Thousands of clinics are closed, sexual and reproductive healthcare services have been cut, and a growing number of countries are experiencing shortages of contraceptives and HIV medicine, according to a new international survey.

The International Planned Parenthood Federation (IPPF) surveyed its member associations in 121 countries to produce the largest global dataset so far on how the COVID-19 pandemic is affecting sexual and reproductive healthcare.

“Millions of women and girls across the world now face an even greater challenge in trying to take care of their own health and bodies,“ said IPPF’s director general Alvaro Bermejo in a statement. “They have needs that cannot wait, but they are facing a lack of time, lack of choice and lack of access to essential services.”

Emergency measures and social distancing rules have caused more than 5,000 of its members’ clinics and care centres to close across 64 countries. Roughly a third of these closures have happened in the South Asia region alone.

Countries in other regions with more than 100 closures include Germany, Colombia, El Salvador, Ghana, Sudan, Uganda, Zambia and Zimbabwe.

Meanwhile, dozens of IPPF member associations around the world have had to scale down their HIV testing, contraceptive and gender-based violence services, according to the group’s global dataset, seen by openDemocracy.

Reduced travel between countries has meant that about 30 members are already facing shortages of contraceptives while 15 are running short of HIV medicines.

“Our members are working on providing virtual services that minimise physical contact. But without political will and additional resources such as PPE [personal protective equipment], face-to-face services cannot be delivered safely during this pandemic,” said Bermejo, calling on governments to step in and help.

Similar trends

Other organisations have also warned about increasing difficulties. Marie Stopes, a UK-based NGO that provides contraception and abortion services internationally, has similarly decreased its services amid restrictions and national lockdowns.

“Unless governments act now, up to 9.5 million vulnerable women and girls risk losing access to our contraception and safe abortion services in 2020 due to the COVID-19 pandemic,” warned the organisation in a statement.

According to this group’s estimates, service disruptions related to COVID-19 in the 37 countries where they operate could lead to an additional three million unintended pregnancies, 2.7 million unsafe abortions and 11,000 pregnancy-related deaths.

Mara Clarke, from the Abortion Support Network, also warned that the current emergency is having significant impacts on women who live in places where abortion rights or services are already limited and who have to travel to access these.

Clarke’s network supports women who need to cross borders for abortions. On the weekend before Poland closed its borders, she said the network experienced a boom in calls from women in that country, which has extremely restrictive abortion laws. They received 140 calls in just a few days, almost half their usual monthly total.

“We had one person,” Clarke adds, “who had her flight cancelled three times.” Recently, she also scrambled to find an appointment for another woman nearing the legal time limit for an abortion. The clinic she was due to go to had just closed.

Clarke believes that current difficulties in accessing abortion services are likely to mean an increase in demand for second-trimester terminations, although only a few countries in Europe allow abortion on request beyond the first 12 weeks of pregnancy.

“We are playing it by ear and we will do whatever we can to help anyone who will contact us, whether with information or helping them to go from point A to point B,” concludes Clarke, cautioning that travel has already become “very difficult”.