The COVID-19 pandemic spread to Australia early this year, triggering a national lockdown from March 22 to May 8, 2020. Non-essential travel was strongly discouraged unless to access essential goods and services, to receive or provide care, to exercise, or to attend work or education where these activities could not take place at home. This approach led to very few cases and deaths in Australia. However, the lockdown led to other forms of hardship. One of these areas is that of social and reproductive health (SRH).
Shortages of SRH Services and Products
A current study by researchers at the University of Melbourne and published in August 2020 on the preprint server medRxiv* shows that the impact of the lockdown on SRH in women in Australia was significant. In March, a leading condom manufacturer warned of a worldwide shortage. Meanwhile, abortions became more difficult as travel restrictions were put in place for both healthcare providers and patients. National family planning organization Maria Stopes Australia warned that unplanned pregnancies and sexually transmissible infections (STIs) would rise. Charity for girls’ equality Plan International predicted that feminine hygiene products might become more challenging to obtain.
Key Takeouts from the Survey
- Nearly a third of participants reported difficulties accessing their usual feminine hygiene products during the lockdown in Australia.
- Participants reported delaying childbearing or deciding to remain childfree due to the COVID-19 pandemic.
- Ensuring continued access to sexual and reproductive health services and products for all who require them during global emergencies is essential.
The Study of Post-Lockdown SRH Impact
The study reports the results of the first serial cross-sectional surveys to assess the effect of the lockdown on the fertility rate in Australia. Some areas covered include changes in sexual practices, contraceptive use, plans for pregnancy, feminine hygiene products, and healthcare access, including emergency contraception.
Of the survey participants, there were about 53% who answered questions on reproductive health. Of these, who came to 625 in all, about 83% were female and below the age of 50 years. The average age was 26 vs. 27 years. About 55% were aged 18-24 years, and 38% were living together with a partner, married or not. 77% were living in urban areas. Only 2% were pregnant at the time, while over 76% were avoiding pregnancy.
A fifth of the participants was not on contraception, with the pill being the most common method used in over 20% of couples. Less than 10% said they had trouble with getting contraceptives, 5% could not obtain SRH products like pregnancy tests or lubrication products, and 37% had difficulty getting their preferred hygiene products, leading to a change of product use in almost half the cases.
Over a fifth needed to make use of healthcare services for their SRH, while a third made use of online health services. About 2% needed abortion or emergency contraception services during this period.
Younger, Unemployed Women Hardest-Hit
The analysis showed that women who were employed, or in the group 25-34 years had 60% lower odds of having trouble with accessing contraception or abortion services. They also had 60% lower odds of not being able to access hygiene products, compared to those younger than this. Women living with their parents, or those who were not living with their partners, had twice as much trouble getting hygiene products compared to those in a cohabiting relationship.
Women in the older age group and in a cohabiting relationship also found it easier to get healthcare for SRH as well as online health services, compared to younger or single women.
Childbearing Plans and Lockdown
Most participants said the lockdown had not changed their childbearing plans. Of those who explained why, it was either because they had not planned for pregnancy in the near future anyway, or because they had already decided to live child-free.
Some people did report that the pandemic caused a reconsideration of whether they should have children. Some had already had doubts which came to a head at this time. Others were concerned that they would not get healthcare as required or did not want to add to the toll on the healthcare system. Still, others were in financial difficulties.
A few said they had not planned conception but were now attempting it as their financial circumstances had improved with the lockdown, or their plans of travel were disrupted. Some just felt so lonely that they wanted to have a baby.
Meanwhile, some others who had wanted children found it financially impossible or decided they would be too old once the pandemic subsided, or even found they could not access artificial reproductive technology such as IVF.
Overall, the impact of the lockdown on SRH in women shows disproportionate effects on younger and unemployed women, especially concerning obtaining access to contraception. This needs to be taken into consideration by the Australian Government when deciding on welfare measures, to provide equitable compensation for those most affected.
medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.