Pandemic Challenges to Women’s Health

For some women, maintaining their own health can have its challenges, whether everyday things like putting family and career ahead of their own needs, or potential barriers to care related to socio-economic status. What kind of a multiplier effect has the pandemic had on those factors? Dr. Shontreal Cooper, a maternal-fetal medicine physician in UConn Health’s Women’s Center, shares her observations from the last two years, what she tells her patients, and a creative way she tries to break down barriers.

(Dr. Shontreal Cooper, Carolyn Pennington, Chris DeFrancesco, May 2022)


Chris: As we try to emerge from the pandemic — if in fact we are close to the tail end of it, as we’d like to think — it’s already clear, certain populations have faced, and are facing, more challenges than others.

Today on the Pulse, we tackle some of those challenges with an expert in one area where preventive medicine is of particular importance.

This is the UConn Health Pule, a podcast to help you get to know UConn Health and its people a little better, and hopefully leave you with some health information you’ll find useful. With Carolyn Pennington. I’m Chris DeFrancesco. Health disparities already were a problem before COVID-19.

Carolyn: And of course the pandemic has caused additional strain for many, especially those dealing with issues related to employment, child care, living conditions, socioeconomic status, or access to care. For women facing those challenges, it can be even harder. That’s why we’ve invited Dr. Shon Cooper, UConn Health maternal-fetal medicine specialist. Thank you so much for joining us.

Dr. Cooper: Thank you. Thank you for having me here today.

Carolyn: Let’s start off with your observations about how the pandemic has impacted women’s health.

Dr. Cooper: Of course, overall, this is on a lot of different levels. So if we’re talking just women’s health in general, take aside, we’re not even talking about pregnancy, the pandemic itself has caused a lot of women to kind of second-guess or ask for a second opinion. Some of them are not really even coming in for services. At the beginning of the pandemic, we struggled a lot with that. A lot of patients were afraid to come in. They thought that, if they came to the hospital, that’s actually where they were going to get COVID. So a lot of times they were seeking advice from social media or other places instead of coming in to ask for advice. On the pregnancy side, we also struggled a lot because a lot of pregnant women did not want to get vaccinated. It was only recently that we’ve slightly improved our vaccination rate among pregnant women, but we’ve struggled with that throughout the pandemic for a lot of different reasons. A lot of them just questioned the validity of getting vaccinated. So after research has come out, that it showed that COVID itself is actually impacting the placenta, it can impact the growth of the fetus, and it also can cause a lot of severe symptoms for pregnant women. Only after that research has come out recently, some of the pregnant women are more likely to get vaccinated. And we still struggle. We’re still struggling to just encourage them to get vaccinated.

Chris: Are you seeing more women, at least now, or maybe more over the last six months, a year, kind of weighing the risk of a hospital-acquired COVID infection against the benefit of, “You know what, I’m overdue for a mammogram, I’m overdue for other regular preventive type things”?

Dr. Cooper: Absolutely. Just in general, the vaccine itself, unfortunately has some political sides of it. And some women have their own opinions about the vaccination. They’d rather get the monoclonal antibodies after they’ve tested positive for COVID versus getting vaccinated in pregnancy. And we go through the risk of getting the monoclonal antibodies and say that this is not a replacement for vaccination, and they still don’t want to get vaccinated. So I don’t know what it’s going to take at this point. A lot of times it’s a personal experience. So someone in their family got really, really sick, or their spouse or their children, someone that personally impacted them, got infected with COVID, and that’s when they typically will come in and say, “Hey, I think I’m ready to get the vaccine.” So we can encourage them. We try to encourage them, even for their regular routine things, they’re more likely to come in for that now versus us getting them boostered and getting them vaccinated in general.

Carolyn: So as far as women of color, what specific challenges have they been facing during this pandemic?

