Family planning behavior before and during the COVID-19 pandemic.

Objective: Contraception use and follow-up visit data from before and in two periods during the coronavirus disease-2019 (COVID-19) pandemic were compared to investigate change in behavior.

Material and methods: A retrospective study of women aged 18-49 years from New York City during three one-year time periods: pre-COVID-19 pandemic [(COV-PRE); n=4,261], early COVID-19 pandemic when the COVID-19 vaccine was not available [(COV-VACNO); n=3,365], and later COVID-19 pandemic when the COVID-19 vaccine was available [(COV-VACAV); n=4,170].

Results: There were higher odds of implant use [odds ratio (OR): 1.42, 95% confidence interval (CI): 1.05, 1.93, p=0.02] during COV-VACNO. There were lower odds for any contraception (OR: 0.88, 95% CI: 0.79, 0.98, p<0.001) or intrauterine device (IUD) (OR: 0.73, 95% CI: 0.61, 0.86, p<0.001) use during COV-VACAV. No differences occurred for bilateral tubal ligation, pill, patch, injection, medical elective abortion, or surgical elective abortion. There was a greater percentage of follow-up visits for any contraception (p=0.02) and IUD (p=0.02) use during COV-VACNO and COV-VACAV than COV-PRE.

Conclusion: When COVID-19 vaccines were unavailable, there were higher odds for use of implants. Once COVID-19 vaccines were available, there were lower odds for any contraception and IUD use. These findings highlight changes in behavior in terms of contraceptive concerns and preferences during a public health crisis that should be planned for by healthcare providers.