitative analysis.

METHODS

Individuals pregnant after January 1, 2020 who received perinatal care in Canada participated in our Pandemic Pregnancy Experiences eSurvey, September 1, 2021 to February 1, 2022. Open-ended survey responses were qualitatively evaluated by thematic and content analysis. Codes were identified both deductively and inductively, categorized using principles of woman-centered care, and developed into major and minor themes.

RESULTS

Prenatal care and COVID-19 vaccination experiences were evaluated from 362 participants, with 234 participants also elaborating on their labor and delivery (L&D) care. Major themes organized by woman-centered care category as follows: Choice of Healthcare Provider (good quality healthcare provider, barriers to provider of choice), Autonomy-Healthcare (autonomy empowered, autonomy impacted), Choice of Delivery Place (wanted hospital birth, got hospital birth), Choice of Support Companion(s) (no support companion for prenatal appointments, hospital restrictions L&D support companion(s)), and, Autonomy-COVID-19 Vaccination (vaccinated while pregnant/breastfeeding).

CONCLUSIONS

Pregnancy and birth experiences were generally positive; however, both COVID-19 and existing constraints of provincial/territorial healthcare systems impacted Canadian perinatal experiences. Limited choice of healthcare provider type and access to prenatal and L&D support companion(s) affected perinatal care satisfaction.