Experiences of Canadian perinatal care during the COVID-19 pandemic: Analysis of open-ended survey responses
Bibliographic record
Abstract
BACKGROUND: The COVID-19 pandemic caused significant socioeconomic and healthcare disruptions in Canada. COVID-19 healthcare policies and local infection rates varied considerably across Canada's geographically diverse, multijurisdictional healthcare system. Emergence of highly transmissible COVID-19 variants and widespread COVID-19 vaccination mandates in Fall 2021 further impacted life in Canada. The experiences of pregnant people, in particular, were challenged by COVID-19 outbreaks, Canadian hospital policies, and local public health restrictions. OBJECTIVE: This study explored experiences of Canadian perinatal care in the context of the COVID-19 pandemic. DESIGN: Online, cross-sectional survey with qualitative analysis. METHODS: Individuals pregnant after January 1, 2020 who received perinatal care in Canada participated in our Pandemic Pregnancy Experiences eSurvey, September 1, 2021 to February 1, 2022. Open-ended survey responses were qualitatively evaluated by thematic and content analysis. Codes were identified both deductively and inductively, categorized using principles of woman-centered care, and developed into major and minor themes. RESULTS: Prenatal care and COVID-19 vaccination experiences were evaluated from 362 participants, with 234 participants also elaborating on their labor and delivery (L&D) care. Major themes organized by woman-centered care category as follows: Choice of Healthcare Provider (good quality healthcare provider, barriers to provider of choice), Autonomy-Healthcare (autonomy empowered, autonomy impacted), Choice of Delivery Place (wanted hospital birth, got hospital birth), Choice of Support Companion(s) (no support companion for prenatal appointments, hospital restrictions L&D support companion(s)), and, Autonomy-COVID-19 Vaccination (vaccinated while pregnant/breastfeeding). CONCLUSIONS: Pregnancy and birth experiences were generally positive; however, both COVID-19 and existing constraints of provincial/territorial healthcare systems impacted Canadian perinatal experiences. Limited choice of healthcare provider type and access to prenatal and L&D support companion(s) affected perinatal care satisfaction.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.008 | 0.023 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.003 | 0.006 |
| Science and technology studies | 0.008 | 0.003 |
| Scholarly communication | 0.004 | 0.001 |
| Open science | 0.002 | 0.006 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".