Contraception during COVID-19 Pandemic

Posted June 12, 2020

A warning from experts is calling the attention of the scientific community, due to difficulties of access to contraceptive methods during the period of COVID-19 pandemic.

The article that raises this issue was published in The European Journal of Contraception and Reproductive Health Care and was authored by Dr. Luis Bahamondes, coordinator of the INCT Hormona Center – Universidade Estadual de Campinas (UNICAMP) and by Dr. Maria Y. Makuch.

The paper, entitled “Family planning: an essential health activity in the pandemic of SARS-CoV-2,” shows the impact of the pandemic on the population’s everyday in different health areas that are not considered essential services, such as distribution of contraceptives. According to Dr. Luis Bahamondes, unplanned pregnancy may lead to serious public health problems, including lack of resources in prenatal care, unsafe abortions, pregnancy complications, and increased maternal and infant morbidity and mortality rates.

“What should be done with regard to the provision of contraception, since many medical clinics and hospitals are facing extremely difficult demands and challenges in the care of individuals with COVID-19? It is necessary to acknowledge the importance of family planning in this special moment,” emphasizes the expert.

According to the researcher, the negative impact regarding contraception will be very significant. Dr. Luis Bahamondes comments that there is still little information on the risks of vertical transmission of COVID-19 – intrauterine or perinatal transmission – or breast milk transmission. “ It is also unknown whether infection at the beginning of pregnancy may cause some problems to the baby, such as in the case of Zika virus. Many women are frightened at the idea of getting pregnant and contracting COVID-19.”

The provision of contraceptives is considered to remain normal in the private health sector, unlike that in the public health sector, which got worse during the pandemic. The researcher suggests that electronic prescriptions by e-mail or messaging apps could be used to enable access to contraceptives. “Even the placement of IUD or implant, which requires in-person care, may be safely performed with the use of personal protective equipment and the remaining safety protocols. One possibility, for example, would be transferring part of the waiting room to an open-air area and placing chairs very far from each other. In some places outside Brazil, an acrylic protective screen was installed between physicians and the patients.”

He recommends that patients using long-acting contraceptives whose expiration date is approaching wait until the end of social isolation to replace the contraceptive, since, according to the literature, its use is safe even one or two years after expiration.

According to the article, it is necessary to find new ways to provide services that do not require personal contacts and thus to reach women of reproductive age who need to continue using contraceptives or who want to start using them. Dr. Bahamondes emphasizes that, “for those using contraceptives, it is important to not discontinue the use of the chosen method, including information on condoms and fertility.”

Global Numbers

According to the main worldwide estimates of United Nations Population Fund (UNFPA), nearly 47 million women may lose access to contraception worldwide, resulting in approximately 7 million unwanted pregnancies.

In Brazil, 52% of pregnancies are expected to occur with no planning. According to Dr. Bahamondes, among female teenagers, the percentage may reach 62%. “Moreover, only 2% of Brazilian women at childbearing age (15 to 49 years old) have access to long-acting contraceptive methods, such as IUD (cooper or hormone-releasing intrauterine device) and implants, which are considered the most effective to prevent pregnancy”.

With no expected date for routines to return to normal, the UNFPA is working with governments and partners to prioritize the needs of women of reproductive age to find solutions that focus on providing essential contraceptive supplies.

Dr. Bahamondes emphasizes that it is important to change some public health policies, including the provision of contraceptives to prevent even more severe problems in the future.

Sources:

United Nations Population Fund [https://www.unfpa.org/press/new-unfpa-projections-predict-calamitous-impact-womens-health-covid-19-pandemic-continues] , Agência Fapesp [http://agencia.fapesp.br/anticoncepcao-e-atividade-essencial-em-tempos-de-coronavirus-alertam-especialistas/33234/], and The European Journal of Contraception and Reproductive Health Care [https://escrh.eu/education/covid-19/]