Covid 19: a wake-up call to eliminate barriers to SRHR

31 March, 2020

 

Written by Christina Zampas, human rights lawyer and Associate Director of Global Advocacy at the Center for Reproductive Rights

© Rolf Luginbuehl https://luginbuehl.photo/

Barriers to sexual and reproductive health (SRH) services have always existed but the Covid-19 pandemic has brought to the fore the stark reality of these barriers. The general population across the globe is now experiencing what many marginalised persons, such as adolescents, persons with disabilities, persons living in rural areas and in humanitarian settings, and members of LGBTIQ communities, have long experienced — limited or no access to SRH services.   While persons belonging to these groups are bearing the brunt of the stigma and limitations imposed by states’ Covid-19 responses,[1] many in the general population are experiencing for the first-time barriers such as restrictions on movement, lack of availability of providers and closed clinics.

 

Covid-19 is starkly showing the weak points and inequities of our health systems across the globe, including contraceptive production and supply chains, over-medicalisation, health insurance restrictions, vulnerability of health care workers, and more. The legal and policy barriers imposed on contraceptive and abortion services in various settings all over the world powerfully illustrate these weaknesses. And these weaknesses are being exploited by those who have long sought to restrict access to SRH services, with potentially grave harm to health and human rights. Some countries are limiting continuation of IVF treatment, no longer allowing doulas and partners into birthing rooms, and limiting access to  abortion; in the US some states are introducing measures to limit or ban access to abortion under the guise that it is not an essential health service and thus, must not divert limited resources.[2],[3],[4],[5],[6],[7] While some countries are using the crisis as a means to trample on privacy and confidentiality, in other places production and supply chains for contraceptives are being broken due to physical isolation and limitations on movement, which could affect availability of contraceptives globally.[8] While we will continue to counter these challenges, as we have before the pandemic, we also have an opportunity, in the midst of tragedy, for positive change.

 

Covid-19 opens the door of opportunity to create the change we have long been advocating for — greater access to abortion and contraceptive services. Covid-19 is showing us that the same places where we see limits are also places where we can create possibilities.  Restrictive and criminal abortion laws, as well as unnecessary requirements, such as multiple provider authorisation, mandatory waiting periods, mandated clinic visits for taking medication abortion, restrictions on telemedicine counselling, bans on mailing of abortion medications, criminal penalties for self-managed abortions, and prescriptions for contraceptives, and unnecessary restrictions on home birth, are but a few examples of legal and policy barriers that Covid-19 is glaringly exposing as what we have long known to be not only unnecessary but also harmful.[9]

 

Under the false guise of medical necessity and purportedly acting in the best interest of women, these barriers are in fact rooted in political ideologies, power dynamics between patient and provider, and harmful stereotypes of women being unable to make their own decisions about their health and their future. Removal of such barriers will not only ensure optimal use of limited health care resources by freeing up human and financial capital, but also protect and promote health and human rights.[10],[11]

 

Advocacy in all forms and on all fronts will be necessary to realise these and other changes, and to make them lasting and sustainable. Encouraging a state of empowerment and participation, where people can be supported in making the right choices for themselves and for those around them, not only helps to contain the virus, but helps the realisation of human rights. Creating equitable systems that promote gender equality and non-discrimination ─ not policing ─ will help serve the well-being of all, with regard not only to the illness itself, but also to the structures in which society engages. Structures that have long served only the few, and not the many, are ripe for being challenged. We can use the pandemic to illustrate the inequities in our systems and to work with a wide range of stakeholders, including law and policy makers, the judiciary, and health care workers, to introduce rights-based concepts and make the changes needed for more fair and just societies.

 

[1] Kimberly Sears Allers, Covid 19 Restrictions on Birth and Breastfeeding: disproportionately harming black and native women, We news, 27 March 2020 https://womensenews.org/2020/03/covid-19-restrictions-on-birth-breastfeeding-disproportionately-harming-black-and-native-women/

[2] Julia Hussein (2020) COVID-19: What implications for sexual and reproductive health and rights globally?, Sexual and Reproductive Health Matters, DOI: 10.1080/26410397.2020.1746065

[3] Center for Reproductive Rights, Press Release, Center files emergency lawsuit in Texas to protect essential abortion access during pandemic, 26 March 2020, https://reproductiverights.org/story/center-files-emergency-lawsuit-texas-protect-essential-abortion-access-during-pandemic

[4] Catherine Durand and Marianne Leach, Avorter en plein crise du Covid-19, la solitaire angoisse des femmes, Marie Claire, 27 March 2020, https://www.marieclaire.fr/avortement-ivg-france-confinement-coronavirus,1342654.asp

[5] UK abortion law briefly changes during Covid outbreak, The Guardian, 24 March 2020, https://www.theguardian.com/world/2020/mar/24/uk-abortion-law-pills-home-covid-19-outbreak

[6] State control over women’s bodies is an unforeseen outcome of the coronavirus crisis, The Guardian, 29 March 2020, https://www.theguardian.com/commentisfree/2020/mar/29/state-control-womens-bodies-covid-19-crisis

[7] Position statement: Emergenza Covid-19 e assistenza rispettosa all a aertinita e nascita, 24 March 2020, https://ovoitalia.wordpress.com/2020/03/24/position-statement-emergenza-codiv-19-e-assistenza-rispettosa-alla-maternita-e-nascita/

[8] Chris Purdy, Opinion: How will COVID-19 affect global access to contraceptives — and what can we do about it? Devex, 11 March 2020, https://www.devex.com/news/opinion-how-will-covid-19-affect-global-access-to-contraceptives-and-what-can-we-do-about-it-96745

[9] World Health Organization, Safe abortion: technical and policy guidance for health systems, (2012)   https://www.who.int/reproductivehealth/publications/unsafe_abortion/9789241548434/en/

[10] Zara Ahmed and Adam Sonfield, Guttmacher Institute, Covid-19 Outbreak: potential fallout for sexual and reproductive health and rights. https://www.guttmacher.org/article/2020/03/covid-19-outbreak-potential-fallout-sexual-and-reproductive-health-and-rights

[11] UN Human Rights Committee, General Comment 36 on the right to life, Un Doc. A/CCPR/C/GC/36, para 8 (2018)

 

Please note that blog posts are not peer-reviewed and do not necessarily reflect the views of SRHM as an organisation.

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