Pandemic Pregnancy Experiences and Risk Mitigation Behaviors: COVID-19 Vaccination Uptake in Canada
Abstract
1. Introduction
2. Methods
2.1. Sample
2.2. Survey
2.3. Analysis
2.4. Ethics
3. Results
3.1. Sample
3.2. COVID-19 Experiences
3.3. Predictors of COVID-19 Vaccination
3.4. History of COVID-19 Infection
4. Discussion
4.1. COVID-19 Vaccination Uptake
4.2. COVID-19 Infection History
4.3. Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Characteristic | n | % |
---|---|---|
Age (mean, SD) | 32.2 ± 4.17 | |
Indigenous | 34 | 6.0 |
Racialized | 40 | 7.1 |
Immigrant | 29 | 5.1 |
Gravidity 1 | ||
Primigravid | 328 | 58.2 |
Multigravid | 236 | 41.8 |
Education 2 | ||
Some high school/high school | 55 | 9.8 |
College | 138 | 24.5 |
University | 234 | 41.5 |
Post-graduate | 137 | 24.3 |
Income 3 | ||
<$40,000 | 32 | 5.7 |
$40,000–69,999 | 35 | 6.2 |
$70,000–99,999 | 129 | 22.9 |
$100,000–149,999 | 183 | 32.5 |
>$150,000 | 159 | 28.2 |
Prefer not to answer | 25 | 4.4 |
Location of Prenatal Care | ||
British Columbia | 24 | 4.3 |
Alberta | 40 | 7.1 |
Saskatchewan | 28 | 5.0 |
Manitoba | 41 | 7.3 |
Ontario | 282 | 50.0 |
Quebec | 34 | 6.0 |
Atlantic Bubble 4 | 102 | 18.1 |
The North 5 | 10 | 1.8 |
Characteristic | n | % | Characteristic | n | % |
---|---|---|---|---|---|
COVID-19 Rates in Prenatal Care Region 1 | COVID-19 Vaccination | 494 | 87.4 | ||
High | 145 | 25.7 | Yes- while trying to conceive | 60 | 10.6 |
Moderate | 158 | 28 | Yes—when pregnant | 294 | 52 |
Low–No COVID-19 | 78 | 13.8 | Yes—when breastfeeding | 89 | 15.8 |
Household size (mean, SD) | 2.86 ± 1.09 | Yes (not pregnant, not breastfeeding) | 51 | 9 | |
Regular close, social, unmasked contact | Not vaccinated | 67 | 11.9 | ||
Limited to household members | 86 | 15.2 | History of COVID-19 infection | 52 | 9.2 |
Non-household contacts | 476 | 84.4 | Infected when trying to conceive | 3 | 0.5 |
Non-household contacts included (n = 476, check all): | Infected when pregnant | 35 | 6.2 | ||
Extended family members | 346 | 72.7 | Infected when breastfeeding | 9 | 1.6 |
Close friends | 334 | 70.2 | Infected, not pregnant, not breastfeeding | 5 | 0.9 |
Work colleagues/customers/clients | 119 | 25.0 | No history COVID-19 infection | 512 | 90.6 |
Daycare/childcare providers | 55 | 11.6 | Travel outside of home city/town in past month | ||
Religious community | 18 | 3.8 | No travel | 205 | 36.3 |
Home services (e.g., cleaning, repair) | 16 | 3.4 | Travel | 354 | 62.8 |
Felt socially isolated | Purpose of travel (n = 354; check all): | ||||
Always/often | 288 | 51.1 | Visiting extended family | 233 | 65.8 |
Sometimes | 227 | 40.2 | Prenatal/maternity healthcare services | 143 | 40.4 |
Rarely/never | 49 | 8.7 | Visiting friends | 81 | 22.9 |
Limited non-essential trips outside home | Work | 66 | 18.6 | ||
Always | 158 | 28.0 | Non-reproductive healthcare services | 59 | 16.7 |
Often | 231 | 41.0 | Social event | 58 | 16.4 |
Sometimes | 141 | 25.0 | Vacation/activities | 18 | 5.1 |
Rarely–Not at All | 34 | 6.0 | Religious/spiritual event | 17 | 4.8 |
