Provision of pregnancy care during the COVID-19 restrictions

The COVID-19 pandemics has resulted in decreasing the provision of medical care in cases without emergency. However, some health care services during pregnancy have time constraints, and one of them is antenatal care. The aim of the study was to evaluate the impact of COVID-19 and social restriction measures on health care during pregnancy. Online quantitative survey and qualitative research (using in-depth interviews and focus group discussions) were conducted from July to October 2020 as a part of the international multi-country study I-SHARE (International Sexual and Reproductive Health Survey in the time of COVID-19) and the state research project “Impact of COVID-19 on health care system and public health in Latvia; ways in preparing health sector for future epidemics” (VPP-COVID-2020/1-0011). Data were summarized and analyzed using MS Excel and IBM SPSS 26.0. 1173 Latvian inhabitants participated in the online survey – from 966 women 70 were pregnant during the COVID-19 pandemics. Almost a half (41.4%) of the pregnant women identified that their antenatal appointments were cancelled or postponed, mostly by the care provider (58.6%). More than one fourth of women (27.6%) did not attend the antenatal care appointment due to the fear of becoming infected. Care providers noted the delay in prenatal genetic screening due to the woman's self-isolation. The attitude of care providers toward pregnancy termination services differed – some claimed to understand that pregnancy termination is time-limited and included surgical termination in the list of essential services. The access to medical termination of pregnancy as the best choice during COVID-19 pandemic was not discussed in details. It is essential to define essential sexual and reproductive health services which should be available during all crises. The understanding of time-limited services provision should be discussed with health professionals, managers of the health care institutions and policy makers.