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New report shows a majority of women skipping prenatal care due to COVID-19

By CAROLINE BECK, Alabama Daily News

MONTGOMERY, Ala. – The coronavirus pandemic is altering pregnant women’s care and, according to a new report from Blue Cross Blue Shield, one in four women surveyed skipped prenatal care appointments since the beginning of the pandemic.

The Blue Cross Blue Shield Health of America Report on Maternal Health released on Wednesday examines 1.8 million pregnancies between 2014 and 2018 among commercially insured women ages 18-44.

The report said 61% of women surveyed saw limited office hours for their doctors and 48% had their appointments done virtually instead of in person.

Most doctor’s offices in the nation were forced to close or move to emergency appointments only once state’s enacted stay-at-home orders to reduce the spread of COVID-19.

Hospitals also changed their visitation policy and, in some cases, severely reduced the number of people in delivery rooms and the number of visitors allowed after giving birth.

The report says that 53% of women surveyed said they were not able to have a loved one in the delivery room with them, 28% delivered in a different hospital than originally planned and 15% shifted to doing a home birth.

Multiple midwives in April told Alabama Daily News they had seen an increase in interest in doing home births because of concerns over COVID-19.

Increase in pregnancy complications and postpartum depression

The report also showed that a greater number of women are entering pregnancy with pre-existing conditions, rates of pregnancy complications due to the pre-existing conditions are rising and diagnosis of postpartum depression has increased nearly 30% since 2014.

Between 2014-2018, the rates of pregnancy complications rose more than 16%, while rates for childbirth complications rose more than 14%. About seven out of every 1,000 pregnant women experienced both kinds of complications, a nearly 31% increase since 2014.

More than two-thirds of women diagnosed with postpartum depression had at least one other behavioral health diagnosis before becoming pregnant, and more than 1 in 4 women had two or more pre-existing behavioral health conditions including anxiety, major depression, and substance use disorder, the report says.

The Blue Cross Blue Shield Association also included data on the top 100 metropolitan statistical areas nationwide, which includes data on the Birmingham and Hoover area.

In 2018 there were 3,433 pregnancies in the Birmingham/ Hoover area and 3,001 deliveries. Out of 1,000 of those pregnancies, 214.1 had pregnancy complications and 76.5 had postpartum depression.

The Blue Cross Blue Shield report says that rates of complication are rising in women due to gestational diabetes and preeclampsia due to high blood pressure.

When it comes to postnatal care though, most women reported receiving the recommended postpartum care at six weeks and were screened for postpartum depression.

Blue Cross said in a press release it is expanding its access to telehealth practices for in-network providers with no member cost-sharing in addition to office visit consultations by physicians.

Blue Cross Blue Shield also said pregnant women who are concerned about attending doctor’s appointments due to COVID-19 are advised to talk with their healthcare provider about steps they are taking in their offices.

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