Abstract
OBJECTIVE: During the COVID-19 pandemic, more precisely as a result of restrictions on movement and continuing altered perception of essential health care services, women’s health is disproportionately affected due to reduced access to services as per reports and statements made by different global and national level Government and non-government agencies. We aimed to evaluate the health care impacts related to contraception, family planning, and safe motherhood in an Indian Armed Forces secondary level care hospital during the COVID-19 pandemic. STUDY DESIGN: Immediate health care effect on women’s sexual and reproductive life during pandemic months (April to August of the year 2020) is analyzed through a retrospective observational cohort study in a single Indian Armed Forces secondary level care hospital experience. RESULTS: It has shown more late reported unintended pregnancies requiring surgical intervention, more late-registered antenatal cases and consequently delayed essential evaluations, increased trend in high-risk cases requiring in-patient care (IPD), and reduced access to contraception and family planning services in comparison to those in the previous two years. CONCLUSION: Considering these negative impacts noted in this observation, with the help of policymakers, government, and other non-government agencies, all services should be made available to women including un-interrupted out-patient (OPD) and IPD services in all hospitals, along with continued basic infection prevention and control precautions (IPC) to both clientele and health care workers (HCW). Telemedicine can also play a supplementary role in various aspects of women’s health to avoid upcoming population explosion and for better maternal-child health care.
Highlights
World Health Organization (WHO) had declared COVID19 disease as pandemic on 11 March 2020
The retrospective observational cohort study was conducted in a secondary level care hospital catering to defense service personnel, ex-servicemen, and their dependents, with an aim to endpoint assessments in various denominators like delivery rate, OPD and IPD loads, mortality data, high-risk pregnancies, different ultrasonography (USG) modalities, medical termination of pregnancies (MTP), and various family planning services parameters
During the pandemic times (April- August 2020), all departments of this hospital were fully operational and the Department of Obstetrics & Gynecology had even extended the services through disseminating basic Antenatal care (ANC) monitoring by placing fetal monitoring equipment to peripheral medical facilities under the supervision of paramedics and by the implementation of telemedicine and social media platform to clienteles and to health care professionals (HCP) of peripheral primary care medical facilities as per guidelines of International Federation of Gynecology and Obstetrics (FIGO) statement dated 30 March 2020 [6]
Summary
World Health Organization (WHO) had declared COVID19 disease as pandemic on 11 March 2020. A global ‘Lockdown’ with information on COVID-19 related mathematical data had taken over the world health care services ignoring essential health care services. Antenatal care (ANC) is the systematic supervision of a pregnant woman and its objective is to ensure a normal pregnancy with the delivery of a healthy baby from a healthy mother [1]. WHO made a comprehensive guideline on routine. ANC for pregnant women and adolescent girls in 2016, recommending eight ‘contact’ models to improve maternal, fetal, and newborn outcomes through evidence-based perinatal morbidity and mortality data [2]. Contraception, family planning including abortion services are always considered essential services worldwide. Unsafe abortions account for 8% of the Maternal Mortality
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