COVID-19 risk perception lowered prenatal care utilization for Indigenous women

Key takeaways:

• Prenatal care utilization among Indigenous women fell by more than 50% in Mexico during the pandemic.
• Perception of COVID-19 severity, but not susceptibility, was tied to lower odds of attending prenatal visits.

Indigenous pregnant women living in Mexico were less likely to attend antenatal appointments during the COVID-19 pandemic because of perceived fear of infection, according to study results published in BMC Pregnancy and Childbirth.

“In Mexico, the utilization of antenatal care services is widespread, with most women attending at least one antenatal care visit. Nevertheless, significant disparities persist based on ethnicity, wealth and education, particularly affecting marginalized communities,” Paulina Gómez-Chávez, MD, from the Policies, Population and Health Research Center at National Autonomous University of Mexico, and colleagues wrote. “The challenges of accessing these services have been further exacerbated by the COVID-19 pandemic, which has disrupted health systems and impeded care access for women.”

Gómez-Chávez and colleagues conducted a retrospective crossover study interviewing 98 women (mean age, 21.9 years) from San Cristóbal de las Casas, Chiapas, between June and December 2021. All participants had recurrent pregnancy with previous pregnancy occurring up to 3 years before the COVID-19 pandemic and the current or most recent pregnancy occurring during the COVID-19 pandemic. Researchers estimated the odds of having an adequate number of antenatal care visits during vs. before the COVID-19 pandemic.

Researchers found that the percentage of women who received an adequate number of antenatal visits fell from 73.5% before the pandemic to 21.4% during the pandemic (P < .05), a reduction of more than 50%. Less than half (44.9%) of women reported being concerned about COVID-19 infection for themselves or their offspring at prenatal care visits, 52% reported perceiving COVID-19 as more aggressive in pregnant women vs. the general population and 51% reported perceiving recovery from COVID-19 to be more difficult for infected pregnant women.

Prenatal care visit attendance was less likely during COVID-19 compared with before the pandemic (adjusted OR = 0.83; 95% CI, 4.8-14.5).

Women’s perception of COVID-19 severity was associated with lower odds for attending adequate prenatal care visits (OR = 0.25; 95% CI, 0.1-0.65; P < .05). Perception of COVID-19 susceptibility was not associated with prenatal care utilization.

“The significant impact of perceived fear of COVID-19 contagion on the utilization of appropriate antenatal care visits underscores the role of psychological factors in shaping health care-seeking behaviors,” the researchers wrote. “However, it is important to acknowledge that the observed reduction in care utilization may also be attributed to broader contextual factors, such as the diminished availability of health care services in Mexico.”