Preventing Unintended Pregnancies in the Context of COVID-19

The COVID-19 pandemic continues to weaken health systems and cause major disruptions to health services, including sexual and reproductive health (SRH) services. Research suggests that even a minimal 10% reduction of services will have a devastating impact on SRH outcomes, including 49 million additional women with unmet need for modern contraception and 15 million unintended pregnancies in low- and middle-income countries annually. The pandemic is posing challenges on human resources, supply-chains, service delivery, and service seeking among women and girls in countries across the globe, however it is disproportionately affecting women and girls in low- and middle-income countries. School closures, limited access to comprehensive sexuality education and contraception, and risk of violence against young women and girls put them at higher risk for unintended pregnancies.

The Wilson Center’s Maternal Health Initiative in collaboration with the United Nations Population Fund (UNFPA), hosted a panel discussion on strategies to prevent and address unintended pregnancies in the face of COVID-19. This public roundtable discussed current country strategies and practices for ensuring access to and continuity of SRH services during the COVID-19 pandemic.

Follow the conversation on Twitter at @Wilson_MHI and on Instagram at @MaternalHealthInitiative using the hashtags #COVID19andSRH and #MHDialogue. Find more coverage of these issues on our blog, NewSecurityBeat.org/Dot-Mom.

Selected Quotes

Sarah B. Barnes

“The current pandemic is straining human resources, disrupting supply chains and service delivery, and negatively impacting service seeking among women and girls in countries across the globe. However, it is disproportionately affecting women and girls in low and middle income countries. School closures, limited access to comprehensive sexuality education and contraception, and risk of violence against women and girls, put them at a higher risk for unintended pregnancies.”

Anneka Knutsson

“This topic, the increasing unintended pregnancies that we know and the situation of young women, older women, everyone, every person in the COVID pandemic, has really exacerbated the vulnerabilities that we know exist already.”

Elizabeth Sully

“There are three overarching points from the worldwide abortion study evidence that I want to highlight. First, unintended pregnancy and abortion are reproductive health experiences that are shared by tens of millions of people around the world, irrespective of other personal status or their circumstances. What differs, are the obstacles that they face in obtaining these services or having these experiences. These are legal, social, economic, and other obstacles. The second key point is that unintended pregnancy and abortion occur where abortion is broadly legal and where abortion is restricted. And the third, is that in developing countries, abortions tend to be unsafe and health systems in those countries lack the capacity to provide essential abortion services.”

“If all unmet needs for modern contraception and pregnancy related care were met in low and middle income countries, there would be approximately a two-thirds decline in unintended pregnancies, going from the current estimate of 111 million to 35 million per year, a two-thirds decline in unsafe abortions, from 35 million to 10 million, and two-thirds decline in maternal deaths, from 299,000 to 113,000. The impacts of investing in these services would have immense benefits for women and their families and communities.” 

“When we look at the data across countries on impact [of COVID], we’re starting… to see the data come in and really it’s just for 2020, we haven’t even seen what’s happened in 2021 yet, we are not through this pandemic it’s still ongoing, but we’ve seen a lot of range of different experiences. So, we just released a report of adolescence access to contraceptive services in 2020 in Uganda, and we found there was an early dip right in April of 2020, but it actually increased back to regular levels and in the end they actually ended up having more services in 2020 than they had the prior year, and so there was this sort of success story and I think that’s where we have to start to look at, to what are the things that governments have done, what were the actions taken by NGO providers and other actors in the private sector that ensure that these services were maintained. And I think some of this cross-country comparison work is going to be really informative, I think we’re going to start to see a lot more data coming out in the coming months and years, and to really learn from that.”

Valeria Isla

“We [Argentina] are a federal country, there’s 24 jurisdictions, 24 provinces, that in turn have local governments, municipalities, and the health system is within the remnant of the provinces and some municipalities while the national ministry of health has the oversight, its responsible for very few health services, so in that sense, declaring this as an essential service was the tool for the teams in the provinces, and us, to be able to generate in the services established for COVID, the importance for SRH.”

“Moderator asked the following question: success factors - what are they on your mind?] On the one hand, a very important factor was activism in Argentina and the development of organizations and feminist networks and organizations. As of 2015, the Ni Una Menos [Not one less] movement, the green tide that took to the streets and that created a process that catalyzed and unified campaigners… who would fight in the streets for comprehensive sexuality education in schools."

“[During COVID] we saw an increase in gender based violence, we have a ministry that was established in late 2019 by current president Mr. Alberto Fernandez, the Ministry of Women and Gender and Diversity, and they have a toll free line 144 that receives reports and we have had an increase and we haven’t been able to reduce the number of femicides and trans-femicides reported in Argentina. As to girls and teenagers, with the 0-800 line and the referrals from the gender violence, gender based violence line we’ve managed to give visibility and see the increase in the number of calls and interventions of the protection system, also forced pregnancies, access to termination of pregnancy, we still don’t have official statistics, but we’re in line with what’s been happening in the region.”

Lirisha Tuladhar

“This of unintended pregnancy, abortion, and especially the woman related issues they are not discussed freely in the [Nepalese] society itself. It is almost taken as a taboo topic to be discussed about.”

“[Moderator asked question: When discussing really important success factors in your country, in the environment where you are working, to really make sure that we don’t lose what we have gained in SRHR, and how can we increase the resilience of systems.] One of the most important parts is that we have to work inter-sectorally. So, it’s an issue that just one person or just one organization can not solve it, or it can not help it to be more successful. So I think there is a need for collaboration from each and every sector, not just the health sector that is working on this but also from the education sector, from maybe the infrastructure sector, so in that way if we collaborate together and work then only we can address this issue.”

Dr. Jean Claude Mulunda

“In terms of [the pandemic’s] consequences, I think this is not the same, you know, the COVID situation did not have the same impact on all the regions in the world. It’s depending also on the level of preparedness for this kind of situation, you know many countries or regions with high income were able to prepare themselves, which is really different from DRC, from my country, but also from many other countries in the world.”

“[Moderator asked question: success factors - what are they on your mind?]. For the DRC for example, our work was related to the litigation protocol, which allowed women to get access to the abortion, so one of the gains that we wanted to protect and move forward after the pandemic was on the advocacy level. And one of the things that we did, you know to be sure that we protect these gains, is to invest in not only community engagement but in national ownership. So on all levels, from the leadership to the bottom, everyone can have access to the information, but also we cultivate all the categories of people, of leadership, like women's rights, supporting them with training.”