As the COVID-19 pandemic continues to spread across the globe – pushing healthcare systems to their limits and compelling governments and healthcare institutions to make difficult and increasingly urgent decisions about how to deliver care while also curbing virus transmission – it is critical that responses to this crisis recognize that sexual and reproductive health services are essential, respecting people’s rights to make decisions about their bodily autonomy and integrity.
The COVID-19 pandemic poses particular threats to poor and marginalized women who face greater difficultly in protecting themselves from transmission due to lack of information, resources, and access to quality health and social services. Women’s societal roles as caregivers, both within their own households and for others, places them at greater risk of infection and exacerbates the impact of COVID in their lives. The rights and health of these women must be central considerations as governments and other stakeholders formulate their response to this public health crisis.
At the same time, anti-abortion groups and some governments are exploiting this situation to deny women and girls access to abortion services. These cynical attempts to rollback decades of progress in increasing women and girls’ access to safe, legal abortion care must be stopped. They otherwise threaten to increase the strain on already over-burdened health care systems by compelling individuals to seek out unsafe abortion services and increase the need for post-abortion care.
As resources are rapidly being redeployed in response to COVID-19, we are calling on all governments to:
Provide abortion as an essential health service. Abortion access is essential preserve the life and health of pregnant people. The attendant impacts of COVID-19 have the potential to severely undermine access to abortion services, as travel restrictions limit transportation options, the economic slowdown pushes many individuals into more precarious financial situations, and healthcare system capacity becomes increasingly limited. Abortion is always a time-sensitive procedure that should not be postponed. Measures that undermine access to abortion care will force people to seek out unsafe abortion services or services later in pregnancy, putting their lives and health at risk.
Remove Legal and Administrative Barriers to Abortion Services, including to Medical Abortion. Governments and healthcare institutions must also remove all legal and administrative hurdles to access abortion services, including lifting criminal sanctions on abortion, and ensure all possibilities to guarantee safe access while minimizing contact with healthcare personnel at the frontlines of tackling the pandemic, including the adoption of technological advancements such as telemedicine and ensuring women and girls are not unnecessarily compelled to make multiple trips to healthcare facilities.
Medication abortion is a safe, cost-effective means for enabling women and girls to end an unwanted pregnancy. Misoprostol, one of the active drugs for Medication abortion, is included in the WHO’s Model List of Essential Medicines—meaning that governments should register it as an essential medicine. Yet in many countries, Medication abortion remains unavailable. To increase access to safe abortion services while also reducing the strain on healthcare systems, medication abortion should be made widely available, including over the counter at pharmacies. When desired, women and girls should also be able to utilize telemedicine to consult with healthcare providers on medication abortion.
Comply with the Minimum Initial Services Package for Reproductive Health, an international standard of care that should be implemented at the onset of every emergency, including public health emergencies. This priority set of lifesaving and essential services includes obstetric, prenatal, and postnatal care; contraceptive information and services, including emergency contraception; and post abortion care and post-rape care.
Guarantee Access to Quality, Respectful Maternal Health Care. As resources are reallocated to respond to the pandemic, it remains critical that all people have access to quality maternal health care, free from discrimination, violence and coercion. Resource constraints and emergency situations are often precursors to human rights violations in maternal health settings, such as mistreatment and abuse of women during delivery and violations of the right to informed consent. Such violations disproportionately impact marginalized populations, such as racial and ethnic minorities, poor women and rural women. Governments must take steps to guarantee women and girls’ rights in these settings. Furthermore, as information continues to evolve about the risk of COVID-19 to pregnant women and newborn children, it is paramount that governments and health care providers continue ensuring women’s rights to make decisions about labor and childbirth to the extent feasible.
Ensure Timely Access to Contraception, Including Emergency Contraception. Disrupted supply chains and reallocation of health resources during COVID-19 can have dire impacts on access to contraception. In addition to being essential for enabling people to make decisions about their reproductive autonomy, guaranteeing access to contraception can also mitigate near-term demands on the healthcare system that would result from unplanned pregnancy. States must ensure access to contraceptive information and services as an essential measure for enabling people to avoid unintended pregnancy, which can have significant impacts on their lives and health.