Survey: Women Are Rethinking Having Kids As They Face Pandemic Challenges

Jun 24, 2020

Whether it's online-only consultations, closed pharmacies or having to wonder whether going into an office is safe, the coronavirus has upended access to health care. And it has presented particular challenges for women and reproductive health.

A new survey released Wednesday by the Guttmacher Institute, a research group that advocates for reproductive rights, finds 34% of women said the pandemic was causing them to delay getting pregnant, or to have fewer children. A slightly smaller proportion of the roughly 2,000 women who responded to the survey also said they were struggling to access birth control during the pandemic.

"What we heard from them very clearly was that due to the COVID-19 pandemic, far fewer women want to get pregnant. And at the same time, contraception is harder for them to get," said Laura Lindberg, the study's lead researcher, in an interview with NPR's All Things Considered. "Those two opposing forces mean that people are going to have a harder time delaying pregnancies during the crisis, even as more people say they don't want to get pregnant right now."

The problems highlighted by the survey were especially pronounced among women of color. While 29% of white women said they were struggling to access birth control, among Black women and Latinas, the figures were 38% and 45%, respectively.

"Black and Hispanic women were more likely to face delays or were unable to get contraception or other care than were white women," says Lindberg. "This is what health care inequities look like in action."

Here are excerpts from the interview.

The COVID-19 pandemic has highlighted these existing racial disparities ... Is what we're seeing in terms of access to contraception, is it different, or worse, than before the pandemic?

I think it's certainly worse than before the pandemic. Couple of things are going on. So one is cost. If you've lost your job right now, you may have lost your health insurance, and that limits the kind of providers you can go to or access. Transportation, child care, physically leaving your home are all more difficult right now. That's for individuals.

For the health care providers side, we know the clinics and pharmacies and health care providers have been closed or haven't been providing as much care because of COVID-19. It's harder to get contraceptive care right now than ever before.

At the same time that many women were having more difficulty accessing contraception, they were also reporting a desire to use birth control more consistently and to delay childbearing in many cases. Why?

We found that about one-third of women said that they wanted to either delay childbearing or even have fewer children than they had prior to the pandemic. ... Women are making decisions in a time of uncertainty. The pandemic has really been a disruption in our lives. I mean, imagine, what is September going to look like if schools don't fully reopen? What's September going to look like for a working woman if infant child care no longer exists or is double the price?

What is the upshot of this? Fewer children in the next year?

Usually, I'm not willing to do a crystal ball prediction, but in this case, I think it's pretty clear we're going to have a baby bust, not a baby boom. Women are clearly expressing a desire to delay childbearing right now. And although we're only in the first few months of this pandemic, as more time passes, I think the fuller effects are still going to unfold. ... Overall, there'll be a decline in fertility, but we need to be concerned about individual women who can't get the contraception they need to achieve their own fertility goals.

Listen to the full interview at the audio link above.

Copyright 2020 NPR. To see more, visit https://www.npr.org.

SARAH MCCAMMON, HOST:

The coronavirus has upended access to health care - online-only consultations, closed pharmacies, having to wonder whether going into an office is safe. And it's presented particular challenges for women and reproductive health. A third of women in a new survey say they've struggled to get birth control during the pandemic, and many said that the pandemic is causing them to rethink their plans to have children. The survey out today is from the Guttmacher Institute, a research group that advocates for reproductive rights. I spoke earlier with the study's lead researcher Laura Lindberg.

Thanks so much for joining us.

LAURA LINDBERG: Thank you for having me today.

MCCAMMON: So first of all, why did you want to conduct this study? I mean, take us back to early in the pandemic when you began asking women these questions. Was there something you were seeing that tipped you off that there might be a problem?

LINDBERG: Yes. So we were already planning to survey women about their contraceptive use. We had a study scheduled to start in late March. And in mid-March when we looked around, we thought, we can't possibly talk to women about their contraceptive experiences right now without taking the pandemic into account.

MCCAMMON: And what did you hear from them?

LINDBERG: What we heard from them very clearly was that due to the COVID-19 pandemic, far fewer women want to get pregnant, and at the same time, contraception is harder for them to get. And those two opposing forces mean that people are going to have a harder time delaying pregnancies during the crisis even as more people say they don't want to get pregnant right now.

MCCAMMON: Right. Your survey found that about a third of women were struggling to get birth control during the pandemic. Those numbers were more pronounced for women of color. So 29% of white women reported challenges compared to 38% of Black women and 45% percent of Latinas. What's the disparity about?

LINDBERG: This COVID-19 pandemic has really compounded existing racial inequities in reproductive care. Black and Hispanic women were more likely to face delays or were unable to get contraception or other compared - other care than were white women. This is what health care inequities look like in action. At the same time, we should remember that there are also racial inequities through who gets to work from home, who risks losing their job, whose job isn't going to come back immediately even when the stay-at-home orders are lifted.

MCCAMMON: And the COVID-19 pandemic has highlighted these existing racial disparities that you describe. Is what we're seeing in terms of access to contraception - is it different or worse than before the pandemic?

LINDBERG: Yes. I think it's certainly worse than before the pandemic. A couple of things are going on. So one is cost. If you've lost your job right now, you may have lost your health insurance, and that limits the kind of providers you can go to or access. Transportation, child care, physically leaving your home are all more difficult right now. That's for individuals. For the health care provider side, we know that clinics and pharmacies and health care providers have been closed or haven't been providing as much care because of COVID-19. It's harder to get contraceptive care right now than ever before.

MCCAMMON: What is the upshot of this? Fewer children in the next year? We heard about the possibility of a baby boom from the pandemic. Can you make any predictions based on what you're seeing in the data?

LINDBERG: Usually I'm not willing to do a crystal ball prediction, but in this case, I think it's pretty clear we're going to have a baby bust, not a baby boom. Women are clearly expressing a desire to have - to delay childbearing right now. And although we're only in the first few months of this pandemic, as more time passes, I think the fuller effects are still going to unfold, and that's going to be a decline in fertility.

MCCAMMON: So a decline in fertility despite the difficulty getting access to contraception?

LINDBERG: Overall there'll be a decline in fertility. But we need to be concerned about individual women who can't get the contraception they need to achieve their own fertility goals.

MCCAMMON: Laura Lindberg is a research scientist at the Guttmacher Institute.

Thank you so much.

LINDBERG: Thank you. Transcript provided by NPR, Copyright NPR.