Estimation of pregnancies during COVID-19 pandemic lockdown in urban field practice area of Bangalore Medical College and Research Institute.

Introduction:

Corona virus disease 2019 first broke out in the month of December 2019 at Wuhan, China and spread globally by beginning of 2020. On March 11th 2020 the World Health Organization declared COVID-19 outbreak a “Global Pandemic”. As the pandemic spread, countriesimposed lockdown of different magnitude to contain the spread of the virus. Whenever there is a complete shutdown of health services,women suffer the most.

Amidst the COVID-19 pandemic the United Nations in the month of May 2020 predicted a sharp rise in the global birth rates with India topping the list.¹ A phenomenon “Lockdown imposed intimacy” has been observed especially in India which in turn resulted in the rise of unplanned pregnancies and abortions.² According to UNICEF report, 116 million babies are estimated to be born under the shadow of COVID -19 pandemic, with India anticipated to top the list with 20.1 million births in 9 months since pandemic declaration, the UN body reported.³

An eligible couple refers to a currently married couple where in the wife is in reproductive age i.e., 15-45 yrs. There will be at-least 150 – 180 such couples per 1000 population in India. With the COVID -19 containment measures lifesaving health services like childbirth, antenatal care is affected putting millions of pregnant mothers and their babies at risk.

Lack of contraceptive coverage and health care services during lockdown led to high chances of unplanned pregnancies, abortions and still births among the eligible couple, hence the study.

Materials and methods

The present community based Cross-sectional study was conducted in the field practice area of Bangalore Medical College and Research Institute, Bengaluru among eligible couplesfrom September to December 2020. Sample size was calculated as 125 eligible couple.

Inclusion criteria is eligible couple residing in the study area with pregnant females whose LMP is after 1st April 2020. Exclusion criteria is age more than 45 years. After obtaining approval from Institutional Ethical Committee (IEC) & Medical Officer of Health, Chickpet, Bengaluru South, the study was conducted among 4420 eligible couples over 3 sectors in the field practice area, by probability proportion to size 22, 43 & 60 eligible couples were randomly selected from sector I,II,&III respectively.

The data was collected using a pretested, semi-structured, face validated questionnaire by household interview method. The data was entered in MS Office Excel and analyzed using SPSS software.

Results

Out of 125 participants 36 (28.8%) eligible couples were pregnant with 9 (25%) in 1st trimester,15 (41.7%) in the second trimester and 12(33.3%)in the third trimester. Mean age of the participant was 27.71±5.90 years and mean age of spouse was 33.68±5.89 years.

Minimum age of the participant 18 years and maximum age being 40 years. Minimum age of the spouse 22 years and maximum 48 years. Distribution of study participants based on religion showed 54.4% Hindus, 38.4% Muslims and 7.2% Christians among which 52.8% participants lived in joint family and 47.2% in nuclear family.

99.2% participants and 97.6% of their spouse were unemployed during lockdown compared to 21.6% participants and 98.4% spouses being employed before the lockdown. 54% participants were scared to visit the hospital for antenatal check-ups and 72.2% participants had fear of delivering during the pandemic. 29.8% eligible couple had no access to contraceptives during lockdown. There was no significant association between pregnant women and their religion or type of the family (p>0.05 by chi square test)

Conclusion:

This study shows there was an increase in pregnancy rate (28.8%) during the pandemic as compared to the Indian pregnancy rate (20%)⁴ , with majority of pregnancies being unplanned (77.8%)

Limitations:

As the study was carried out in limited field setting, a bigger study involving multiple areas with larger population would have helped in generalizing the results of the study.

Recommendation:

Unplanned pregnancies could have been addressed by creating awareness & educating the eligible couples and increasing the accessibility to contraceptives in health centers during pandemic.