Unplanned pregnancies almost twice as likely during first UK lockdown, study finds

Women were almost twice as likely to have an unplanned pregnancy during the first UK lockdown as before, owing to a lack of access to contraception, a new study has shown.

Researchers analysed data from 9,784 women, who are all participants of the ongoing Contraception and Pregnancy Study (Cap-Covid) based at UCL and UCLH.

Of the overall group, 4,114 conceived pre-lockdown (defined using the date of April 1 to ensure restrictions were in place) and 5,670 conceived post-lockdown.

Once researchers had taken account of factors likely to influence the results, including ages of the women and time of conception, women were found to be nine times more likely to have difficulties in accessing contraception owing to the pandemic.

The proportion of women reporting issues getting contraception rose from 0.6% pre-lockdown, to 6.5% post-lockdown.

The proportion of unplanned pregnancies also nearly doubled over the period, from 1.3% pre-lockdown to 2.1% post-lockdown.

Women in the study were pregnant between May 24 and December 31 2020.

The report’s senior author Dr Jennifer Hall, of the UCL Institute for Women’s Health, said: “During the Covid-19 pandemic, many countries, including the UK, recognised the need for continuing contraception provision and implemented new practices and policies to deliver this.

“The UK saw a significant shift to telemedicine along with remote prescription for progestogen-only pill and combined oral contraceptive pill for up to a year compared to the usual three to six months, and many maternity services also worked to improve the postnatal contraception provision available in hospitals.

“However, we found that despite the introduction of new policies and practices by contraception and abortion service providers during the first lockdown, women continued to report ongoing difficulties in accessing contraception leading to a significant rise in the proportion of unplanned pregnancies.”

Researchers say the percentage of unplanned pregnancies reported in the study may be an underestimate as they may not have captured data from women who did not plan to continue their pregnancy.

Dr Neerujah Balachandren, part of the Reproductive Medicine Unit at UCLH, said: “Prior research has pointed to several factors which may explain why it was harder to access contraception during the Covid-19 pandemic.

“These include a lack of clarity about the legitimacy of trying to access Sexual and Reproductive Health services (SRH) during a pandemic, uncertainty about which SRH services are still available, limited GP appointments, challenges to contraceptive prescribing and closure of usual points of access to free condoms within community settings.”