FeaturesNujhat J Khan

Access to Contraception During the Pandemic

According to data revealed by UNFPA, ‘the ongoing lockdown and major disruptions to health services during the COVID-19 pandemic could result in seven million unintended pregnancies in the coming months’. It is estimated that if the situation persists for the next six months, it may lead to 7 million unintended pregnancies throughout the world. The latest data reveals that the contraceptive prevalence rate in Bangladesh was 62.4% as of 2014 (Huda, F.A. et. al., 2017). However, whatever progresses has been made in the field of family planning and contraception over the years, might be rolled back because of difficult situations caused by the pandemic.  

Contraception can save lives by preventing unwanted pregnancies. Sexual activity among couples will not stop during the pandemic, hence it is important to protect women and girls from negative health effects of unintended pregnancies.Contraception reduces the risk for women and girls by reducing the need to terminate pregnancies by menstrual regulation. 

There is a risk of a rise in the number of unintended pregnancies in Bangladesh due to limited access to family planning and contraception information and services during lockdown. Increase in the number of unintended pregnancies, and complications that may arise from the termination of pregnancies will have a negative impact on the health system which is already under a huge amount of pressure. 

The following recommendations were formulated by the representatives of DGFP, DGHS, OGSB, UNFPA, DFID, USAID, GAC, IPAS, SMC, Pathfinder, jhpeigo, IPPF, options ltd. and other stakeholders.

  1. It will be a wise decision for couples if they plan their pregnancies according to the overall situation of the COVID-19 pandemic. 
  2. Couples should maintain distance from each other if any one of them show COVID-19 like symptoms. 
  3. You can access  information and contraceptive services from a healthcare provider by calling 16767. 
  4. You may opt for a contraceptive method that is available over the counter. Such as condoms or pills.
  5. If you cannot access a contraceptive method of choice perhaps because it requires a prescription, or because it can only be given by a health worker consider using condoms, fertility awareness-based methods, lactational amenorrhea (if exclusively breastfeeding), or other contraceptive methods that are recommended for self-care. The recommended self-care methods could include the pill or mini pill, emergency contraception pills, and Injectable (DMPA- Subcutaneous, Sayana Press®). However natural methods are risky if the instructions are not followed properly and can lead to unwanted pregnancy.
  6. During the lockdown, the schedule of injectable contraceptives may have been hampered. They can be taken within 28 days of the missed schedule. Communicate with your service provider to get your injection.
  7. If you suspect pregnancy, do not use any unapproved medicines or try Menstrual Regulation with Medicines (e.g. MR kits, Cytomis®) at home WITHOUT consultation with your OBGYN/doctor. The consequences can be life threatening.
  8. For removal of long acting methods such as implants or IUDs, after the recommended period of use, seek advice from health provider. If, due to restrictions on movement due to the COVID-19 pandemic, cannot have long acting method removed straight away, it is important to use another method of contraception to avoid pregnancy at this time. There are no medical problems caused by delaying removal of long acting methods such as implants or IUDs. Do not try to remove the contraceptive method at home; wait until you are able to access health care from a trained provider 

 

Sources: 

Citation: 

Huda, F.A., Robertson, Y., Chowdhuri, S. et al. Contraceptive practices among married women of reproductive age in Bangladesh: a review of the evidence. Reprod Health 14, 69 (2017). https://doi.org/10.1186/s12978-017-0333-2

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