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Will coronavirus impact access to contraception?
What we know about contraceptive access during the pandemic
SARS-CoV-2 (the new coronavirus responsible for COVID-19) is a global public health crisis that is overwhelming health care systems across the globe (1, 2). As a result, barriers to sexual and reproductive health are impacting access to contraception.
Even before this pandemic, people who use birth control faced obstacles accessing it, including financial barriers, lack of insurance, difficulty visiting a clinic, provider requirements like pelvic exams and Pap tests, and trouble accessing a pharmacy (3).
You probably want to know how the pandemic will impact you and your contraceptive choice. Access to contraception may or may not be altered where you live, since rules, regulations, production, and imports vary from place to place. Still, with stay-at-home orders and safety concerns about exposure to the virus, everyone across the globe is being impacted. You might be concerned about how to access your contraception when you need to be staying at home during this pandemic.
Let’s take a look at the ways contraceptive access has changed due to coronavirus and what you can do to manage the specific contraception you need.
Will coronavirus limit access to contraception?
Contraceptive supply chains are being impacted by the pandemic (4). A producer of family planning and reproductive health products has reported that access to contraception might be limited in the upcoming months due to coronavirus. This idea is based on a few factors, the first being many Chinese factories where contraception is produced were shut or not producing their usual volume during the peak of the outbreak in China. Other issues related to contraceptive access include inventory in the country where you live, travel restrictions that might impact regulatory constraints, and lack of face time between pharmaceutical salespeople and clinicians. The specific types of contraception that will be impacted by these disruptions aren’t exactly clear, but it appears to include hormonal birth control and condoms (5).
The most likely way that the COVID-19 outbreak will impact access to contraception is by reducing the perceived urgency of contraceptive needs.
Some healthcare providers are rescheduling any visits considered “non-essential,” or moving these visits to telemedicine and this may include visits for contraceptives, including the pill, the shot, the ring, the patch, the implant, and the IUD. Some people might also lose access to contraception if they feel it is unsafe to leave their home during quarantine. In some countries, healthcare providers may prescribe and refill contraceptives without an in-person visit using telehealth (6, 7).
In countries without a national healthcare system, like the United States, access to contraception is threatened by the widespread job loss seen during coronavirus. Unemployment poses both a loss of health insurance as well as a loss of earnings to enable the purchase of contraceptives.
Some low-cost reproductive health care clinics in the U.S. have been forced to close during this pandemic. Several countries in Sub-Saharan Africa and Asia have seen many family planning services close, creating a contraceptive desert. University shutdowns are impacting students across the globe who access contraception at university health clinics.
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Will coronavirus limit access to abortion?
In many countries, access to abortion is already limited or may be provided only to save a person's life, preserve their health or on social or economic grounds. The pandemic may also have far-reaching effects at limiting abortion in other nations.
Lawmakers in some U.S. states have classified abortion as a “non-essential” procedure. Because abortion is an essential part of health care and a time-sensitive service, the American College of Obstetricians and Gynecologists (8), has stated that during the COVID-19 pandemic, abortion should be categorized “essential.” The International Federation of Gynecology and Obstetrics (9), suggests that in order to lessen pressure on the healthcare system, abortion should be offered through telemedicine, by providing easy access to mifepristone and misoprostol ("the abortion pill"), and removing any unnecessary waiting periods (9).
In Europe, 100 non-governmental organizations (NGOs) issued a joint statement asking European governments to provide safe and timely access to abortion during the COVID-19 pandemic (10). Some European hospitals and clinics where abortions are provided have either shut their doors or limited services during the pandemic (10).
How to refill hormonal contraception during coronavirus
Most countries in Europe require a prescription to access birth control (11). If you don’t have a regular birth control provider, you can reach telemedicine practitioners with a smartphone or computer. See the end of this article for a list of telemedicine providers.
Getting the pill during coronavirus
Many reproductive health providers are now being encouraged to provide birth control pills with 12-month refills (5, 6). You might not be able to fill the whole prescription at once because insurance often regulates supply. Ask the pharmacist how much you can refill at one time. Mail order pharmacies and drive through pharmacies should be used if that’s a possibility (6). In the U.S., pharmacists in California, Colorado, District of Columbia, Hawaii, Idaho, Maryland, New Mexico, Oregon, Utah, and West Virginia, can provide birth control pills (12).
Getting the birth control patch or ring during coronavirus
Similarly to getting a birth control pill prescription, providers should be able to prescribe up to 12 months of the patch or ring during this time. The amount you can refill at one time may be limited by your insurance.
Getting a new IUD or implant during coronavirus
If your IUD or implant is set to expire soon, you might not need a new one right away (6, 7). Copper IUDs, higher-dose hormonal IUDs (52 mg), and implants are believed to be effective one to two years beyond their expiration date (13). Lower-dose hormonal IUDs (13.5 mg and 19.5 mg) require a backup method like a condom or progestin-only pill if used beyond their expiration date, but these IUDs don’t need to be removed immediately if they are expired (6).