Education | 8 | 2.3 | |||
Shopping/supplies | 7 | 1.9 |
Variables | Vacc. | Unvacc. | Variables | Vacc. | % | Unvacc. | % | ||
---|---|---|---|---|---|---|---|---|---|
Sociodemographic Characteristics (n = 561) | Gravidity (n = 561) χ2(1) = 4.34, p = 0.047 | ||||||||
Age (mean, SD) | 32.4 ± 4.1 | 31.61 ± 4.66 | Primigravid | 295 | 90.5 | 31 | 9.5 | ||
Household size (mean, SD) | 2.84 ± 1.06 | 3.09 ± 1.30 | Multigravid | 199 | 84.7 | 36 | 15.3 | ||
n | % | n | % | Prenatal HCP (n = 379) | |||||
Racialized (n = 40) | 35 | 87.5 | 5 | 12.5 | OB/GYN | 176 | 89.8 | 20 | 10.2 |
Indigenous (n = 34) | 28 | 82.4 | 6 | 17.6 | GP | 81 | 84.4 | 15 | 15.6 |
Immigrant (n = 31) Χ2(1) = 10.90, p = 0.004 | 20 | 69.0 | 9 | 31.0 | Midwife | 65 | 83.3 | 13 | 16.7 |
Education (n = 561) U = 12,020.0, Z = −3.84, p < 0.001 | Nurse/NP | 6 | 85.7 | 1 | 14.3 | ||||
Some high school/high school | 38 | 70.4 | 16 | 29.6 | |||||
College | 119 | 86.9 | 18 | 13.1 | HCP discussed vaccine (n = 329) | 223 | 86.8 | 34 | 13.2 |
University | 208 | 89.3 | 25 | 10.7 | |||||
Postgraduate degree | 129 | 94.2 | 8 | 5.8 | Employment Status (n = 557) | ||||
Household Income (n = 535) U = 10770.5; Z = −2.70, p = 0.007 | Full-time/part-time/seasonal | 307 | 90.3 | 33 | 9.7 | ||||
<CAD 40,000 | 24 | 75.0 | 8 | 25.0 | Work/maternity leave | 141 | 86.0 | 23 | 14.0 |
CAD 40,000–69,999 | 30 | 85.7 | 5 | 14.3 | Unemployed/leaves of absence | 43 | 81.1 | 10 | 18.9 |
CAD 70,000–99,999 | 111 | 86.0 | 18 | 14.0 | Employment Characteristics | ||||
CAD 100,000–149,999 | 168 | 92.8 | 13 | 7.2 | Essential 1 worker (n = 564 2) | 330 | 88.7 | 42 | 11.3 |
>CAD 150,000 | 145 | 91.8 | 13 | 8.2 | Could work from home (n = 563 2) | 251 | 88.4 | 33 | 11.6 |
COVID-19 rates 3 (n = 379) | Worked outside the home while pregnant (n = 561) | ||||||||
High | 124 | 86.7 | 19 | 13.3 | Always/often | 281 | 88.1 | 38 | 11.9 |
Moderate | 137 | 86.7 | 21 | 13.3 | Sometimes/rarely | 86 | 89.6 | 10 | 10.4 |
Low–no COVID-19 | 67 | 85.9 | 11 | 14.1 | Never/did not work | 127 | 87.0 | 19 | 13.0 |
Variable | COR | 95% CI | AOR | 95% CI |
---|---|---|---|---|
Immigrant status (CAD 1) | 0.27 | 0.12–0.62 | 0.20 *** | 0.09–0.49 |
Gravidity (multigravid 1) | 1.72 | 1.03–2.88 | 1.61 | 0.94–2.75 |
Education (some high school/high school 1) *** | ||||
College | 2.78 | 1.29–5.99 | 2.72 * | 1.24–5.94 |
University | 3.50 | 1.71–7.17 | 4.01 *** | 1.91–8.40 |
Postgraduate | 6.79 | 2.70–17.08 | 7.31 *** | 2.84–18.81 |
Variables | Infect. Hist. | No Hist. | Variables | Infect. Hist. | % | No Hist. | % | ||
---|---|---|---|---|---|---|---|---|---|
Sociodemographic Characteristics (n = 564) | COVID-19 Rates 3 (n = 381) | ||||||||
Age (mean, SD) | 32.06 ± 3.99 | 32.32 ± 4.19 | High | 19 | 13.1 | 126 | 86.9 | ||
Household size (mean, SD) r(559) = 0.109, p = 0.01 | 3.38 ± 1.48 | 2.81 ± 1.03 | Moderate | 15 | 9.5 | 143 | 90.5 | ||
Low-no COVID-19 | 7 | 9.0 | 71 | 91.0 | |||||
n | % | n | % | ||||||
Racialized status (n = 40) χ2 (1) = 5.90, p = 0.023 | 8 | 20.0 | 32 | 80.0 | Limited non-essential trips outside home (n = 564) | ||||
