The Role of COVID-19, Race and Social Factors in Pregnancy Experiences in New York State: The CAP Study

Abstract

Given that New York State’s (NYS) was the first epicenter of the COVID-19 pandemic in the United States (US), we were interested in potential racial/ethnic differences in pregnancy-related experiences among women pregnant during versus prior to the pandemic. We surveyed 1,525 women (18–44 years) proportionate to geographic and sociodemographic distribution between June 9, 20 and July 21, 20. We carried out bivariate analysis of various social and pregnancy-related factors by racial/ethnic identity (White, Black, Hispanic) and binary logistic and linear regression assessing the association between race/ethnicity, pregnancy prior to/during the pandemic, demographic characteristics, health and social wellbeing, and employment as an essential worker with pregnancy-related healthcare delays and changes. Overall, Black and Hispanic women were significantly more likely to experience a host of negative prenatal and postpartum experiences. In general, multivariate analyses revealed that individuals who were pregnant during the pandemic, lived in NYC, participated in social welfare programs, lacked health insurance, and/or were essential workers were more likely to report delays in prenatal and postpartum care and/or more changes/negative experiences. In light of previous evidence of racial disparities in birth experiences, the higher rates of negative pregnancy/birth-care and postpartum/newborn-care experiences among Black and Hispanic women in bivariate analysis warrant further inspection given that their aggregation for multivariate analysis may have obscured differences at the level of individual events. Findings support continued efforts for universal health insurance and improved social welfare programs. Guidelines are needed to protect essential workers’ access to health services, particularly related to pregnancy given the time-sensitive nature of this care.

Supplemental data for this article is available online at https://doi.org/10.1080/08964289.2021.1997893 .

Keywords:

• Pregnancy
• healthcare
• COVID-19 pandemic
• race/ethnicity
• social-ecologic framework

Acknowledgements

We would like to acknowledge the research assistance of Rebecca Berger, MPH, Jessie Losch, MPH, and Sarah Pickering, MPH, in the development of the study materials, data collection process, and background research. We are very grateful for the survey design research support provided by Laura Ansley Hobbs, MPH. We are also grateful for the participation of the survey respondents, who shared personal information with us during a very challenging period of their lives.

Disclosure statement

The authors have no financial or other potential conflicts of interest to disclose.

Additional information

Funding

This work was supported by a research grant from the CUNY Graduate School of Public Health and Health Policy.