Getting the birth control shot during coronavirus
The contraceptive injection usually requires in-person visits. It’s given as an injection every 13 weeks (14, 195). Current birth control shot users may want to consider switching to a progestin-only pill (6). If the pills are started up to 14 weeks after the last shot, no backup method is needed (6). Users who self-administer the birth control shot can ask their provider for a 12-month supply (6).
Getting emergency contraception during coronavirus
Emergency contraception (EC) is contraception taken to prevent pregnancy following unprotected sex. Depending on where you live, it may be available over-the-counter. If you require a prescription, call your provider immediately after unprotected sex for a prescription. If you have birth control pills on hand, certain types of pills can be used for emergency contraception, but you’ll need the guidance of your provider to instruct you how to use pills for this use (14).
Getting condoms during coronavirus
If you’re sheltering in place but need access to a barrier method, you can order condoms, spermicide, and sponges online. Male/external condoms offer the best over-the-counter protection against pregnancy and are 87-98% effective (14). Female/internal condoms are 79-95% effective at preventing pregnancy (14). Spermicide prevents pregnancy between 79-84% of the time while sponges prevent pregnancies 73-91% of the time (14). Using any two methods together will further increase the chance of preventing pregnancy (14).
What to do if you can’t access birth control during coronavirus
If birth control becomes too difficult for you to access during this pandemic, you have a few options to prevent pregnancy. Keep in mind that condoms are the only way to protect against sexually transmitted infections (STIs). Using contraception together with a condom is the most effective way to protect against pregnancy and STIs (14).
Barrier methods like condoms, spermicides, and sponges reduce pregnancy risk (14).
Fertility awareness methods work by predicting ovulation and abstaining from sex on days that are high risk for pregnancy (15).
Withdrawal can reduce the risk for pregnancy when a partner removes their penis before ejaculation (16).
Hormonal contraceptives can prevent pregnancy, but many people take them for other benefits as well. In many cases, hormonal birth control can improve acne, reduce period pain, improve menstrual related mood disorders, and regulate bleeding (14). When a person stops using hormonal birth control, some of these cycle-related symptoms could return. You can track your cycle and any changes you’re feeling using the Clue app.
People all over the globe are dealing with uncertainties regarding this pandemic. Impacted access to contraception and abortion means people who need contraceptives will be disproportionately affected by this pandemic. Organizations worldwide are working to offer these services remotely. Hopefully your contraceptive access won’t be interrupted by coronavirus, but if it is you can look to Clue for more information on switching types of birth control, going off birth control, or using fertility awareness methods at home. You can also find more resources on our Instagram.
United Kingdom birth control resources:
Superdrug Online Doctor: Delivers contraception throughout the UK.
Kry: Online access to healthcare providers for a fee (Also available in Sweden, France, the UK, Germany, and Norway).
EuroClinix: Delivers contraception throughout the UK.
121 Online Doc: Online access to contraception with delivery option.
NHS UK: Find a sexual health clinic.
NHS Scotland: Telephone consultation for sexual health.
United States birth control resources:
Bedsider.org: Organization aiming to increase access to birth control.
877-257-0012 for referrals to clinicians who provide abortion care.
National Abortion Federation: COVID-19 abortion resources.
Free the Pill: Review the contraceptive laws in your state regarding co-pays, access without a prescription, pharmacist access, and insurance coverage for 12 month supplies. See a comprehensive list of how to get birth control online here.
Nurx: Telemedicine for contraception.
The Pill Club: Telemedicine for contraception.
France birth control resources:
Doctolib: Access to healthcare providers online.
Kry: Online access to healthcare providers for a fee.
Germany birth control resources:
Zava: Online providers with prescription delivery.
Australia birth control resources:
Simple Online Doctor: Offers birth control refills online.
Qoctor: Assessments and refills for birth control online.
Canada birth control resources:
Felix: Assessments and refills for birth control online.
Birth control resources where contraception is not readily available:
Women on Web: Provides access to birth control, emergency contraception, and medication abortions.
*If you are currently experiencing domestic violence, and are located in one of the following countries, please call a hotline for resources. If your country is not listed below, please search for a trusted resource specific to your location online.
United States Domestic Violence Hotline 1-800-799-SAFE (7233)
United Kingdom National Domestic Violence Helpline 0808 2000 247
German Violence Against Women Hotline 08000 116 016
Australia National Sexual Assault, Domestic Family Violence Counselling Service 1800 RESPECT (1800 737 732)
New Zealand Women's Refuge 0800 REFUGE (0800 733 843)
France:
SOS Viols (rape) : 0 800 05 95 95
Domestic violence Victims : 08 842 846 37
Ending Violence Association of Canada Visit website for phone number for each state
