Exploring factors associated with pregnant women's experiences of material hardship during COVID-19: a cross-sectional Qualtrics survey in the United States

• Published in: BMC pregnancy and childbirth Vol. 21; no. 1; p. 755
• Main Author: Johnson, Laura
• Format: Journal Article
• Language: English
• Published: England BioMed Central 08.11.2021; BMC
• Subjects: Adult; Anxiety - epidemiology; Coronaviruses; COVID-19; COVID-19 - economics; COVID-19 - epidemiology; COVID-19 - psychology; Cross-Sectional Studies; Depression - epidemiology; Domestic violence; Economic Status; Female; Financial strain; Humans; Income - classification; Income - statistics & numerical data; Intimate partner violence; Intimate Partner Violence - psychology; Intimate Partner Violence - statistics & numerical data; Pandemics; Post traumatic stress disorder; Posttraumatic stress disorder; Poverty; Pregnancy; Pregnant Women - psychology; SARS-CoV-2; Stress Disorders, Post-Traumatic; Surveys and Questionnaires; United States - epidemiology; Womens health; United States; United States > US; COVID-19; Pregnancy; Posttraumatic stress disorder; Intimate partner violence; Financial strain
• ISSN: 1471-2393; 1471-2393
• DOI: 10.1186/s12884-021-04234-1

The COVID-19 pandemic has exacerbated the financial insecurity of women and their families globally. Some studies have explored the impact of financial strain among pregnant women, in particular, during the pandemic. However, less is known about the factors associated with pregnant women's experiences of material hardship. This cross-sectional study used a non-probability sample to examine the factors associated with pregnant women's experiences of material hardship during the COVID-19 pandemic. In January 2021, 183 pregnant women living in the United States participated in an online Qualtrics panel survey. In addition to socio-demographic characteristics, individuals were asked about their finances and predictors of financial well-being, mental health symptoms, and intimate partner violence (IPV) experiences. Chi-square analysis and one-way ANOVA were used to examine whether women's experiences with material hardship and associated factors differed by income level (i.e., less than $20,000; $20,000 to $60,000; more than $60,000). Ordinary least squares regression was used to calculate unadjusted and adjusted estimates. Study findings showed that the majority of women in the sample experienced at least one form of material hardship in the past year. Individuals with an annual household income less than $20,000 reported the highest average number of material hardships experienced (M = 3.7, SD = 2.8). Compared to women with household incomes less than $20,000, women with incomes of more than $60,000 reported significantly fewer material hardships, less financial strain, and higher levels of financial support, economic self-efficacy, and economic-self-sufficiency. Women with incomes of $60,000 or more also reported significantly lower levels of psychological abuse, and a smaller percentage met the cut-off for anxiety. Economic self-sufficiency, financial strain, posttraumatic stress disorder, and economic abuse were all significantly associated with material hardship. A contribution of this study is that it highlights the significant, positive association between economic abuse, a unique form of IPV, and material hardship among pregnant women during the pandemic. These findings suggest the need for policy and practice interventions that help to ameliorate the financial insecurity experienced by some pregnant women, as well as respond to associated bidirectional vulnerabilities (e.g., mental health symptoms, experiences of IPV).