How do perceptions of Covid-19 risk influence health decisions in pregnancy? A mixed methods study

Pregnant people have experienced many difficult circumstances during the Covid-19 pandemic, which likely affected the way they made and enacted health decisions. We know that pregnant people have a higher risk of severe Covid-19 disease than non-pregnant people, resulting in higher rates of hospitalization and death. Additionally, the well-being of women has been affected by policies designed to prevent and control Covid-19 infection, which have resulted in higher rates of intimate partner violence, mental health distress, employment loss and increased childcare responsibilities. This research seeks to understand how these circumstances have changed the health decisions of pregnant people. Health decisions during pregnancy are particularly important because they have longitudinal effects on the health of the child and family. We will use administrative health data from Ontario and BC to examine how vaccination, prenatal care and place of birth, and mental health have changed between people pregnant before and during the pandemic. We will conduct qualitative interviews with people pregnant during the pandemic to understand why and how their perceptions of Covid-19 risk influenced their health decisions. For example, how did they balance need for social connection and support with Covid-19 risk precautions about physical distancing and limiting contacts outside the household? By combining these two types of data together, we will be able to describe changes and offer explanations for those changes. This new knowledge will help inform public health policy and clinical counselling decisions as the Covid-19 pandemic continues and in the future.