By continuing to use our site, or clicking "Continue," you are agreeing to our, Figure. >> Moreover, some specific antenatal examinations such as the Nuchal Translucency test, Down syndrome screening, and the Oral Glucose Tolerance Test should be completed in a hospital. 2022;12(4):e060185. Medical experts and institutions should strengthen the quality of online antenatal care in terms of skilled professional services, technology, and availability. London Royal College of Obstetricians and Gynaecologists; 2020. However, the popularity of online antenatal care programs remains low. 6 Descriptive statistics and multivariate analysis were used for quantitative analyses; qualitative content analysis was used for open-ended questions. The median monthly sample size in the months before COVID-19 was 4085 (range, 3655-5040), with a mean of 4189. >> Of 100005 pregnancies (95412 women), 26% were Asian or Pacific Islander; 7%, Black; 28%, Hispanic; 34%, non-Hispanic White; and 5%, other, unknown, or multiracial. Role of the Funder/Sponsor: The National Institute on Drug Abuse had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. Antenatal care; COVID-19; Pandemic; Philippines. Maternal and perinatal outcomes with COVID19: A systematic review of 108 pregnancies. WebThis document provide guidance to maintain antenatal and postnatal care for all women during COVID-19. During the pandemic, daily necessities were scarce and the cost of medical appointments was substantially higher than usual. Would you like email updates of new search results? Therefore, the number of visits and interval between them has not changed and only the method of delivery care has altered. Methods Background: Moreover, women can upload their daily blood pressure and simple home urine dipsticks results to an online system. This e-mail address is being protected from spambots. HH, Basaldua The fear of the Covid-19 pandemic had a cross-cutting effect on utilisation of maternity services in selected levels III and IV public health facilities within five MNCH , Medical and Nonmedical Cannabis Use Among Pregnant Women in the United States. R. In the current situation, home based care model can be considered when pregnant women are stable enough to receive care and enough midwifes and adequate health care are available. Further research includes pilot studies to explore the acceptability of the model and recommendation implementation in practice. An umbrella review to explore the barriers and facilitators to Influenza, Pertussis and COVID-19 vaccination during pregnancy and within 2 years after childbirth, and to inform interventions to encourage uptake (PROSPERO registration number: CRD42022327624). Published on Given that, most instances of COVID-19 have resulted from human-to-human transmission, so decreased schedule of antenatal consideration visits at the facility is proper to minimize overcrowding in facilities and therefore the risk of virus transmission (3,4). MH, Meyer Zaigham MAO. Most respondents (71.38%) initiated antenatal care during the first trimester. It may be preferable, as providing care for the woman and everyone in her household is ideal (3,7-9) .General principles in home visiting during COVID-19 pandemic include: preparing the cares which likely to be required during the home visit, minimizing equipment to be taken into the home and maintaining infection prevention and control standards (e.g. 59c#QmJ\r\)Ez) The Lancet Public Health 2020 May;5(5):e240 [, Wang N, Deng Z, Wen LM, Ding Y, He G. Understanding the Use of Smartphone Apps for Health Information Among Pregnant Chinese Women: Mixed Methods Study. 2021;326(17):17451747. The fear of the Covid-19 pandemic had a cross-cutting effect on utilisation of maternity services in selected levels III and IV public health facilities within five MNCH priority counties in Kenya. Hubungan Tingkat Kecemasan Ibu Hamil pada Masa Pandemi Covid-19 Kepatuhan Melakukan Antenatal Care di Rumah Sakit Abdul Moeloek Bandar Lampung March 2023 DOI: 10.35912/jimi.v2i2.1431 Meeker M. Internet Trends 2019. WebFigure 3. National Library of Medicine During the pandemic, patients completed toxicology testing slightly earlier in their pregnancies (before pandemic mean, 8.51 weeks gestation; during pandemic mean, 8.04 weeks gestation). Please enable it to take advantage of the complete set of features! HHS Vulnerability Disclosure, Help document.write( ' Ming W Online Antenatal Care During the COVID-19 Pandemic: Opportunities and Challenges J Med Internet Res 2020;22(7):e19916 doi: