Women struggling to access usual contraception as coronavirus plunges sexual health services into chaos

Women are struggling to access their usual methods of contraception due to sexual health services being plunged into chaos in the wake of the coronavirus crisis, service providers have warned.

Sexual health clinics have been shut or are running a skeleton service, as staff have been deployed to other parts of hospitals to help with the coronavirus emergency while large numbers of GPs are off sick with coronavirus or self-isolating.

A study carried out by the British Association for Sexual Health and HIV since the Covid-19 outbreak found 86 per cent of clinics could not offer the most effective long-acting contraceptive choices of a coil or an implant, and only two-thirds could still fit a coil for emergency contraception.

Tracey Forsyth, lead contraceptive nurse at British Pregnancy Advisory Service, told The Independent some sexual health clinics are saying they are open online when they are not.

Ms Forsyth, whose contraceptive team speaks to around 400 women a week via the phone, added: “GPs are saying ‘use condoms’ to women when they ring up and ask for a repeat prescription of contraceptive pills or ask to have the coil fitted or another form of contraception.

“Women are having difficulty getting access to contraception. They are telling me they can’t get long-acting reversible contraception [LARC] fitted at the moment. This includes the implant, coil and injection.

“If someone needs to have an emergency coil that stops them getting pregnant because the condom splits, they should be able to. It is essential contraceptive services are open at this time. Most people I’m speaking to are saying they are having more sex because they have got more time. They may be furloughed and have not got the stress of going out to work.

“But women are frustrated and annoyed. They don’t understand why they can’t access the service. They don’t want an unwanted pregnancy. Especially not with the economic uncertainty of the current situation. They are worried about the future and whether they have a job go back to and bills are piling up. Not being able to get contraception is an additional pressure in what is already a difficult situation.”

Ms Forsyth, who has been running the UK-wide contraceptive and sexual health phone service for 11 years, said the Faculty of Sexual and Reproductive Healthcare has released new guidelines in the wake of coronavirus but claimed not all GPs are following them.

The nurse said some GPs are blocking women from getting the contraceptive pill due to not having their blood pressure reading or only having a reading from a year ago, despite the new guidelines stating this is no longer necessary in the wake of the coronavirus crisis.

Ms Forsyth, who said the pandemic was exacerbating existing cuts to sexual health services, noted women she speaks to are fearful of contracting coronavirus while picking up their contraceptive pills from GP clinics. She said some GP practices are only offering a tight time slot to pick up prescriptions, which can be difficult if you are having to juggle collecting them with being at work for set hours.

Peter Greenhouse, spokesperson for the British Association for Sexual Health and HIV, an association of specialists who work in sexual health clinics, said: “The longer the lockdown goes on, the worse the situation will get for women’s sexual health.”

The sexual health consultant, whose organisation carried out a survey of all sexual health clinics in the country, added: “Anything that limits availability and choice of contraception harms women’s health and Covid’s had a huge impact on sexual health services. Our UK-wide live survey found that two-thirds of clinics had less than 20 per cent capacity for face-to-face consultations.

“A third of services have stopped giving three-monthly contraceptive injections (Depoprovera), 86 per cent of clinics couldn’t offer the most effective long-acting choices of a coil or an implant, and only two-thirds could still fit a coil for emergency contraception.

“Although 90 per cent offer telephone advice on choice and supply of pills, switching methods during the current crisis is more difficult and only one in five clinics can provide pills or patches online. So while social distancing is reducing opportunities for the spread of STIs, women who need to adjust their contraception, or manage heavy or severely painful periods, will have a much more challenging time.”

Anne Lashford, vice president of the Faculty of Sexual and Reproductive Healthcare, said the progestogen-only pill is being prescribed as a “temporary bridging method” for women who are not able to get a hold of other methods of contraception.

Dr Lashford added: “For some people, the progesterone pill might not be their ideal form of contraception but they can move back to their preferred method once services are open. You can’t predict what sort of bleeding pattern you will get on the progesterone pill. Around half of the women who take it have no periods. Some will have a reasonably regular cycle. Others will have erratic bleeding.

“One group running into some problems is those who have contraceptive injections which need to be done in person every 12 weeks but you can extend to 14 weeks.”

The Faculty of Sexual and Reproductive Healthcare has released new guidance for decision-makers and doctors on how services should be run in the wake of the pandemic – as well as releasing a leaflet with information for women on what contraception they are able to access.

The organisation, which said consultations are now being carried out via phone or video, said the new guidelines advise women to extend the use of their implants or IUDs.

Sexual health services were overstretched before the coronavirus emergency; frontline service providers previously told The Independent women’s health is being put at risk and abortion rates are rising, because clinics providing women with contraception are being forced to close due to “damaging” cuts.

Figures show spending on contraception has fallen by almost a fifth since 2015 – with data provided by the Advisory Group on Contraception showing the proportion of councils reducing the number of places providing contraceptive services has risen from just nine per cent in 2015-16 to 26 per cent in 2018-19.