Sexual and reproductive health a COVID-19 priority (Statement)

Burnet Institute, 28 May, 2020

Burnet Institute is a member of a consortium of Australian-based non-governmental organisations (NGOs) and academic institutes concerned about the detrimental effects of the COVID-19 pandemic on the sexual and reproductive health and rights of women and girls globally.

The International Sexual and Reproductive Health and Rights Consortium, which includes Save the Children, Family Planning NSW, CARE Australia, The Nossal Institute for Global Health, and Médecins Sans Frontières Australia, is calling on the Australian Government to prioritise the needs of women and girls in its response to COVID-19.

Collectively, the consortium works across 160 countries to champion universal access to sexual and reproductive health and rights.

It’s concerned that women and girls across the globe are struggling to access critical sexual and reproductive health care, citing evidence that COVID-19 lockdowns are likely to cause millions of unplanned pregnancies.

In the Pacific, travel to rural and remote areas have been curtailed, and physical distancing requirements have forced the cancellation of most group training on sexual and reproductive rights.

A recent UNFPA report determined that a six-month lockdown could mean 47 million women and girls globally cannot access contraception, and seven million will become pregnant.

The consortium has issued a joint statement setting out priorities to ensure Australia’s global response to COVID-19 meets the critical needs of all women and girls, including:

  • Recognise and respond to the gendered impacts of the pandemic, and the increased risk to women and girls from gender-based violence and other harmful practices
  • Improve the supply of contraceptives and menstrual health products which are being impacted by the strain and disruption on global supply chains
  • Increase flexibility in delivering sexual and reproductive health services during lockdown using innovative health delivery models such as task-sharing, tele-health and pharmacy distribution
  • Support sexual and reproductive health workers and clinics to continue delivering services sagely with access to personal protective equipment as well as training on how to refer, test or diagnose COVID-19.

 

SEXUAL HEALTH MATTERS: new clinical podcast from SHINE SA

SHINE SA, May 2020

Filled with quality clinical guidance and tips for best practice, SHINE SA’s new Sexual Health Matters – Clinical Podcast delves into the intimate regions of the body and broaches the uncomfortable conversations necessary to ensure client safety and sexual/reproductive well-being.

Through discussion, interview and explanation, experienced sexual health clinicians raise awareness of guidelines, resources, research and emerging trends to ensure that clinicians everywhere can provide excellent sexual and reproductive care to improve client outcomes.

If you have a topic you would like us to cover in future podcasts, email courses@shinesa.org.au to let us know!

U.S. FDA Approves Evofem Biosciences’ Phexxi™, the First Non-Hormonal Prescription Gel for the Prevention of Pregnancy

Evofem Biosciences via PRNewswire, May 22nd 2020 

Evofem Biosciences, Inc. today announced that the U.S. Food and Drug Administration (FDA) has approved Phexxi™ (lactic acid, citric acid and potassium bitartrate) vaginal gel for the prevention of pregnancy in females of reproductive potential for use as an on-demand method of contraception.

Phexxi is the first non-hormonal, on-demand, vaginal pH regulator contraceptive designed to maintain vaginal pH within the normal range of 3.5 to 4.5 – an acidic environment that is inhospitable to sperm.

Situational Report: Sexual and Reproductive Health Rights in Australia

Marie Stopes Australia, Updated 17 April 2020

Situational Report: Sexual and Reproductive Health Rights in Australia – A request for collaboration and action to maintain contraceptive and abortion care throughout the SARS-COV-2 / COVID-19 pandemic

Executive Summary

We are in a context of increased risk of unplanned pregnancy, reproductive coercion, sexually transmitted infections, lack of pregnancy options and a multitude of barriers to healthcare. Access to contraception and abortion throughout the pandemic will mitigate broader public health risks for years to come. 
.
At Marie Stopes Australia, during the pandemic we have had to:

 Cancel surgical abortion care lists- meaning women and pregnant people have had to continue with their pregnancies or are likely to seek a termination at a later gestation
 Reduce our national gestational limit for surgical abortion to 22 weeks
 Face increased costs in the provision of regional healthcare, having no other option than to charter private flights for clinical staff
 Continuously scramble for Personal Protective Equipment (PPE)
 Reduce in-clinic list capacity to enable physical distancing
 Reduce contraceptive services in order to prioritise abortion access
 Reduce financial support for clients experiencing financial hardship
 Face increased risk of staff fatigue and burn out
 Evolve models of care in an effort to maintain access to care. To address this situation, we need to review legislation and policy, evolve models of care, maintain people’s rights to access care and make healthcare more affordable.

