How did the lockdown restrict women’s access to their choice of contraceptives, an essential?

In many ways, factors affecting women’s access to contraceptives during the lockdown were similar to that of abortion:

What are the likely choices for a woman who could not access contraception and discovers her pregnancy during the lockdown?

Possible choices for such a woman include:

For women, what are the long- and short-term impacts of being denied contraceptives?

Women who are unable to access contraceptives are likely to make decisions that may not be as per their preference – whether it is the continuation of their unintended pregnancy or second trimester or unsafe abortion. All of these are likely to have profound consequences for their overall health and well-being, including physical health since the unintended pregnancy may not ensure adequate spacing with the previous childbirth, as well as mental health (beyond the lockdown’s own impact). Unsafe abortion may lead to morbidities with long-term consequences on health and in the worst case, result in mortality among women. There would be financial implications as she/her family may have to spend significantly more in seeking an abortion or in continuing with the pregnancy. In an environment of job loss and economic instability due to COVID-19, this could be detrimental to the well-being of the entire family, including young children, as nutrition, family dynamics etc are likely to be impacted.

Unsafe abortions are the third largest cause of maternal deaths in India. Did these rise during the lockdown?

As per the World Health Organization, abortions are:

Was access to contraceptives worse for women in rural areas?

Yes, it is worse for women in rural areas, due to:

With COVID-19 screenings made mandatory for procedures and an increase in demand for abortions, will costs go up? If yes, what can be done to prevent unfair practices from further keeping women away from accessing abortion services?

Given that in usual times, 73% of abortions happen outside the facility using medical abortion drugs, the increased need for facility-based abortions will significantly increase the cost of abortions for women, particularly for second-trimester abortions. This includes facility-level costs for additional lab tests, admission in the hospital (second-trimester abortion typically requires admission in contrast to first trimester ones that are day-care or OPD procedures) in addition to COVID-19-related hospital costs. There will be higher out-of-pocket expenditure including travel cost as well as opportunity cost as women may be required to travel longer distances than they did earlier to access abortion services. To improve women’s access, it is important to conduct a rapid mapping of facilities (both public and private) to identify geographic distribution of those offering first or second-trimester abortion, followed by assessing facility preparedness and strengthening them to offer abortion services, especially second-trimester abortions. Capping of costs in private facilities as well as offering transport subsidies to women/families belonging to the poor socio-economic background are additional measures.

What should the government have done to ensure contraception/abortion access for women during the lockdown? What can be done if situations like these arise again?

We need to understand that the adverse outcomes from medical complications that resulted from lack of contraceptives and inadequate SRH services, including abortion, are very significant. It is hence crucial to plan and ensure that sexual and reproductive health should be embedded into the country’s disaster management plan. This includes ensuring sustained availability of essential SRH services during a crisis situation, as well as being an integral part of the relief measures.

1 Million Women Failed To Get Abortion During Lockdown: Expert Says Why

In the first three months of the COVID-19 lockdown, 25 March to 24 June, 2020, 47% of the estimated 3.9 million abortions that would have likely taken place in India in this span under normal circumstances were possibly compromised. This means that 1.85 million Indian women could not terminate an unwanted pregnancy, concluded a May 2020 modelling study conducted by the Ipas Development Foundation (IDF), India, a non-profit dedicated to preventing and managing unwanted pregnancies.

Of these 1.85 million women, 80% or 1.5 million compromised abortions were due to the lack of availability of medical abortion drugs at pharmacy stores, the study found.

The estimation builds on data from telephone surveys of 509 public-sector facilities across eight states, 52 private-sector providers, expert opinion of members of the Federation of Obstetric and Gynaecological Societies of India (FOGSI), sales data on medical abortion drugs, and trend estimation by pharmaceutical industry experts.

BECOME A MEMBER

Why 1 Mn Women Failed to Get Abortion During Lockdown

Millions of women would have thereby been forced to either continue with an unwanted pregnancy or unsafe abortion.

Read Latest News and Breaking News at The Quint, browse for more from gender and women

Topics: Anti Abortion Abortion Laws Abortions