How reproductive rights have changed during COVID-19
"Reproductive health needs don't stop because of a pandemic, and that care should never be restricted."
Anna Selle works at Planned Parenthood. We reached out to ask her to let us know what’s happening in this confusing time, regarding the ways reproductive health is being managed, and the political hurdles that clinics now face. As with everything under coronavirus, it’s important to be aware of how the world around us is changing.
Here’s what she had to say:
It’s too early to know exactly how the COVID-19 pandemic will continue to shape our health and well-being for the foreseeable future. Though many states—including Kansas and Missouri—are beginning to lift restrictions on public gatherings and business operations after two months of Stay-At-Home orders, the way we view health care is starkly different.
Telehealth Increases Access
Like many health care providers, Planned Parenthood Great Plains has spent the last several weeks examining our practices, reflecting on how to create innovative solutions to guidelines that, though restrictive, ensure the safety of our patients and staff. Our patients continue to require care, and sexual and reproductive health care is essential. As spring progresses into summer, it’s becoming more and more apparent that social distancing will continue to be necessary to decrease exposure risks for several months. In that time, patients will need refills on prescriptions, STI testing and treatment, emergency contraception, and more.
There is a simple and effective way to ensure that patients continue to receive safe and accessible care throughout the COVID-19 pandemic and beyond: telehealth. Prior to the spread of COVID-19, many providers were already beginning to utilize telehealth for the same benefits that are amplified now, from reducing patient and staff risk of exposure to pathogens to gaining the ability to fit care into an otherwise busy schedule and to reduce the need for patients to travel to and from health centers.
In states with large rural populations, like Kansas and Missouri, traveling to a health center that provides the same kind of specific services that PPGP offers can be an hours-long journey, something that’s been discouraged for months in order to flatten the curve of COVID-19 infections. In more densely populated areas, having a provider accessible by a smartphone can limit the need to take public transportation or make a trip to the gas station.
Opening access to telehealth during the COVID-10 pandemic could also be a potential answer to a pressing concern: the possibility for a spike in STIs as a result of this pandemic. Already, Randolph County in Missouri saw double the number of new STI diagnoses between February and March, when stay-at-home orders were first announced. Many health officials who have been trained in patient tracing to combat outbreaks of STIs like syphilis and HIV are refocusing their time and energy to reduce the spread of COVID-19 using similar tracing tactics. State health departments used to be a major provider of STI testing, but their resources have also been reallocated to fight the spread of COVID-19. In these gaps is where Planned Parenthood and telehealth become even more essential to the health and safety of our communities, to provide continually accessible forms of care and treatment.
After implementing a new telehealth program and launching the Planned Parenthood Direct app for contraception delivery directly to homes, it’s clear that these programs will positively benefit patients long after Stay-At-Home orders have expired and we begin to ease into a post-COVID-19 reality. Now, care can meet people where they are.
Abortion Is Essential Care
In response to growing concerns about the spread of COVID-19, several politicians have pushed anti-abortion executive orders and policies that have restricted access to care. Though these bans appear to be protective measures ensuring the conservation of personal protective equipment and hospital beds during the COVID-19 pandemic, the reality is that most abortions require only one set of gloves, if that. Likewise, only a very small percentage of abortions happen in hospitals or have complications that require hospitalization. In fact, states like Texas, where an almost-total ban on abortions still stands during the COVID-19 pandemic, regulations, and restrictions keep patients from receiving abortion care in hospitals. Kansas and Missouri are also on the list of states that restrict abortions from being performed in public facilities.
Most abortions that occur in hospitals are due to life-threatening medical situations for the person who is pregnant, and since most of the executive orders banning abortion during the pandemic include exceptions for these cases, these bans aren’t likely won’t affect hospital intake at all.
But, what these bans did do, is create a significant burden for many people to get abortion services. Those who were planning to have an abortion but were unable to in their home-state are were left with two options: wait it out and hope that they can receive the care they need before they pass the legal gestational age limit, or travel out of state to a care provider that hasn’t been affected by an executive order.
For those that choose to travel, the financial burden of receiving the care they need may increase substantially. Some patients have driven as much as 600 miles one-way to access care. Gas, food, lodging, missed work, and childcare are all additional financial constraints that push care out of reach and make abortion services inaccessible to many. By traveling across state lines, patients are putting themselves, clinic staff, and their loved ones back home at a higher risk of exposure to the novel coronavirus.
We know that many clinics have shuttered or reduced hours and appointments available, and many are reluctant to schedule appointments for patients seeking abortion care, knowing that their state governments might limit access. Because the cost of travel is too significant, or the uncertainty is overwhelming, or for any number of other factors, we can say with almost certainty that people will be forced to carry pregnancies to term that they would have safely and legally ended had they been given the reasonable access to abortion services, without undue burden.
Bodily Autonomy Means Personal Autonomy
The reality is that for many people, now is not an ideal time to be pregnant or to give birth. People who can become pregnant should continue to have the right to choose whether or not to carry a pregnancy to term, no matter what. That right is especially important in the middle of a global health crisis. With uncertainty lingering around employment, health insurance, and how long this crisis will last, it is vital to the health and well-being of our community that access to care remains accessible. And, with an economic recession looming on the horizon, the communities who are most affected by jobless during the COVID-19 pandemic will likely see an increase in abortion services, as was observed during the last large-scale economic recession in 2008.
In the larger landscape of the COVID-19 pandemic, the doctors providing prenatal care for these patients will have to use personal protective equipment for check-ups, ultrasounds, and pelvic exams. The risk for serious complications increases the later a pregnancy progresses, meaning there may be a need to be admitted to a hospital even before the birth process. Most births happen in hospitals, meaning that someone giving birth would most likely need to be given space and a bed in an already under-resourced hospital, where medical health professionals may also be tending to patients with COVID-19, an airborne virus, only a floor or two away. Though some births can happen at home or in a birthing center, the process would require at least one additional person present.
Reproductive health needs don’t stop because of a pandemic, and that care should never be restricted. Our health care system must provide uninterrupted access for patients, even during uncertain times.