To put it lightly, the COVID-19 pandemic has had a huge impact on sexual and reproductive health. In March, sexual health clinics, such as those testing for and treating STIs and administering birth control, were forced to shut down, delay or cancel appointments. Abortion services were declared “non-essential” in eleven states, disrupting services for up to a month.

Those expecting faced similar disruption of services that increased the risk of pregnancy and birth complications. According to the CDC, “pregnant people might be at an increased risk for severe illness from COVID-19 compared to non-pregnant people.”

What you’ll find here is an overview of the impact of the pandemic on sexual and reproductive health in the U.S. with a small summary on the global impact, as well.

It’s important to note that all of the statistics we found were based on binary gender data. In most cases, we preserved the gendered terms to stay true to the studies. What this means: we have no idea what the specific effects of the pandemic have been on the sexual and reproductive health of transgender and nonbinary folks. We do know that many studies found that individuals who identified as queer (as opposed to straight) were more likely to have reported various adverse effects from the pandemic.

Similarly, people of color and lower-income individuals were, across the board, more impacted by a disruption of services and loss of income to receive services.

At present, with the virus still not contained, it is impossible to understand its full effects. We need more time to accumulate data and research facilities operating at full capacity. We also need to see where this is going. What follows is what we know so far.

Decreased Access to Sexual and Reproductive Health Services

83% of STD programs deferred STD services or field visits (Source)

In May, the National Coalition of STD Directors published a survey of STD service providers. They found that over 80% of programs were forced to defer STD services such as testing and treatment programs during the quarantine. Over 60% of STD programs could not maintain their HIV and syphilis caseloads and experienced reduced capacity to treat STDs. Over half of STD clinics were redeployed to COVID-19 facilities. 

One in three women faced delayed or canceled SRH care  (Source)

33% of women have been forced to delay or cancel a visit to a health care provider for sexual and reproductive health care or have faced difficulties getting birth control.  These barriers were more common among Black and Hispanic, queer, and lower-income populations.

Some of these delays are due to limited access to sexual health clinics. Some are also due to financial reasons. Women are more likely than men to have lost their job or be unable to work because of the lack of child care. The rise in unemployment also means more people have lost their employment-based health insurance.

Eleven states prevented access to abortions (Source)

Using state-level public health emergency regulations, eleven states defined abortion as non-essential. Each of these regulations was challenged by court order, governor action, or new executive order; however, each state effectively banned surgical (and in some cases medication) abortions for several weeks up to a month.

Texas, where abortions were banned for one month, saw an increase in second-trimester abortions and an overall number of surgical abortions. Many other patients who were planning nonsurgerical medication abortions went over the ten-week limit and were forced to undergo a surgical abortion which is more invasive and overall dangerous, The Cut reported.

Probable Increase in STI Cases

The number of sexually transmitted infections,  including gonorrhea, syphilis, and chlamydia were at an all-time-high before COVID and the numbers have been climbing over the past five years due. 

Because of a decrease in screening and testing and a national shortage of STI test kits and lab supplies, in part due to supply chain disruptions caused by the pandemic, experts do not have the stats to verify an increase in STIs since the lockdown in March; however, there is strong reason to suspect that the lack of screening will lead to a spike in new cases.

Coronavirus Increases Risks in Pregnancy

Higher risk for pregnancy and birth complications (Source)

Studies from the Centers for Disease Control and Prevention have found that pregnant individuals infected with COVID-19 are at a higher risk for serious pregnancy and birth complications, including premature births. They are also at increased risk for serious disease related to COVID-19.

Increased Number of Stillbirths (Source)

UNICEF estimates that somewhere between 60,000 and 200,000 additional stillbirths across the globe over a 12-month period as a result of health service disruptions due to COVID. Lower-income countries are the most at-risk for this increase; however, African American women in the U.S. have almost twice the risk of stillbirth compared to white women.

Emily Carter, a public health researcher at John Hopkins University told Nature Magazine, “To understand the full effects of the pandemic on pregnancies, future studies will need to use population-level data to assess outcomes in mothers who opted not to go to [the] hospital and gave birth at home or in smaller facilities during the pandemic … Sometimes, we’re missing how dire the situation was, even before the pandemic, for certain segments of the population.”

Decreased Desire To Have Children

Over 40% of women have changed their plans around childbearing (Source)

A Guttmacher survey found that over 40% of women polled changed their plans about when to have children or how many children planned. One third had decided to delay pregnancy or have fewer children. Black and Hispanic, queer, and lower-income women were more likely to have reported these changes in their preferences.

Global Impact

According to the United Nations Population Fund (UNFPA), disruptions in services could leave 47 million women in low- and middle-income countries without safe contraceptives. This could lead to 7 million unintended pregnancies. In addition, the organization predicts that six months of lockdowns could result in 31 million new cases of gender-based violence.

Marie Stopes International (MSI) which provides contraceptive and abortion services to 37 countries, reported that 1.9 million clients lost access to their services in the first half of 2020. They predict this will lead to 900,000 additional unintended pregnancies, 1.5 million additional unsafe abortions, and 3,100 additional pregnancy-related deaths.

“This pandemic has strained healthcare services all over the world, but sexual and reproductive healthcare was already so under prioritised that once again women are bearing the brunt of this global calamity,” Dr Rashmi Ardey, Director of Clinical Services at MSI’s India programme, explained.

We hope that this global crisis brings new awareness to the importance of sexual and reproductive health.