Assessing differences in contraceptive provision through telemedicine among reproductive health providers during the COVID-19 pandemic in the United States

Providers faced challenges in maintaining patient access to contraceptive services and public health safety during the COVID-19 pandemic. Due to increased barriers to care, providers increasingly used telemedicine for contraceptive care as well as using curbside services, mail-order pharmacies, and on-line or home delivery of contraceptive methods, including self-administration of subcutaneous depo medroxyprogesterone acetate (DMPA-SQ). This study examined use of telemedicine and other clinical practice changes among U.S. contraceptive providers during the COVID-19 pandemic. We surveyed providers (n=907) in April 2020–January 2021, collecting data on contraceptive service delivery challenges and adaptations, including telemedicine. Our analyses showed that, in response to the pandemic, many clinics adopted telemedicine to offer contraceptive services. Furthermore, clinics that were closed on-site were just as likely to start offering telemedicine visits during the pandemic as those that remained open. Despite these adaptions, clinics still faced challenges in offering the full range of contraceptive methods, providing contraceptive counseling, and meeting the needs of patients in marginalized communities. Offering telemedicine visits during the pandemic did not reduce the challenges in offering contraceptive services. Few studies have focused on providers and the clinical practice changes they rapidly achieved to maintain contraceptive access for their patients during the pandemic. Our results highlighted that telemedicine should be considered as a complement to on-site care because of the challenges in providing full services without in-person visits. Maintaining in-person care for contraceptive services, in spite of staffing shortages and financial difficulties, is an important objective during and beyond the pandemic.