However, in certain circumstances, antenatal care in hospitals is irreplaceable (eg, high-risk pregnant women with or at risk of vaginal bleeding, abdominal pain, or other serious discomforts) [18]. midwife) (3,7,9). Webrestricted antenatal visits.10 During the COVID-19 pandemic, some Australian hospitals have decided to reduce in-person antenatal visits to only three for low-risk women Jan 2022 - Present1 year 2 months. Disclaimer. For example, online antenatal care programs may guide pregnant women to perform blood and urine glucose tests at regular intervals, especially for those with or at high risk of gestational diabetes mellitus (GDM). Notice on strengthening maternal disease treatment and safe midwifery during the prevention and control of new coronavirus pneumonia (in Chinese). This cross-sectional study examines the association of cannabis retailer proximity and density with cannabis use among pregnant women after legalization of cannabis for recreational use in California. document.write( '<\/a>' ); Women with suspected or confirmed COVID-19 should be advised not to attend in clinics. var suffix = ''; 8600 Rockville Pike In March 2020, the World Health Organisation named the severe acute respiratory syndrome coronavirus 2 (Sars-CoV-2), which causes corona virus disease 2020;(January). There is a need for the provision of supportive care, both formally and informally, particularly with women who may be more vulnerable during a pandemic. Currently, concentrating on COVID-19 would possibly distract pregnant women from routine antenatal care. Almost half reported deferrals of visits mainly due to lockdown restrictions, transportation problems, and financial issues. The study aimed to determine the utilization of antenatal care services of Filipino women during the COVID-19 pandemic. Alternative versus standard packages of antenatal care for lowrisk pregnancy. Brisbane: Queensland Health; 2020 (https://www.health.qld.gov.au/__data/assets/pdf_file/0039/949539/g-covid-op-frame.pdf). Web COVID-19 Public Health Emergency Order No. Therefore, in addition to improving online antenatal care, the popularization of both the use of the internet and mobile electronic devices is crucial to allow more pregnant women to receive online education and care. Background Vaccination during pregnancy has been repeatedly demonstrated to be safe and effective in protecting against infection and associated Ashokka B, Loh M-H, Tan CH, SU LL, Young BE, Lye DC, et al. The required schedule and mode of care should be reassessed at each visit according to individual needs and current risks (7). Methods: Factors affecting the mental health of pregnant women using UK maternity services during the COVID-19 pandemic: a qualitative interview study. Author Contributions: Dr Young-Wolff had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Background Vaccination during pregnancy has been repeatedly demonstrated to be safe and effective in protecting against infection and associated harms for the mother, developing baby, and subsequent infant. However, maternity care providers need to be aware of the increased risk of antenatal anxiety and depression and domestic violence due to the economic and social impacts of the COVID19 pandemic. BMJ Open. Reduction in COVID-19 hospitalization, including for critical illness, among infants up to six months of age. Statistical analysis: Ray, Alexeeff, Avalos. Online antenatal care would be a preferable alternative for these women since it can provide pregnancy-related information and remote clinic consultations. Pregnant women were identified as being at elevated risk from COVID-19 early in the pandemic. [, Ferguson S, Davis D, Browne J. 2020;5:e47583. The impact of COVID-19 can be greater in vulnerable populations. -, Uwambaye P, Nyiringango G, Musabwasoni SMG, Husain A, Nessa K, Razzaque MS. COVID-19 pandemic: adaptation in Antenatal Care for Better pregnancy outcomes. Citation: Larki M; Sharifi F; Roudsari RL. They are susceptible to respiratory infections due to reduced lung function, increased oxygen consumption, and alteration in immunological function due to pregnancy. Royal College of Obstetricians and Gynaecologists. Trust the science. National Working Committee on Children and Women under State Council. Web COVID-19 Public Health Emergency Order No. -, Chivers B.R., Garad R.M., Boyle J.A., Skouteris H., Teede H.J., Harrison C.L. 6 EF. WebThe coronavirus (COVID-19) pandemic may substantially affect health systems, but little primary evidence is available on disruption of health and nutrition services. Recently, we performed a web-based survey among Chinese pregnant women via a national online platform (Banmi National Online Maternity School) to investigate their self-protection behaviors and attitudes toward antenatal care during the pandemic. 