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COVID testing hesitancy among pregnant patients: Lessons learned from the COVID-19 pandemic about the unique needs
Insights
Pregnant patients declined COVID-19 testing due to concerns about accuracy, facility exposure, and separation during labor. Understanding these barriers is crucial for future public health strategies in maternal care.
Area of Science:
- Obstetrics and Gynecology
- Infectious Disease Epidemiology
- Public Health Policy
Background:
- Pregnant individuals are a vulnerable population significantly impacted by SARS-CoV-2 infection, affecting obstetric outcomes.
- While COVID-19 testing was a key infection control measure, a subset of pregnant patients declined testing, with reasons remaining unclear.
- This study aimed to explore pregnant patients' perspectives on COVID-19 testing to inform infection prevention strategies for this medically complex group.
Approach:
- A qualitative study was conducted using in-depth telephone interviews with currently or recently pregnant patients during the early pandemic.
- An interview guide facilitated data collection, which was then coded using NVivo software.
- Grounded Theory methodology was employed for data analysis.
Key Points:
- Participants cited concerns regarding test accuracy and potential exposure to SARS-CoV-2 within testing facilities as barriers.
- Fears of isolation and separation during labor and delivery, alongside a perceived diminished healthcare quality and patient experience, were significant factors.
- Qualitative analysis revealed themes related to barriers in accessing and utilizing COVID-19 tests among pregnant patients.
Conclusions:
- Universal COVID-19 testing policies did not adequately address the specific needs and challenges faced by pregnant patients.
- Understanding the reasons and implications of COVID-19 test refusal in pregnant individuals is essential for developing effective infection prevention strategies in future health emergencies.
- Future public health initiatives must consider the unique circumstances of pregnant populations to ensure adequate healthcare and infection control.
Abstract:
Background Pregnant patients were a significant population to consider during the pandemic, given the impact of SARS-CoV-2 infection on obstetric outcomes. While COVID testing was a central pillar of infection control, it became apparent that a subset of the population declined to test. At the same time, data emerged about pregnant persons also declining to test. Yet, it was unknown why pregnant patients declined tests and if those reasons were similar or different from those of the general population. We conducted this study to explore pregnant patients' attitudes, access, and utilization of COVID-19 testing to support healthcare for infection prevention management for this unique and medically complex population. Methods We conducted a qualitative study of patients who were currently or recently pregnant during the early stages of the pandemic and received outpatient prenatal care at one of the participating study sites. An interview guide was used to conduct in-depth telephone interviews. Coding was performed using NVivo, and analysis was conducted using Grounded Theory. Results The average age of the participants (N = 37) was 32 (SD 4.21) years. Most were < 35 years of age (57%) and self-described as White (68%). Qualitative analysis identified themes related to barriers to COVID-19 testing access and use during pregnancy, including concerns about test accuracy, exposure to COVID-19 in testing facilities, isolation and separation during labor and delivery, and diminished healthcare quality and patient experience. Conclusions The implementation of widespread and universal COVID testing policies did not address the unique needs and challenges of pregnant patients as a medically complex population. It is important to understand the reasons and implications for pregnant patients who declined COVID testing during the current pandemic to inform strategies to prevent infection spread in future public health emergencies.
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