ORAL ABSTRACTS

Abstract

Objectives: Research on how major disruptive events – pandemics, wars, and economic recessions – influence people s pregnancy intentions and fertility yields mixed findings. Experts have speculated about the impact of the COVID-19 pandemic on pregnancy desires, but existing research has major limitations, including being cross-sectional, relying on people s perceptions of their preference changes (rather than documenting actual changes), and lacking valid measures. Methods: Using longitudinal data collected from March 2019 to March 2021, we assessed changes in trajectories of pregnancy preferences among women aged 15-34 in Arizona, New Mexico, and Texas (N=630, n=2,860). At baseline and quarterly for one year, participants responded to a validated measure of feelings and desires around pregnancy within 3 months (Desire to Avoid Pregnancy [DAP] scale, range 0-4, 4=higher preference to avoid pregnancy). We used multivariable mixed effects segmented regression to examine changes in pregnancy preferences before and during the pandemic. Results: Over the 12-months prior to the first shelter-in-place order (April 2020), marginal DAP scores decreased steadily over time (coefficient.=-0.24/year [95% CI: -0.31- -0.17], p<0.001). When shelter-in-place went into effect, DAP scores stopped declining and became flat (coefficient.=0/year, change in slope: p<0.001). Scores remained flat until the resurgence in COVID-19 cases in November 2020, when DAP scores started to increase, but insignificantly (coefficient.=0.25/year). Time-by-socioeconomic status interactions were insignificant. Conclusions: Pandemic onset was associated with changes in people s preference to avoid pregnancy, stalling a general trend toward greater openness to pregnancy over time. Understanding how COVID-19 affected people s pregnancy preferences is essential for evaluating pandemic effects on contraception and abortion.