Indigenous status (n = 34) | 4 | 11.8 | 30 | 88.2 | Always/often | 35 | 9.0 | 354 | 91.0 |
Immigrant status (n = 29) χ2 (1) = 4.78, p = 0.042 | 6 | 20.7 | 23 | 79.3 | Sometimes | 12 | 8.5 | 129 | 91.5 |
Income (n = 538) | Rarely/not at all | 5 | 14.7 | 29 | 85.3 | ||||
<CAD 40,000 | 5 | 15.6 | 27 | 84.4 | |||||
CAD 40,000–69,999 | 4 | 11.4 | 31 | 88.6 | Gravidity (n = 564) χ2(1) = 5.91, p = 0.018 | ||||
CAD 70,000–99,999 | 11 | 8.5 | 118 | 91.5 | Primigravid | 22 | 6.7 | 306 | 93.3 |
CAD 100,000–149,999 | 21 | 11.5 | 162 | 88.5 | Multigravid | 30 | 12.7 | 206 | 87.3 |
>CAD 150,000 | 10 | 6.3 | 149 | 93.7 | Prenatal healthcare provider (n = 379) | ||||
Education (n = 564) | OB/GYN | 21 | 10.7 | 176 | 89.3 | ||||
Some high school/high school | 7 | 12.7 | 48 | 87.3 | GP | 7 | 7.2 | 90 | 92.8 |
College | 15 | 10.9 | 123 | 89.1 | Midwife | 9 | 11.5 | 69 | 88.5 |
University | 19 | 8.1 | 215 | 91.9 | Nurse/NP | 2 | 28.6 | 5 | 71.4 |
Postgraduate degree | 11 | 8.0 | 126 | 92.0 | |||||
Employment Characteristics | HCP discussed vacc. (n = 329) | 27 | 10.5 | 231 | 89.5 | ||||
Essential 1 worker (n = 564 2) | 38 | 10.2 | 335 | 89.8 | |||||
Could work from home (n = 563 2) | 31 | 10.9 | 254 | 89.1 | COVID-19 vacc. (n = 561) | 42 | 7.5 | 452 | 80.6 |
Employment status (n = 560) | |||||||||
Worked full time/part-time/seasonal | 29 | 8.5 | 314 | 91.5 | Worked outside home while pregnant (n = 564) | ||||
Work—maternity leave | 15 | 9.1 | 149 | 90.9 | Always/often | 29 | 9.1 | 291 | 90.9 |
Unemployed/leaves of absence | 8 | 15.1 | 45 | 84.9 | Sometimes/rarely | 5 | 5.2 | 91 | 94.8 |
Never/did not work | 18 | 12.2 | 130 | 87.8 |
Variable | COR | 95% CI | AOR | 95% CI |
---|---|---|---|---|
Gravidity (multigravid 1) | 0.49 | 0.28–0.88 | 0.68 | 0.34–1.38 |
Household size | 1.40 | 1.08–1.81 | 1.26 | 0.92–1.73 |
Racialized status (no 1) | 2.71 | 1.18–6.24 | 2.78 * | 1.19–6.50 |
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Shaw-Churchill, S.; Phillips, K.P. Pandemic Pregnancy Experiences and Risk Mitigation Behaviors: COVID-19 Vaccination Uptake in Canada. Int. J. Environ. Res. Public Health 2025, 22, 425. https://doi.org/10.3390/ijerph22030425
Shaw-Churchill S, Phillips KP. Pandemic Pregnancy Experiences and Risk Mitigation Behaviors: COVID-19 Vaccination Uptake in Canada. International Journal of Environmental Research and Public Health. 2025; 22(3):425. https://doi.org/10.3390/ijerph22030425
Chicago/Turabian StyleShaw-Churchill, Sigourney, and Karen P. Phillips. 2025. "Pandemic Pregnancy Experiences and Risk Mitigation Behaviors: COVID-19 Vaccination Uptake in Canada" International Journal of Environmental Research and Public Health 22, no. 3: 425. https://doi.org/10.3390/ijerph22030425
APA StyleShaw-Churchill, S., & Phillips, K. P. (2025). Pandemic Pregnancy Experiences and Risk Mitigation Behaviors: COVID-19 Vaccination Uptake in Canada. International Journal of Environmental Research and Public Health, 22(3), 425. https://doi.org/10.3390/ijerph22030425