Dr. Cooper: Absolutely. So women of color in general have faced, I think, more, they’ve been impacted the most out of everything that has happened with the pandemic. And that’s mainly because of the environmental barriers and social barriers that they were already facing prior to the pandemic. So a lot of women of color, sometimes you’re in a single parent home or they’re solely working. And so they are responsible for going out and working. They can’t take off from work. They can’t really come to these appointments. And so when we’re requiring them to come in to be seen or be evaluated, some of them may not show up for the appointment or they’re missing work. And so that really, really impacts if they’re going to be compliant or if they’re going to come in. The other part of this is that there’s been so much mistrust with these patients and providers in general, that they don’t want to come in. And if they come in, they’re not asking the correct questions or they’re coming in and they may be defensive a little bit, but they’re not really trusting what the providers are saying. They’re kind of going for outside sources. And so we’re kind of combating two things. We’re combating these socio-economic problems that these women have, but we’re also battling the mistrust that they have with providers, which is kind of longstanding. And this is not something that started with a pandemic, it’s just being brought up a lot more with the pandemic. But we’re trying to combat these things on both sides.

Chris: When you have a woman of color come in to see you, do you think by being a woman of color yourself, does that put maybe you in a little bit more of a position of advantage to try to maybe have the proper advice resonate with that patient?

If they can say, “OK, this person’s relatable, we have some similarities that maybe my white doctor doesn’t have that connection with.” Do you find that that helps reach some of these people?

Dr. Cooper: Absolutely. I’ve had patients who travel from Danbury or, very far just to come see me because they’re looking for a provider that looks like them. Or I’ve had a patient, they saw their OB and then they come see me for an ultrasound and they’re like, “I didn’t understand anything my OB said.” And so it’s honestly just breaking things down in layman’s terms. I had a patient in the hospital and I was with another provider, we were kind of signing off at each other. So the provider is talking in medical terms and then I look at the patient’s face and she doesn’t understand a thing he says. And then I basically just say, “He’s just saying this.” And she’s like, “Oh, OK.” So it’s really kind of trying to relate to these patients, and basically I tell a lot of patients, I’m talking to you as if you’re my sibling, so we’re going to have that kind of conversation. And I’m not really gonna use a lot of medical terms. And I think it’s just how you relate. It really, really comes down to looking at your patient and really trying to understand, “OK do you even understand anything I’m saying?” So a lot of times they trust someone that looks like them, but it’s not even a lot looking like them as more as just relating to them and trying to understand where they’re coming from.

Carolyn: Now you’re finding some other creative ways of connecting with your patients. Tell us about your social media presence.

Dr. Cooper: That’s, it’s so funny because I really only got on social media heavily because I had patients coming to me saying, well, I saw this on TikTok, or I saw this on Instagram and I’m like, “What did you see?” So they’re showing me the TikTok videos and I’m just like, “OK, I’m going to get on TikTok.” So I really just started getting on there and I would just do little crazy dances, but answer the questions that literally patients were coming in the office and asking me. And then I feel like within maybe a month, my TikTok just kind of like grew, and I don’t even know how many followers I have. It’s definitely over a hundred thousand followers now. And I kind of backed off a little bit and I’m just starting to get back on TikTok now. But when we were in the pandemic it was just so important to get on there and address all those, like the misinformation that was out there about the COVID and then just in general pregnancy. And so, it’s growing, and I get a lot of questions, a lot of demands from these followers. And so I had to back off.

Carolyn: Do you have a really funny TickTok experience or anything you can divulge?

Dr. Cooper: Oh my God. I think, a lot of times TikTok is supposed to be like that one social media that you can just go to and just kind of wind down at night. And so sometimes these followers, they think that they can just say whatever to you. So sometimes I get on there and, it’s a funny story. I was on a committee and the vice president, Kamala Harris, she was on the call and I didn’t know, and somebody mentioned one of my TikToks and she wanted to look at it. And I had to go through and start deleting TikToks because I was like, I don’t know if there’s something inappropriate.

Carolyn: Oh no! So is Vice President Harris now a follower of yours?

Dr. Cooper: I don’t know if she’s following. If she is, I would probably pass out, but I don’t know she’s actually following me, but I know she did request to see my TikTokking, so, I was just like, “Oh, wow, I guess I really kind of am a little famous on TikTok.” So it’s been fun. It’s definitely been fun.

