How do Perceptions of Coronavirus Disease (COVID-19) Risk Influence Health Decisions in Pregnancy?

Pregnant people have a higher risk of severe COVID-19 disease. Pregnant people have been disproportionately impacted by COVID-19 infection control policies, which have resulted in higher rates of intimate partner violence, mental health distress, employment and income loss. This project examines the impact of accumulated individual health decisions, describing how perinatal healthcare use and outcomes changed during the COVID-19 pandemic.Objectives, questions and hypothesesThis research study has two objectives:Describe differences between Pre-Pandemic (05/01/2019-12/01/2019 births), Early-Pandemic (05/01/2020-12/01/2020 births), and Late-Pandemic (05/01/2021-12/01/2021 births) pregnancy cohorts in Ontario and British Columbia relative to key outcomes and quality of care indicators related to vaccination, perinatal care, and mental health. Examine the differential impacts on racialized and low-income pregnant people. (Quantitative strand)Understand how pregnant people's perceptions of COVID-19 risk and pandemic circumstances influenced their decision-making about key elements of pregnancy, including vaccination, perinatal care, social support and mental health. (Qualitative strand)Research questions and hypotheses have been operationalized according to our three themes:Theme 1: Vaccination Theme 2: Perinatal Care Theme 3: Mental Health and Social Support

Inclusion Criteria:live, in-hospital birth during the investigators' timeframes of interestvalid birth date or death date in administrative recordsbe of female sexbeen eligible for Ontario Health Insurance Plan in Ontario or Medical Services Plan in British Columbia for the entirety of their pregnancy periodExclusion Criteria:birth outside of a hospitalstillbirth