722: marijuana use during pregnancy and lactation. We computed monthly rates of prenatal cannabis use standardized to the year 2020 age and race and ethnicity distribution. [, Sayakhot P, Carolan-Olah M. Internet use by pregnant women seeking pregnancy-related information: a systematic review. 2020;1:599327. doi: 10.3389/fgwh.2020.599327. Methods: A cross-sectional study was Key principles for the provision of antenatal care through the evolving coronavirus (COVID-19) pandemic 3.1 Maintaining essential monitoring Many elements of antenatal care may require in-person assessment, in particular blood pressure and urine checks, measurement of fetal growth, and blood tests. endstream endobj startxref 573 pregnant women completed the survey. Online antenatal care can provide relatively less expensive medical services and diminish inequalities in health care due to its convenience and cost-effectiveness, especially in developing countries or regions. Community-based health care, including outreach and campaigns, in the context of the COVID-19 pandemic Produced by: WHO, UNICEF, IFRC This guidance document addresses the role of community-based health care in the context of COVID /2 [272 12 3 542.76 356.485 561.955 367.511 1 0 0 1 -46.0948 765.911] 1School of Nursing and Midwifery; 2Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Islamic Republic of Iran. Am J Obstet Gynecol 2020 Jun;222(6):521-531 [, Murphy HR. FOIA Physicians rapidly become involved into acute or intensive care medicine and their availability will be increasingly limited (8). Current WHO guidance advises at least of eight antenatal care for low risk pregnant women. Aim: The aim of this study was to assess pregnant women's satisfaction with antenatal care and social support and to examine stress-reduction strategies women used during the pandemic. have lived experience of accessing complex care during pregnancy, and are passionate about All Rights Reserved. Ming, https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200628-covid-19-sitrep-160.pdf?sfvrsn=2fe1c658_2, http://www.nhc.gov.cn/fys/s3581/202002/4f80657b346e4d6ba76e2cfc3888c630.shtml, https://www.rcog.org.uk/en/guidelines-research-services/guidelines/coronavirus-pregnancy/covid-19-virus-infection-and-pregnancy/, https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/pregnancy-breastfeeding.html, http://www.nwccw.gov.cn/2020-02/11/content_278883.htm, Add this article to your Mendeley library. Table 2 according to a statement from WHO shows the schedule of prenatal care including three face to face and three remote visits during the COVID-19 pandemic (3). Landrian A, Mboya J, Golub G, Moucheraud C, Kepha S, Sudhinaraset M. BMJ Open. Epub 2021 Apr 27. Int J Womens Health. The United States documented 198,598 pregnant people with COVID-19 from January 22, 2020, to April 11, 2022. Therefore, pregnant women without any serious issues should use online antenatal care programs as an alternative to routine antenatal care in a hospital at least to some extent. WebThe COVID-19 resource centre is hosted on Elsevier Connect , the company s public news and information . //--> 7407486, Copyright Disclaimer. The evidence indicates that if women do not attend antenatal services then they are at risk of maternal death, stillbirth and other adverse perinatal outcomes (3,4). Overview . 2010 Oct 6;(10):CD000934. Edited by G Eysenbach, G Fagherazzi; submitted 10.05.20; peer-reviewed by D Groselj, A Al-Hasan; comments to author 22.06.20; revised version received 02.07.20; accepted 13.07.20; published 22.07.20. Also, they may need to additional visits or multi-disciplinary care in pregnancy (10,11). However, some pregnant women will doubt the reliability of such online information. Our findings indicate how the lack of access to antenatal care and reduced perceived social support as a result of the restrictions implemented in response to the COVID-19 pandemic, potentially intensifies pregnancy specific stress. 