Chris: Getting back to preventive health, as a women’s health expert, optimistically by the time someone hears this, the pandemic will be over, right? But no, just in general, what are the important things that women, pandemic or not, regardless of their cultural or racial categories, what are just the things that women need to know about preventive health?

Dr. Cooper: I would say preventive health in general, the most important thing is at least seeking some medical advice at least once a year and not really waiting until you feel pain to come in and seek advice. I think what’s important, and a lot of times a lot of women are hesitant to come in for preventative care because nothing is really wrong, “So why am I taking off from work? Why do I have to take this vitamin if I don’t see any ailment on myself?” and I think what’s very, very important is to at least check on your body. It’s just like, if you’re going to go on a diet or if you’re going to lose weight for a wedding and get in this nice dress, that’s just like your body. And so I think that’s very important for women to just understand, that your body is so important and, and you should at least get it checked once a year.

Carolyn: But women aren’t in tune with that, right? I mean, or they put their family first?

Dr. Cooper: Exactly. So yes, women, family comes first, kids comes, first jobs become first. So a lot of times I will talk to women and just say, “Advocate for yourself. Even if it’s not health, even if it’s something in the environment, socially, advocate for your self care.” That’s so important. A lot of times we just struggle to put ourselves first because we have so many other obligations that we’re trying to take care of. I think self care, advocating for yourself, and just really making sure that you’re at least seeking some medical advice regardless of if you’re physically coming in or if you’re having a consultation over the phone, just seeking some medical advice once a year.

Chris: Going back to the actual process of being pregnant during the pandemic, how has the pandemic effected patients’ approach to prenatal care, or your approach as a provider to prenatal care? Obviously there had to be some impacts.

Dr. Cooper: Absolutely.

Chris: And have we learned anything from them that we can take from beyond the pandemic?

Dr. Cooper: I think the most important thing that we’ve learned from the pandemic from a provider side and also a patient side is that there are some things that we can kind of do without. And and I’m saying that because we always think that a patient needs to come in physically to be seen. But when the pandemic happened, we made do with televideo conference and we realize that, oh, wow, postpartum, I have a lot, a higher show rate if I see this patient over a video conference, because she has a two-week old newborn, versus if I’m trying to bring her into the office with a newborn.

Carolyn: Oh, that’s interesting.

Dr. Cooper: Yeah. And I think that we’ve learned so much from the pandemic in general about things that we essentially need and things that we can essentially survive without. And so I think the pandemic has taught both providers a lot of lessons, and also patients in general, that there are some things that we can kind of compromise on. Telemedicine is really taking over, and it’s not going away. We’re still seeing patients via telemedicine, and obviously we’re still in the pandemic, but it’s working, and it has been working. We thought, OK, pregnant women can’t be seen via telemedicine, but we made do with seeing patients via telemedicine. So this is kind of the new wave, and this is really the way that we’re moving towards is telemedicine.

Chris: Excellent. Before we say goodbye, Dr. Shon Cooper, anything else that we should know about women’s health as we hopefully kind of finish off with the COVID-19 here in 2022.

Dr. Cooper: I think that it’s important for women to understand just in general that they can seek a second opinion. If there’s something that they’re not understanding, or there’s something that they weren’t clear on, it’s OK for you to question your provider. It’s OK to come in with questions. It’s OK for you to ask to speak to a different provider. And I think that if we understand that in general, a lot of women themselves will advocate more for their health. I think that’s just a very, very important message for women’s health in general, is to just push for advocacy for yourself and making sure that you’re keeping yourself healthy, regardless if we’re in the pandemic or not.

Chris: Dr. Shon Cooper, UConn Health women’s health expert, thank you so much for coming in.

Dr. Cooper: Thank you.

Chris: That is our time for today. For Dr. Shon Cooper and Carolyn Pennington, I’m Chris DeFrancesco. Thank you for listening to the UConn Health Pulse. Be sure to subscribe so you can catch us next time, and please share with a friend.