Key recommendations at this point in the pandemic include:
 All Governments, health and hospital services, and health clinics must consider abortion an essential service with Category 1 classification
 Provide access to medical abortion via telehealth for people living in South Australia
 Increase medical abortion provision to 70 days/10 weeks gestation, supported by the  Pharmaceutical Benefits Scheme (PBS)
 All accredited sexual and reproductive healthcare providers should have access to the National Medical Stockpile for PPE
 Intrastate travel support is needed for clinical staff in order to maintain surgical abortion provision in regional and remote clinics
 Do not criminalise women and pregnant people who attempt unsafe abortion

[This report contains] further detail on these points and a longer list of recommendations that Australia will need to consider in o order to maintain sexual and reproductive health
rights throughout the pandemic.

 

 

NEW Fact Sheet for Health Professionals – Contraception During the COVID-19 Pandemic.

SHINE SA, 15/4/2020

SHINE SA have released a new Fact Sheet for health professionals: Contraception During the COVID-19 Pandemic.

Contraception is an essential service during the COVID-19 pandemic. This includes the provision of emergency contraception, access to long acting reversible contraception (LARC) and management of complications of LARC. Health professionals can continue to facilitate access to contraception via telehealth consults and limited face-to-face consultations where possible.

This Fact Sheet provides advice for health professionals on the provision and management of contraception during the COVID-19 pandemic. This includes LARC, combined hormonal contraception, emergency contraception, progestogen only pill and depot medroxyprogesterone acetate (DMPA).

Position Statement on LARC access during the COVID-19 pandemic

SHINE SA, April 7, 2020

SHINE SA, along with Family Planning VictoriaFamily Planning NTFamily Planning TasmaniaSexual Health and Family Planning ACTSexual Health Quarters, and True Relationships & Reproductive Health have co-signed a Position Statement on LARC access during the COVID-19 pandemic.

Extended use of and ongoing access to LARCs during the COVID-19 pandemic

Provision of contraception is essential during the COVID-19 pandemic to prevent unintended pregnancies. This is particularly important for individuals most at risk, including young people due to their high levels of fertility, people with serious health conditions, and for those who are post-abortion. Long Acting Reversible Contraceptive methods (LARCs) are more effective than shorter acting methods and increased community access and uptake is associated with lower abortion rates.

Ongoing access to LARC insertion is essential during the pandemic

Contraception is essential health care and all efforts should be made to continue the insertion of LARCs during the pandemic. To reduce the risk of infection with COVID-19, this may require different approaches to insertion such as a wearing mask during insertion of contraceptive implant or using an inserter-only approach for IUD insertion (with an assistant outside the room for emergencies).

Summary of recommendations during the pandemic

  • All efforts should be made to continue access to insertion of LARCs during the pandemic, particularly for younger people, people with serious health conditions, and post-abortion
  • The etonogestrel implant (Implanon NXT) can be extended off-label for use up to 4 years
  • The 52mg LNG IUD (Mirena) can be extended off-label for use up to 6 years
  • The 19.5mg LNG IUD (Kyleena) cannot be extended beyond 5 years
  • Standard sized T shaped banded copper IUDs can be extended off-label for use up to 12 years
  • 5-year copper IUDs (Load 375 and Copper T short) can be extended off-label for use up to 6 years
  • Additional use of condoms and/or a contraceptive pill should be discussed with users for whom the risk of an unintended pregnancy is unacceptable during extended use.