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Commentary
Now is the time: a call for increased access to contraception and safe abortion care during the COVID-19 pandemic
  1. Manisha Kumar1,
  2. Maura Daly1,
  3. Eva De Plecker2,
  4. Christine Jamet3,
  5. Melissa McRae1,
  6. Aine Markham3,
  7. Carolina Batista4
  1. 1 Medecins Sans Frontieres Operational Centre Amsterdam, Amsterdam, The Netherlands
  2. 2 Medecins Sans Frontieres, Bruxelles, Belgium
  3. 3 Medecins Sans Frontieres, Geneva, Switzerland
  4. 4 Medecins Sans Frontieres, Rio de Janeiro, Brazil
  1. Correspondence to Dr Manisha Kumar; manisha.kumar{at}amsterdam.msf.org

https://doi.org/10.1136/bmjgh-2020-003175

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    Summary box

    • The COVID-19 pandemic has begun to severely limit access to sexual and reproductive healthcare, including contraception and safe abortion care (SAC), which have historically not been regarded as essential health services.

    • Shutdown or delays of contraception and SAC during COVID-19 will disproportionately impact the most vulnerable populations, including women and girls in low-income and middle-income countries, and lead to considerable and preventable death and lifelong disability.

    • Médecins Sans Frontières calls on the global health community to strengthen access to contraception and SAC for populations everywhere, and especially in poor and crisis settings, by engaging with women and their communities to develop self-managed models of care.

    With unsafe abortion a significant cause of maternal mortality and morbidity, especially in poor and crisis settings, Médecins Sans Frontières (MSF) calls for the urgent expansion of contraception and safe abortion care (SAC) during the COVID-19 pandemic. The development of self-managed models of care through engagement with women and their communities is needed to prevent a spike in these avertable deaths.

    While the COVID-19 pandemic is unprecedented in many ways, experience from previous humanitarian emergencies shows that when routine healthcare services are disrupted, the consequences can be catastrophic, especially for women and children who are disproportionately affected by crisis.1 For example, reports from the 2014–2015 Ebola epidemic suggest that the shutdown of routine services resulted in more maternal and child mortality and morbidity than the outbreak itself.2 3 Here we argue that despite this compelling evidence on the indirect but devastating impact of epidemics, the global health community is dangerously close to repeating similar mistakes with regard to an often-neglected aspect of sexual and reproductive health (SRH): access to safe abortion and contraceptive services that reduce numbers of potentially fatal or debilitating pregnancy-related complications.

    The current crisis has intensified the need for SRH …

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