Better data collection and measures such as prescription-free contraception could improve women’s health care during disasters, researchers have recommended.
Researchers at the University of Warwick Medical School conducted a study to investigate access to contraception during major disasters, including the COVID-19 pandemic. The study reviewed existing research into the impact of disasters on contraception in higher income countries, such as the UK, to assist in disaster response planning.
Access barriers to sexual health services
The findings highlight additional barriers that women faced in accessing contraception during the COVID-19 lockdown, including disruption to sexual health services and fears about contracting the virus, as well as a pressing need to ensure that access to contraception is maintained to avoid the health and social impacts of unplanned pregnancies beyond the pandemic.
The research has been published in the European Journal of Contraception and Reproductive Health Care.
Previous research has shown that disasters are associated with increased rates of early pregnancy loss, stillbirth, and premature birth, as well as with increased birth rates. However, this is the first review of how the uptake of contraception is affected, and what impact this may have on women’s reproductive health.
In the UK, contraception is free through the NHS but requires a prescription. However, the COVID-19 pandemic created new barriers that may have prevented women from accessing contraception. For example, they may avoid going to a healthcare provider due to the fear of contracting COVID-19, or concerns about travelling.
The research highlighted examples of good practice in overcoming these barriers, such as drive-through or kerbside provision of contraception. Some health providers were able to maintain access to contraception using telehealth (i.e., video or phone consultations), but these presented safeguarding and privacy issues. Evidence from outside the UK also showed that making emergency birth control prescription-free rather than cost-free has a greater impact on unplanned pregnancies.
Despite these insights, researchers said that the lack of data collected prior to the pandemic means it is unclear how successful the measures implemented during the pandemic have been. It is also not clear how women’s access to contraception has been affected. The researchers recommend collecting more data on the uptake of contraception, awareness of the benefits and pitfalls of telehealth methods, and a move to making more contraception prescription-free, as is currently being considered for the progestogen-only pills.
Co-author Dr Julia Gauly, from Warwick Medical School, said: “We don’t have a clear picture of how the uptake of contraception changes during disasters or the COVID-19 pandemic, because we don’t have enough data from before, during, and after the crisis to compare. Collecting better data would put us in a better position in the future to predict things like birth rates.
“It’s important that women can access contraception and have a choice, especially during disasters. Many people lost their jobs during the pandemic or they became sick with COVID, so the needs of women for contraception may have changed. Someone who was planning to start a family might change their mind during a crisis or pandemic, due to financial or health reasons. So it’s important that women and their partners have a choice in their family planning.”