Children may be less vulnerable to COVID-19, but the pandemic is disrupting their access to sexual and reproductive health worldwide. Schools are closed, community clinics are shut or reducing services, and some governments are exploiting the crisis to prevent abortions.
UNESCO reports that over 1.5 billion students are out of school worldwide because of COVID-19—that’s over 91 percent of students in the world, more than the entire population of China. While many schools are turning to online and virtual classes, many others lack access to the internet or necessary technology.
A new report from Human Rights Watch (HRW) highlights—among many other issues—how many students are now losing out on invaluable sexual and reproductive health education. And for the many students who didn’t receive comprehensive sex education before the pandemic, they now have even less access to information when confined at home.
The long-term effects of a lack of information include unwanted pregnancies, unsafe abortions and sexually transmitted diseases. “Young adolescents, ages 10 to 14, have a higher risk of health complications and death from pregnancy than adults,” HRW wrote. “The World Health Organization reports that complications from pregnancy and childbirth are the leading cause of death for girls and young women ages 15 to 19.”
Accessing sexual and reproductive health services within your community has now become harder almost everywhere. The International Planned Parenthood Foundation (IPPF) released a global survey April 9 showing that over 5,600 community sexual health clinics in 64 countries had already closed due to the pandemic.
Many of those clinics that do remain open have reduced services for HIV testing, contraception, gender-based violence and abortion care. Lockdown restrictions mean that clinics are having a harder time transporting and importing commodities and supplies, and are suffering shortages of HIV and contraception medications. Lack of personal protective equipment for sexual health workers also means they can’t do their jobs safely.
Some governments are exploiting the pandemic to further restrict access to abortions and other reproductive health services. Poland’s parliament is debating a new bill that would increase barriers to abortions—already among the strictest in Europe. The new law would ban abortions in cases of foetal abnormality. Illegal abortions are estimated to be anywhere from 10 to 150 times more frequent than legal abortions in Poland.
Abortion access has been restricted in other European countries, as hospitals and clinics have reduce or close reproductive health services because of staff shortages. In countries with severely restrictive abortion laws, it is now much harder to travel abroad to get an abortion. The ability to obtain medication or medical documentation by mail is also impacted.
“European governments must act urgently to guarantee safe and timely access to abortion care during the COVID-19 pandemic,” wrote Leah Hoctor of the Center for Reproductive Rights in an open letter co-signed by 100 organizations. “They should move swiftly to eradicate all medically unnecessary requirements that hamper access to abortion care and should authorize women to access early medical abortion from their homes.”
In the US, too, governments long hostile to abortion are seeing an opportunity. A US appeals court ruled on April 7 that the state of Texas can restrict abortions by “postponing non-urgent medical procedures.” The state’s Attorney General Ken Paxton (R), initially put the restrictions in place in the name of protecting hospitals focused on combatting COVID-19.
But Human Rights Watch and other experts state that abortions are essential healthcare. And people’s ability to make these choices is especially important amid the economic and other vulnerabilities exacerbated by the pandemic.
Around the world, abortion barriers disproportionately harm people with disabilities, people living in poverty, racial and ethnic minorities, survivors of assault and abuse, young people and LGBTQ people. The non-profit Marie Stopes International estimates that over 9 million people globally will lose access to abortions and other reproductive health services this year because of travel restrictions, lockdowns and service cuts. They estimate a resulting 3 million unwanted pregnancies and up to 11,000 pregnancy-related deaths.
“We have to make sure that women and girls, who will experience the greatest care burden and increased levels of interpersonal violence, can get the care they need,” said IPPF Director-General Dr Alvaro Bermejo. “Their rights and safety must be respected. Doing that whilst ensuring the safety of our providers is a priority.”
To that end, IPPF has set up an emergency fund to purchase protective equipment for sexual health workers, and has created a global taskforce to respond to further barriers. The organization is urging governments to reduce restrictions to care by allowing patients to receive medical care virtually when possible and take-home medications, including for abortion.
“This will help deliver the care women and girls need urgently and lift some pressure from over-stretched public health services,” Bermejo said.