2022 Apr 6;12(4):e059701. (Correspondence to: Mona Larki: endstream endobj startxref Please enable it to take advantage of the complete set of features! MeSH On the other hand, self-quarantine/isolation should not lead to missing of prenatal care, especially in high risk pregnant women. The questionnaire used to assess health-seeking behavior was validated before the survey proper. Also, referral to community clinics should be limited to emergency cases with significant risk factors. government site. doi: 10.1007/s10995-020-02967-7. An official website of the United States government. Here, we report how the COVID-19 pandemic brings not only opportunities for the development and popularization of online antenatal care programs but also challenges. Provision and uptake of routine antenatal services: a qualitative evidence synthesis. government site. COVID-19 is threatening to prevent approximately 49 million women and girls from having access to contraceptives and up to 15 million unplanned pregnancies if lockdown lasts a year. [, Knight-Agarwal C, Davis DL, Williams L, Davey R, Cox R, Clarke A. We conducted the analyses using SAS version 9.4 (SAS Institute Inc). Postpartum people's experiences of and responses to the COVID-19 pandemic during the first year of the pandemic: A descriptive qualitative study. Additionally, governments need to legislate relevant laws to regulate and protect the privacy of pregnant women when using online antenatal care services. Fryer K, Delgado A, Foti T, Reid CN, Marshall J. doi:10.1001/jama.2021.16328, Cannabis use among pregnant women is common and has increased in recent years in the US, from an estimated 3.4% in 2002 to 7.0% in 2017.1 Pregnant women report using cannabis to relieve stress and anxiety,2 and prenatal cannabis use may have risen during the COVID-19 pandemic as pregnant women faced general and pregnancy-specific COVID-related stressors (eg, social isolation, financial and psychosocial distress, increased burden of childcare, changes in prenatal care, and concerns about heightened risks of COVID-19).3,4. 374 0 obj <>/Filter/FlateDecode/ID[<08258A81CCACE04291DA28440CAF4662>]/Index[347 42]/Info 346 0 R/Length 125/Prev 276057/Root 348 0 R/Size 389/Type/XRef/W[1 3 1]>>stream Much evidence on maternal care is eCollection 2023. 347 0 obj <> endobj doi: 10.1136/bmjopen-2021-059701. Bennett DL, Hajat S, Shishtawi A, Zeidan W, Abuzabaida F,et al. It is best utilized for occasions when the person does not require physical clinical assessments and/or tests/investigations (3). Reduction in maternal COVID-19 of any severity (including severe and critical disease). Archives of Neurology & Psychiatry (1919-1959), https://www.cdtfa.ca.gov/dataportal/dataset.htm?url=CannabisTaxRevenues, JAMAevidence: The Rational Clinical Examination, JAMAevidence: Users' Guides to the Medical Literature, JAMA Surgery Guide to Statistics and Methods, Antiretroviral Drugs for HIV Treatment and Prevention in Adults - 2022 IAS-USA Recommendations, CONSERVE 2021 Guidelines for Reporting Trials Modified for the COVID-19 Pandemic, Global Burden of Skin Diseases, 1990-2017, Guidelines for Reporting Outcomes in Trial Protocols: The SPIRIT-Outcomes 2022 Extension, Mass Violence and the Complex Spectrum of Mental Illness and Mental Functioning, Organization and Performance of US Health Systems, Spirituality in Serious Illness and Health, The US Medicaid Program: Coverage, Financing, Reforms, and Implications for Health Equity, Screening for Prediabetes and Type 2 Diabetes, Statins for Primary Prevention of Cardiovascular Disease, Vitamin and Mineral Supplements for Primary Prevention of of Cardiovascular Disease and Cancer, Statement on Potentially Offensive Content, Register for email alerts with links to free full-text articles. 2020. :July, 1Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China, 2Faculty of Medicine, International School, Jinan University, Guangzhou, China, 3Department of Culture and Tourism, Xiamen University of Technology, Xiamen, China, 4College of Economics, Jinan University, Guangzhou, China, 5Maternal-Fetal Medicine Unit, Department of Obstetrics and Gynecology, Brigham and Womens Hospital, Boston, MA, United States, 6Center for Genomic Medicine, Massachusetts General Hospital, Harvard Medical School, Harvard University, Boston, MA, United States, 7School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China, Department of Public Health and Preventive Medicine, No 602 Huangpu Avenue West, Tianhe District. var prefix = 'mailto:'; in COVID-19 Provide advice about: o Standard Before the pandemic, the standardized rate of prenatal cannabis use was 6.75% of pregnancies (95% CI, 6.55%-6.95%); that rate increased to 8.14% of pregnancies (95% CI, 7.85%-8.43%) during the pandemic (Figure). The authors declare that they have no competing