Objective: To understand how the COVID-19 pandemic affected women of reproductive age, specifically their economic conditions, desire for pregnancy, and access to contraceptive services during the pandemic. Study Designs: A total of 554 women respondents age 18 to 49 and reside in the United States were recruited using social media between May 16, 2020 and June 16, 2020. Logistic regression models assessed predictors of reporting pandemic-related changes in economic conditions, desire for pregnancy, and contraceptive access. Results: Compared to White/Caucasian respondents, Hispanics/Latinx and Black/African Americans have 4 times the odds of experiencing inability to afford food, transportation, and/or housing ( p < 0.01) during the pandemic; Hispanics/Latinx have twice the odds of experiencing food insecurity ( p < 0.05). Inability to afford food, transportation, and/or housing was associated with drop in desire to be pregnant ( p < 0.01). Despite the 25% of participants who reported a drop in desire for pregnancy, 1 in 6 reported difficulty accessing contraceptives, particularly those who experienced reduced income ( p < 0.01). Conclusions: In our sample, the pandemic unevenly affected people from different socioeconomic groups. Many simultaneously experienced reduced income, difficulties in accessing contraception, and a greater desire to avoid a pregnancy. This combination of factors increases the chance that people will experience unintended pregnancies. Implications: The pandemic caused economic hardship and an increased desire to postpone or prevent pregnancy at the same time that it created new barriers to contraceptive services. This pattern may lead to a potential net effect of an increase in unintended pregnancy, particularly among people who had difficulty affording food, transportation, and/or housing during the pandemic.
and dental research. BrAMedJ' 1989;299:757. k23 September.l Mumps, measles, and rubella vaccination and encephalitis SIR,-Dr Suzanne Crowley and colleagues describe the onset of encephalitis in a 14 month old girl 27 days after she was given mumps, measles, and rubella vaccine. In this case it should be emphasised that there is no proof that the encephalitis was due to the mumps component of the vaccine. The fourfold rise in mumps S titre could simply reflect successful immunisation. In Canada, where there have been several reports of meningitis arising within four weeks of giving mumps, measles, and rubella vaccine, mumps virus was isolated from the cerebrospinal fluid in all cases, although it was not possible to prove the origin of the viruses.'After over one million doses of mumps, measles, and rubella vaccine it would be surprising if the occasional neurological reaction did not occur, but it would be a pity if current initiatives to improve the protection of British children from measles, mumps, and rubella were to be affected adversely by the publication of such a speculative case report. Nevertheless, it is most important that such cases are fully documented and reported on the "yellow card" system to the Committee on Safety of Medicines so that the benefits and risks of new vaccines can be kept in perspective. Experience to date indicates that the frequency of central nervous system complications after mumps vaccination is lower than the background incidence in the normal population. It is also worth emphasising that this patient and the Canadian patients recovered completely from the encephalitis.
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