Why abortion and contraception are essential healthcare

The COVID-19 pandemic is stretching healthcare systems around the world to breaking point. As a result, many people are finding it harder than ever to access abortion and contraception.

A health crisis on this scale means governments are having to make difficult decisions about where to target limited health resources. Already, in some countries, including Nepal and South Africa, providers of abortion and contraception have been forced to reduce or suspend their services.

Even where services remain open, travel restrictions, social distancing measures, job losses, and shortages of medicines are creating new barriers to access.

Here are five reasons why sexual and reproductive health services need to remain available and accessible - during and beyond the pandemic.

These services save lives every day

One in four pregnancies globally ends in abortion. But restrictive laws mean not everyone is able to access this procedure safely. Every year an estimated 22,000 women die from unsafe abortions.

The evidence shows that when there are barriers to accessing contraception and safe abortion, maternal mortality rates rise. This includes death during childbirth, and death after seeking unsafe abortions.

Marie Stopes International (MSI), an NGO which provides contraception and abortion services in 37 countries around the world, has warned that COVID-19 could have a devastating impact on maternal health.

The organization estimates that across the 37 countries where it works, COVID-19 disruptions could lead to an additional 3 million unintended pregnancies, 2.7 million more unsafe abortions, and an additional 11,000 pregnancy-related deaths.

In times of crisis there is even greater demand

In previous pandemics, resources have been disproportionately diverted from reproductive health programs, resulting in a significant rise in maternal deaths.

During the Ebola crisis in West Africa for example, research shows that progress on maternal mortality was set back 15 or 20 years in some countries.

In Sierra Leone, reduced access to reproductive healthcare is estimated to have caused at least as many deaths as Ebola itself. Not only were women and girls unable to access lifesaving services, they needed them more than ever. There was a sharp rise in sexual violence during the Ebola crisis, while school closure contributed to an increase in teenage pregnancies.

These trends are likely to be repeated during the COVID-19 pandemic. Enforced home isolation may increase the incidence of sexual violence; more people might choose to end pregnancies due to economic or health concerns, and demand for contraception may increase as people put off plans to have children.

Restricting services will harm healthcare systems more in the long run

One economic model estimates that every $1 spent on preventing unintended pregnancy reduces the cost of pregnancy related care by $2.20. Meanwhile the WHO estimates that the annual cost of treating major complications from unsafe abortion is US$ 553 million.

It’s not just health that suffers when abortion and contraception are restricted or out of reach.

If women and girls cannot choose when they have children, they are often unable to access an education or have a career, and can struggle to support large families.

Contraception changes lives by empowering us to make decisions about our own futures. Empowerment drives social and economic development, which will help people access their rights and reduce the burden on the health systems.

We need to protect years of hard-won progress on reproductive rights

Between 2000 and 2017, the maternal mortality rate dropped by about 38% worldwide. Over the last 25 years, more than 50 countries have changed their laws to allow for greater access to abortion and post-abortion care recognizing the vital role that access to safe abortion plays in protecting women’s lives and health. It’s essential that this virus does not undo this progress.

There’s also a risk that anti-choice lawmakers will use the pandemic as an excuse to rollback hard-won reproductive rights. We’ve already seen this in the US states of Texas and Ohio, and similar attempts in Poland.

There are solutions to the challenges posed by COVID-19

Abortion and contraception are time-sensitive. That’s why it’s so important that governments act now to support this kind of healthcare.

From allowing abortion and contraception to be accessed through telemedicine, allowing pharmacies to sell emergency contraception without a prescription, and removing unnecessary waiting times and authorization requirements by several doctors, there are lots of ways governments can protect this essential healthcare and make it accessible to people who need it.

The sooner they act, the more lives will be saved.

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