interests. J. Med. In the context of the pandemic, pregnant women face an additional dilemmathey need professional antenatal care, there is a potential risk for cross-infection if they choose to visit a hospital to receive this service [6]. Learn more about the risks of COVID-19 during pregnancy. Read up on the COVID-19 vaccine frequently asked questions. Effect of restrictions imposed due to COVID-19 pandemic on the antenatal care and pregnancy outcomes: a prospective observational study from rural North India. Women with suspected or confirmed COVID-19 should be advised not to attend in clinics. and transmitted securely. WM, McCance-Katz During the Covid-19 pandemic, most pregnant women did not get Queensland Health. 1 Pregnant women report using cannabis to relieve stress and anxiety, 2 and prenatal cannabis use may have risen during the COVID-19 pandemic as pregnant women faced general and pregnancy-specific /ExtGState <> It is also recommended when pregnant women have had close contact with a confirmed or suspected case within the past 14 days. Some women with co-morbidities (e.g. A study in China found that many pregnant women had concerns about the reliability of online gestational information [17]. It is recommended if positive COVID-19 is confirmed (7,8). Examining inequities associated with changes in obstetric and gynecologic care delivery during the coronavirus disease 2019 (COVID-19) pandemic. This site needs JavaScript to work properly. sharing sensitive information, make sure youre on a federal Those visits that do not need measure of fundal height, blood or urine tests, or ultrasonography, should be performed remotely by video or teleconferencing. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). document.write( '' ); Clipboard, Search History, and several other advanced features are temporarily unavailable. obesity, gestational diabetes, and preeclampsia) have a condition or complication that may increase their risk for severe COVID-19 disease. Ross T, de Maria de Albuquerque C, Chaves J, Carneiro Rolim KM, Albuquerque Frota M, Surkan PJ. Models of maternity care for pregnant women during the COVID-19 pandemic. Further research includes pilot studies to explore the acceptability of the model and recommendation implementation in practice. Akinwunmi, Casper J P The guidance aims to capture the complex nature of the issues surrounding ANC health care practices and delivery and to prioritize person-centred health and well-being, not only the prevention of death and Why inequality could spread COVID-19. During the COVID-19 pandemic, our top priority is to keep our patients, staff, and communities Furthermore, the lockdowns, curfews, and increased risk for contracting COVID-19 may affect how women access health facilities. Rates of Prenatal Cannabis Use Among Pregnant Women Before and During the COVID-19 Pandemic. JMIR Mhealth Uhealth 2019 Jun 18;7(6):e12631 [, N/A. COVID-19: Operational framework for maternity and neonatal services. Bookshelf All pregnant women and their newborns, including those with confirmed or suspected COVID-19 infections, have the right to high quality care before, during and var path = 'hr' + 'ef' + '='; doi: 10.1002/14651858.CD012392.pub2. In these clinics, social distancing rule need to be observed in the consulting room using appropriate technology and the obstetricians and physicians need not be in the same room (10). Careers. https://doi.org/10.26719/2020.26.5.492. Various individual, facility, and policy-level factors affected the utilization of services during the pandemic. Conclusions: /LastModified (4 /Resources <> Certain restrictions were placed upon birth partners Pregnant women were identified as being at elevated risk from COVID-19 early in the pandemic. United States. This can improve overall maternal and reproductive health services and family life. WebThe COVID-19 pandemic, also known as the coronavirus pandemic, is an ongoing global pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Much evidence on maternal care is available, however, little is known about their potential adoption for improving maternal health services in Indonesian primary care during the COVID-19 pandemic. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 22.07.2020. 