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- reproductive health services
- family planning services
- long-acting reversible contraception
- health services accessibility
No area of healthcare is immune to the impact of COVID-19. The pandemic will affect sexual and reproductive health (SRH) worldwide in positive and negative ways. Home isolation and fears of contracting the virus appear to have led to decreased uptake of SRH services, increased reports of intimate partner violence, and in some settings reduced access to contraception and safe abortion care.1 2 Vulnerable populations are disproportionately affected, including young people, Indigenous peoples, as well as refugees and asylum-seekers whose safety and care is deprioritised.3 Predictions have been made about higher rates of unintended pregnancy, unsafe abortion, short interpregnancy intervals, and untreated sexually transmitted infections.1
The pandemic has also led to rapid implementation of innovations and legal and regulatory changes that have transformed and improved care for some people. New policies, practices and even enactment of laws have removed barriers to care which could otherwise take years of bureaucracy to overturn.4–6 This editorial draws on the expertise of a range of international clinicians and researchers to examine these changes to policy and practice, many of which may have lasting community benefits.
Many countries have recognised continuity of contraception provision, particularly long-acting reversible contraception (LARC), as essential. Where infrastructure permits, there has been a significant shift to telemedicine, for instance in the United States (US), Canada, UK, France, Australia, Scandinavia, China, South Africa and Nepal.4 6 ,7 Some countries have been able to maintain LARC access through brief procedural visits with appropriate personal protective equipment (PPE) following a virtual …