Fragile rights and deepened inequalities: health care for pregnant and postpartum women in the COVID-19 socio-health crisis

Abstract

The impact of the COVID-19 pandemic on women was severe. In sexual and reproductive health, it led to an increase in maternal deaths among black women. This study sought to analyze access and quality of care for pregnant and postpartum women during the pandemic. It involved an online survey, with 324 women who gave birth during the pandemic. Bivariate and multivariate analyses with logistic regression investigated the association between sociodemographic factors and reproductive outcomes. Inadequate prenatal care was associated with lower education (3.0; 1.5-5.5) and depression (2.2; 1.2-4.0); difficulty in hospitalization for the birth with ≥3 children (1.6; 1.0-2.8); difficulty in postpartum consultation being black (2.9; 1.5-5.6) and giving birth in the SUS (2.8; 1.4-5.7). Lack of professional guidance on COVID-19 was associated with non-heterosexual orientation (2.5; 1.0-5.9) and prenatal care in the SUS (1.7; 1.0-2.8); inadequate information about breastfeeding being black (2.3; 1.3-3.9), ≥3 children (1.8; 1.2-2.7) and prenatal care in the SUS (3.8; 2.2-6.5). Online surveys limit the participation of people with poor internet access, though it was possible to identify how the socio-health crisis affected women’s reproductive rights in a situation of vulnerability.