Two weeks after the lockdown had been announced, 26-year-old Avantika*, a resident of Mumbai found herself panicking after a home pregnancy test she took was positive.
“I didn’t know what to do, I didn’t believe it at first and took 2 more tests which also were positive, and that’s when I really started to panic. I live with my friend and her cousin, who really supported me through the whole process. My friend’s cousin called up a few hospitals near where we live to find out if we could get a scan to confirm the pregnancy, nearly all of them said no,” she says.
"My family lives in Delhi and telling them what was happening was not even an option. Eventually my friend managed to get the contact of a gynecologist who did a scan and prescribed me medications for ending the pregnancy.”
Across the country, scores of women like Avantika have been unable to access abortions, contraceptives and other reproductive and sexual health care, in light of the lockdown due to the coronavirus pandemic.
“While the World Health Organisation (WHO) declared abortion an essential service, this wasn’t included on the list of essential services which were released by the Indian government in the last week of March,” explains Jasmine Lovely George, the founder of Hidden Pockets, a referral platform for sexual and reproductive health for women, “It was added later, only on April 14, but even so many women are still facing difficulties in accessing these services.”
Several hospitals continue to turn away those who do not need emergency services; something that abortions, emergency contraceptive pills and IUD insertions were not considered under.
Lockdown is probably making it more difficult to find ECPs in Chennai. Worry not, I have a list of places you can find it at & I have already directed quite a few ppl to the right pharmacies. I may not be as active here, but I check my DMs regularly so feel free to get in touch. https://t.co/LPDj1U7KEn
— Potato Bajji (@pepsiwithastraw) May 15, 2020
A recent report released by the Foundation of Reproductive Health Services (FRHS), an NGO based in Delhi, predicts that the COVID-19 lockdown could result in millions of unintended pregnancies, unsafe abortions, and even maternal deaths. VS Chandrasekhar, the CEO of FRHS, has even commented that if women are forced to carry pregnancies to term due to the non-availability of abortion services, this would lead to a high rate of births. This in turn, can adversely affect the vast gains India has made in terms of population management and reducing maternal mortality rates.
“These are safe and essential procedures and making it more difficult for women to access them during a pandemic will contribute to long-term consequences,” explains Dr Hema Divakar Federation of Obstetric and Gynaecological Societies of India (FOGSI), stressing that limiting access to contraceptives and medical termination of pregnancies (MTPs) would only result in women turning to unsafe measures.
In one instance, a young woman from Nagpur had turned to an unqualified 'doctor' to perform an abortion after being turned away by 2 hospitals.
“She was alone and didn’t know what else to do, this ‘doctor’ charged her around Rs 50,000 and the procedure wasn’t even done correctly. Shortly after, she realized that she was still pregnant, when she called our helpline,” says Jasmine.
Women have faced several hurdles even before the lockdown: How do they reach the clinic? Whom do they turn to to accompany them? Such logistical issues, Jasmine explains, have only increased with the lockdown.
In addition to the already existing stigma of an unmarried woman seeking these abortions, women are also calling the helpline at odd hours and sending emails with their queries and concerns in order to avoid questions from their families with whom they are staying with during the lockdown.
“If a woman is found to be in the first four weeks of pregnancy, then we can manage it a lot easier, without worrying about invasive procedures. But because of the lockdown, many young women are finding it difficult to even call and speak to a professional over the phone due to the lack of privacy,” explains Dr Hema Divakar of the Federation of Obstetric and Gynaecological Societies of India (FOGSI).
The Ministry of Health and Family Welfare had already suspended insertion of intrauterine devices and sterilization procedures and access to over-the-counter contraceptive medications too are being curbed slowly, as they are deemed non-essential items.
“In a city like Bengaluru when we see people struggling to get transport to the hospital you can only imagine the situation in smaller towns or cities. There may be limited resources and facilities. Furthermore, everyone is advising that people don’t come to the hospital unless absolutely necessary so as to avoid any exposure to SARS-CoV-2. So there is the fear of that for some women as well,” adds the doctor.
According to the FRHS, public and private healthcare systems have to be improved to be able to handle the demand for family planning and abortion services during the pandemic. Essential drugs, including contraceptive pills should also be made available at all medical shops and reduced restrictions on their sales. Furthermore, NGO and private delivery organisations should be permitted to do deliveries of necessary medicines to individuals requiring them.
Name changed*