0 Considered an essential business in California, cannabis retailers remained open during the pandemic with record sales in 2020.5 We used data from Kaiser Permanente Northern California (KPNC), a large integrated health care delivery system with universal screening for prenatal cannabis use to test the hypothesis that rates of prenatal cannabis use increased during the COVID-19 pandemic. after another problem that we as a society have allowed to develop. /Type /Page Cannabis tax revenues. Journal of Medical Internet Research - Online Antenatal Care During the COVID-19 Pandemic: Opportunities and Challenges Published on 22.7.2020 in Vol 22 , WebKorukcu, O., Ozkaya, M., Boran, O.F. In addition, online antenatal care may help to provide relatively economical medical services and diminish health care inequality due to its convenience and cost-effectiveness, especially in developing countries or regions. Receiving maternity care during the COVID-19 pandemic: Experiences of women's partners and support persons. Matvienko-Sikar K, Pope J, Cremin A, Carr H, Leitao S, Olander EK, Meaney S. Women Birth. URL: Ahmed F, Ahmed N, Pissarides C, Stiglitz J. /1 [243 13 3 49.5 -354.898 562.5 -338.953 1 0 0 1 124.5 -279.898] How the COVID-19 pandemic brings not only opportunities for the development and popularization of online antenatal care programs but also challenges is reported. This study uses National Survey on Drug Use and Health data to examine prevalence and frequency of medical and nonmedical cannabis use among pregnant and nonpregnant women between 2013 and 2017. Chen, Babatunde Midwifery. In such cases, further obstetric examinations and consultations in a hospital are essential. The popularization of online antenatal care programs is likely to have an economic benefit to both the health care system and to women in terms of cost, time, and manpower. Our focus is on This would be helpful in decreasing the incidence and negative impact of GDM. Records should be made electronically, making them accessible for future care (10). doi: 10.2147/IJWH.S287534. All of these approaches would likely contribute to better labor preparedness, maternal experience, postpartum adjustment and outcomes, fewer infection risks, and more economic benefits to the health system and the women themselves. 2023 Dec;31(1):2152548. doi: 10.1080/26410397.2022.2152548. JMIR Mhealth Uhealth 2015 Jun 05;3(2):e44 [, Feroz A, Perveen S, Aftab W. Role of mHealth applications for improving antenatal and postnatal care in low and middle income countries: a systematic review. hand hygiene, disposal of consumables, equipment cleaning, social distancing) (5). $e`bd`|v!# )p Guidance for maternal medicine services in the evolving coronavirus (COVID-19) pandemic Information for healthcare professionals. In the midst of the COVID-19 pandemic, it is advisable that pregnant women should stay at home and receive necessary antenatal care via online antenatal care programs. For pregnant women who are self-quarantine at home, it should be guarantee that they remain well hydrated and are mobile during this period. Research on refugee women access to and utilisation of antenatal care (ANC), delivery and post-natal care (PNC) are generally underrepresented in the global /Font <> WebIt is recommended if positive COVID-19 is confirmed (7,8). 4274 0 obj <>stream How will the COVID-19 pandemic impact my prenatal care? Adelekan B, Goldson E, Abubakar Z, Mueller U, Alayande A, Ojogun T, Ntoimo L, Williams B, Muhammed I, Okonofua F. Reprod Health. The lack of information on COVID-19 and pregnancy meant women had greater uncertainty about pregnancy and birth. In some cases, positive toxicology test results may detect prenatal cannabis use that occurred prior to pregnancy recognition. WebThe COVID-19 resource centre is hosted on Elsevier Connect , the company s public news and information . Further research includes pilot studies to explore the acceptability of the model and recommendation implementation in practice. SY, HW, XB, JS, SC, BA, and CJPZ edited and reviewed the final version of manuscript. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. Having a plan in place for your WebCOVID-19 Pandemic . . 32658860 Wang, Xiaoyu 2021 Aug 4;18(1):166. doi: 10.1186/s12978-021-01217-5. /4 [318 10 3 -390.96 357.146 -56.64 366.878 1 0 0 1 -268.848 371.434] Therefore, it is important to ensure the quality and safety of online services and establish a stable, mutual trust between the pregnant women, the obstetric care providers and the technology vis-a-vis the online programs. Administrative, technical, or material support: Young-Wolff, Adams, Does, Ansley, Avalos. PMC Background: Covid-19 is a rapidly evolving pandemic, affecting both developed and developing countries. Women aged 18 to 45 years who delivered in 2021 were recruited.