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COVID-19: Access to reproductive health services

01 April 2020

Updated 8 April 2020

The COVID-19 pandemic presents significant challenges for health services in Australia and New Zealand. The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) acknowledges the risk posed to the community, health workers and all patients due to the COVID-19 pandemic. RANZCOG also recognises our responsibility to respond to this situation as a large organisation and also as a medical college and health leader.
 
As governments and health jurisdictions evaluate the needs of the community and mechanisms for service delivery, it is essential that vulnerable women continue to receive the medical, social, economic and emotional care and support that they need. RANZCOG asserts this as a fundamental human right. Medical, nursing and other personnel who deliver this healthcare must be fully supported to provide that care.

Abortion
 
RANZCOG emphasises that abortion, both surgical and medical, is an essential healthcare service and services must remain available, even when non-urgent or elective services are suspended.  There is a risk woman will seek unsafe abortion methods if timely access is not provided. Abortion is time- sensitive and services should be organised to provide early access, which is associated with safer outcomes.   
 
The use of self-referral, access to written patient information, Telehealth and virtual consultations, pharmacy access and outpatient services for counselling, prescribing and supply of medication for medical abortion, and continued access to post abortion contraception, are required to ensure abortion care is provided during the COVID-19 pandemic.
 
RANZCOG respects the right of a doctor to exercise conscientious objection but we remind all doctors of their duty of care to ensure that every patients receives the appropriate medical advice and treatment that they require.
 
Contraception
 
Unintended pregnancy has significant potential consequences for women. Medical practitioners are encouraged to ensure that women have access to continuity of their current contraceptive method. Health services should ensure continuity and improve access to Long Acting Reversible Contraception (LARCS).

RANZCOG has revised our advice regarding the efficacy of extended use of the 52 mg levonorgestrol IUCD (Mirena®). There is sufficient data to reassure clinicians and women that replacement of the device can be extended to 6 years.
 
Sexual assault
 
There is strong evidence that incidents of domestic and sexual violence against women increase during times of community distress. Apart from the immediate physical and psychological impact on victims, there are also potential short-term and long-term consequences, including sexually transmitted infections (STIs), unintended pregnancy, genital or other physical injury and psychological trauma. It is essential that medical, legal and police mechanisms remain in place and are augmented, as needed, during this time.



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