COVID-19 EXACERBATES THE RISK OF UNSAFE ABORTIONS
The coronavirus pandemic has hit India’s health systems. As many services get affected, a key area of concern has been reproductive health. This includes safe abortions. It is vital for women’s health that these take place in a proper medical facility under the care of qualified professionals. With many public health facilities having been taken over for Covid-19, and several private health facilities being shut down as a result of a shortage of staff and the lack of supply chains for medicines, there is a real danger of women having to resort to back alley methods for abortion. The fact that contraception is not easily available and that they are unable to travel to a medical facility even if it is within reach adds to the problem.
Unsafe abortions can result in fatalities or permanent health problems for women. The lack of services means that there will be an increase in unwanted pregnancies as well. A recent report from the Foundation for Reproductive Health Services India estimates that the pandemic could result in at least an additional 834,042 unsafe abortions and 1,743 maternal deaths, though the figure could be higher.
The cost of preventive measures for the coronavirus, in terms of medical equipment for workers and sanitation measures, also means that the cost of services in private medical facilities will go up since they will pass the financial burden to patients. This will hit underprivileged women most. A delay in getting medical intervention is crucial as this means a surgical procedure as opposed to a drug-induced one. An abortion after the second trimester becomes all the more difficult as the law requires the approval of two doctors. The Medical Termination of Pregnancy (Amendment) Bill, 2020, was introduced in Parliament in March. This provides for a pregnancy to be terminated within 20 weeks with the approval of one doctor. But as of now, it is not applicable. In the case of pregnancies in unmarried women, there is also the stigma which prevents them from seeking medical help in time.
Many health care workers who were involved in family planning awareness and distribution of contraceptives are no longer available as they have been taken over for Covid19-related work. Even where health facilities are available, many women are fearful of going to them as they fear exposure to the virus.
The choices before women in such a situation are limited. Continuing with an unwanted pregnancy has a profound impact on the woman and the family. At a time when there are huge job losses, the lack of a woman’s ability to work as a result of an unwanted pregnancy could impact the economic condition of the family. In such a situation, it is likely that the woman could approach a quack for abortion services. A botched abortion can result in physical damage to the reproductive organs and psychological issues such as depression and stress. It is important, therefore, to identify facilities within the public health system which can safely conduct abortion services and ensure that these can be strengthened in terms of staff and medical equipment.
Perhaps, an offer of subsidised transport to women in need can also be considered. Medical consultations online can be beefed up, and the supply chain for medicines for pregnant women prioritised.
The lack of safe abortion facilities will have an impact on both health and family planning long after the coronavirus crisis is overcome, both in terms of unwanted pregnancies and unsafe abortions. Planning for this now is the only option.