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COVID-19: Ensure women’s access to sexual and reproductive health and rights

Statement
Strasbourg 07/05/2020
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COVID-19: Ensure women’s access to sexual and reproductive health and rights

It is already clear that the pandemic will deepen existing gender inequalities, given women’s over-representation in professions (and other unpaid activities) which expose them to a high risk of infection and in low-paid and precarious jobs which will be particularly badly affected by the ensuing economic crisis. Worryingly, the lockdown imposed in several European countries has also increased the exposure of women to gender-based violence, in particular domestic violence and sexual violence. While many member states are taking laudable measures in an attempt to mitigate the negative effects of the crisis on women’s rights and gender equality, they should not neglect women’s sexual and reproductive health and rights. Full respect of women’s sexual and reproductive health and rights is an essential component of Council of Europe member states’ obligations to guarantee women’s human rights and advance gender equality.

The COVID-19 crisis and ensuing restrictions complicate access to essential sexual and reproductive health information, services and goods for women and girls. In particular, as recently stated by 100 NGOs in Europe, while abortion care is essential and time-sensitive, access to it has become more difficult in states that have imposed a lockdown and travel restrictions. This situation is particularly worrying for women and girls who live in the few European states where abortion is illegal or severely restricted and who  cannot travel abroad to seek assistance and care, as reported in Malta. But even in states where abortion is legal, pre-existing obstacles, such as mandatory waiting periods and counselling as well as unnecessary hospitalisation, widespread refusals of care on grounds of conscience and the limited use of medical abortion pills, may become unsurmountable in effectively accessing time-sensitive services.

Access to contraception is also essential for women to be able to exercise their right to decide autonomously about their bodies and lives and cannot therefore be delayed until after the pandemic emergency. Unfortunately, there are signs that access to long-acting reversible contraception has been hindered in some European countries. Pre-existing barriers, including the high cost of contraception in some places, have become even more difficult to overcome in these times of economic restrictions and limited freedom of movement.

Moreover, to uphold women’s rights, access to quality maternal health care must be maintained even in times of pandemic. Unfortunately, the crisis has already affected this specific health sector in some places in Europe, with less staff working in maternity wards due to reassignment or other reasons. Problems reported in several European states include harmful practices imposed on women in childbirth, medically unjustified separations of mothers and new-born babies, refusal of a birth companion’s presence and other failures to ensure adequate standards of care and respect for women’s rights, dignity and autonomy in childbirth. In Slovakia, for example, the Public Defender of Rights expressed concern about such practices in the country, stressing that they were at variance with international human rights standards and Word Health Organization (WHO) guidelines.

Lastly, be it for abortion care, contraception or maternal health care, special attention should be given to ensuring effective access by women and girls who are among the most vulnerable, including women at risk or who are victims of gender-based and sexual violence and women experiencing multiple and intersectional forms of discrimination, such as adolescent girls, women living in poverty, rural women, migrant women, Roma women, women with disabilities and LBTI women. 

Some states have taken encouraging initiatives facilitating access to abortion care and contraception during the lockdown.  For instance, measures have been adopted to allow women in England, Scotland and Wales to take medical abortion pills at home following a teleconsultation, while in Northern Ireland the authorities confirmed that abortion care could be performed locally further to a change in legislation that was meant to enter into force in March. In France and Italy, the health authorities have clearly declared that access to abortion is a health care service that has to be maintained during the pandemic and cannot be deferred. Particularly, the French authorities have extended the time limit for performing medical abortions at home from seven to nine weeks. They also temporarily made it possible to buy contraception pills in pharmacies on the basis of a previous prescription without having to renew it.

I welcome such positive measures and urge all member states to follow suit. Regrettably, however, in Poland, the lower house of the Parliament recently failed to reject a bill that would further restrict access to abortion, keeping it instead for further examination. We also need to remain vigilant in the face of worrying attempts by ultra-conservative groups to use the pandemic as an opportunity to call for the rolling back of women’s sexual and reproductive health and rights.

In their response to the COVID-19 pandemic, Council of Europe member states must:

  • ensure full access to sexual and reproductive health care information, services and goods for all women without discrimination, and with specific attention for women at risk or victims of gender-based violence and other vulnerable groups of women;
  • consider access to abortion care, contraception, including emergency contraception, and maternal healthcare before, during and after childbirth, as essential health care services to be maintained during the crisis and take all necessary accompanying measures;
  • in particular: urgently remove all residual barriers preventing access to safe abortion care such as medically unjustified mandatory waiting periods; authorise telehealth consultations where appropriate and provision of emergency contraception over the counter without a prescription;
  • address misinformation, gender stigma and norms that affect women’s access to reliable, evidence-based information on their sexual and reproductive rights;
  • ensure that refusals of care on grounds of conscience do not jeopardise women’s access to their sexual and reproductive health and rights;
  • follow WHO guidelines on access to health care for pregnant and breastfeeding women during the pandemic and guarantee women’s informed consent and decision-making in the context of childbirth at all times;
  • prevent any legislative or policy rolling-back in the field of women’s sexual and reproductive rights;
  • support women’s rights defenders, service providers such as health care staff, shelters for women victims of violence, family planning organisations and humanitarian assistance workers by enabling them to continue playing their essential role in assisting women during the pandemic.

The risk that European women end up paying a particularly heavy toll in this pandemic crisis, as they did during and in the aftermath of the 2008 economic crisis, is high. We should all draw lessons from our recent past. It is of the utmost importance that this pandemic and related restrictions do not further deepen the gender gap and undermine the hard-fought progress in gender equality achieved in Europe in these last decades.  We should see this crisis as a magnifying glass on the persisting violence against women, gender inequalities and barriers in women’s access to sexual and reproductive health care. Measures taken to remove these barriers should be sustained after the crisis as key elements of building a long-lasting transformative equality that will benefit women and society as a whole.  Let’s not forget, even in these dire times - that we celebrate this year the 25th anniversary of the Beijing Declaration and Platform for Action.