Did The COVID Baby Bust And The Rise Of Telehealth Change Reproductive Care For Good?

In Orange County, Michelle Lavoie and her husband came to terms with their own limits during the pandemic. This led her husband to get a vasectomy in July. “The energy and effort to ‘COVID’ with two kids is exhausting and just validated we don’t have the bandwidth to have more.” Their boys are 6 and 2, and Lavoie did not have an easy pregnancy with her younger son — postpartum preeclampsia led to hospitalization after his birth. “The pandemic just made us feel very mortal,” said Michelle. They're confident now, she says, in their crisis-driven decision to not add any more kids to their family.

While their decision was (effectively) permanent, many other people have chosen to start birth control during the pandemic for a host of related reasons. Varsha Rao, the CEO of Nurx, a fully digital healthcare company, says that since March 2020, they’ve seen a 50% increase in birth control requests and a 40% increase in requests for the morning after pill.

For some families, the restrictions of COVID threw a wrench into their plans. For others, it solidified their family structure. It’s clear that there’s a pandemic baby bust, and possibly a birth control boom. But once more and more people are vaccinated and families feel like the universe has taken its finger off the “pause” button, what will happen to reproductive care?

Since March 2020, the digital health care provider Nurx has seen a 50% increase in birth control requests. They have also seen a 40% increase in requests for the morning after pill.

“We’ve heard from our community via social media that economic uncertainty is a big concern right now, and that those who have lost jobs and health insurance find our out-of-pocket prices, of only $15 per pack for generic birth control, to be incredibly helpful,” says Rao. Nurx provides birth control to 350,000 patients, many of whom lack access to traditional medical care.

The increases seen by Nurx are in line with a recent study completed by the Guttmacher Institute. The study found that due to the pandemic, 34 percent of women they surveyed wanted to delay pregnancy or reduce the number of children they planned to have. Uncertainty about the world, anxiety about finances due to pandemic job loss, and concern over the restrictions on prenatal care and birth procedures are all reasons that some families have chosen to delay or cancel their plans to add to their family.

In Pittsburgh, Erin Thompson and her husband RJ are parents to a kindergartener, Amelia, who they conceived via IVF. They were hopeful to transfer their remaining embryos, but COVID-19 has halted their plans. “We pay enough for IVF in terms of money, emotions, and time — we would be devastated if we lost a pregnancy because of a virus,” says Thompson. The couple is also concerned with the self-monitoring and virtual visits that many obstetricians are using right now. Thompson suffers from perinatal anxiety, and she says having to monitor herself seems terrifying. In addition, her husband has cystic fibrosis and is high-risk for COVID-19. With too many compounding factors, the couple halted plans to transfer embryos in 2020.

Despite the shortcomings of virtual visits for people like Thompson, Rao is hopeful that telehealth will stick around long after COVID-19. “I think one of the main trends is now that people have been able to see how easy care can be, you’re going to see a movement of consumers being more focused on preventative health. There are so many areas where prevention is so important, but that initial visit is often the barrier to that. The more people are caring about themselves as a priority, or in a preventative manner, then they can help to have better outcomes for themselves.” Even prior to the pandemic, Rao cites “contraceptive deserts” across the U.S. “According to the nonprofit Power to Decide, more than 19 million women in the US are in need of publicly funded birth control and live in contraceptive deserts. In these areas the clinic may be an hour away, which can be a deal-breaker for people who can’t afford to miss work or somebody who doesn’t have a car.”

As for Erin and RJ Thompson, both of them received their vaccine recently, and have resumed the IVF process. The Thompsons had initially planned two years between kids, but at the minimum their daughter Amelia will be 6.5 before becoming a big sister. COVID only widened the gap that was already there as they paid down debt from the initial IVF. It’s not what they planned, but Thompson hopes the potential age gap has its advantages. “I think Amelia will be a big help. She asks about being a big sister like once a week.”