Declines in contraceptive visits in the United States during the COVID-19 pandemic

Maria W Steenland, Caroline K Geiger, Lucy Chen, Slawa Rokicki, Rebecca A Gourevitch, Anna D Sinaiko, Jessica L Cohen, Maria W Steenland, Caroline K Geiger, Lucy Chen, Slawa Rokicki, Rebecca A Gourevitch, Anna D Sinaiko, Jessica L Cohen

Abstract

Objective: To document the change in contraceptive visits in the United States during the COVID-19 pandemic.

Study design: Using a nationwide sample of claims we analyzed the immediate and sustained changes in contraceptive visits during the pandemic by calculating the percentage change in number of visits between May 2019 and April 2020 and between December 2019 and December 2020, respectively. We examined these changes by contraceptive method, region, age, and use of telehealth, and separately for postpartum individuals.

Results: Relative to May 2019, in April 2020, visits for tubal ligation declined by 65% (95% CI, -65.5, -64.1), LARCs by 46% (95% CI, -47.0, -45.6), pill, patch, or ring by 45% (95% CI, -45.8, -44.5), and injectables by 16% (95% CI -17.2, -15.4). The sustained change in visits in December 2020 was larger for tubal ligation (-18%, 95% CI, -19.1, -16.8) and injectable (-11%, 95% CI, -11.4, -9.6) visits than for LARC (-6%, 95% CI, -6.6, -4.4) and pill, patch, and ring (-5%, 95% CI, -5.7, -3.7) visits. The immediate decline was highest in the Northeast and Midwest regions. Declines among postpartum individuals were smaller but still substantial.

Conclusions: There were large declines in contraceptive visits at the start of the COVID-19 pandemic and visit numbers remained below pre-pandemic levels through the end of 2020.

Implications: Declines in contraceptive visits during the pandemic suggest that many people faced difficulties accessing this essential health service during the COVID-19 pandemic.

Keywords: COVID-19; Contraception; Contraceptive access; Family planning; Health services; Pandemic; Telehealth.

Copyright © 2021 Elsevier Inc. All rights reserved.

Figures

Fig. 1
Fig. 1
Percent change in contraceptive visits relative to May 2019 by contraceptive method, United States, May 2019 to December 2020
Fig. 2
Fig. 2
Percent change in contraceptive visits during the COVID-19 pandemic, immediately (between May 2019 and April 2020) and sustained (between December 2019 and December 2020) in the United States NOTE: Percent change for tubal ligation among adolescents not shown due to the small number of observations for this group. Northeast CT, MA, ME, NH, NJ, NY, RI, VT, DE, PA; South DC, MD, NC, SC, VA, WV, AL, FL, GA, MS, TN, AR, LA, OK, TX; Midwest IN, KY, MI, OH, IA, MN, MT, ND, SD, WI, IL, KS, MO, NE; West AZ, CO, ID, NM, NV, UT, WY, AK, CA, HI, OP, WA
Fig. 3
Fig. 3
Trends in the percent of postpartum individuals with a contraceptive visit relative to May 2019 by contraceptive method, United States, May 2019 to September 2020 Note: The x-axis represents the month when the childbirth took place. Each point measures the percent of individuals who had a contraceptive visit within 3 months after childbirth.
Fig. 4
Fig. 4
Trends in the percent of total visits for the contraceptive pill, patch and ring conducted through telehealth by payer, United States, May 2019 to December 2020

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Source: PubMed

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