Limits on sexual and reproductive healthcare during such states of emergency are often explained away as secondary concerns, non-essential and therefore easy to side-line, while health workers, resources, supply chains, and pharmacists are left to focus on the fallout. At policy level, this suggests a fundamental misunderstanding of the role of sex and reproduction in people’s everyday lives, and even less awareness of how this can change during pandemic responses.
This appears to be the case at present in the Netherlands where a single mother, who was unable to leave her house due to a Covid-19 infected child, was denied access to urgent medical abortion treatment by mail, the court ruling that she must visit a clinic. Such incidents highlight the knowledge gap between provision of services during a health emergency and their importance, value, and necessity in everyday life.
The other possible explanation for such a disconnection between policy and practice is that governments who understand the importance of sexual and reproductive health see it more as an issue to be manipulated than an enabler of women to lead healthy lives. This no-man’s land emerges when states vacillate over whether to relax access to safe abortion during health emergencies or not. In the United Kingdom, the government has recently made a number of reversals on a public health decision that eventually permitted women access to at-home medical abortion. The concern was that emergency measures would become a Trojan horse for the relaxation of wider laws once the pandemic ends.
Indeed, evidence from previous health emergencies, and early indications from the response to the Covid-19 pandemic, suggests that states are more likely to restrict rather than relax regulations around sexual and reproductive health during times of crisis. This, in turn, becomes the norm post-emergency. This is certainly the case in Poland, where the government is proposing a “Stop Abortion” law in the midst of the current state of emergency. The move has significant implications for the wellbeing of women during the pandemic, including immediate issues of unwanted pregnancy and longer term implications regarding the reversal of previous advancements made on access to sexual and reproductive health.
These examples are a potent reminder that pandemics do not pose a threat to sexual and reproductive health, rather the danger comes from governments who make decisions during these crises. As we’ve argued in a recent article in International Studies Quarterly, “as long as state monopoly over reproductive security remains unchallenged, the state continues to determine when women’s lives can and should be secured from preventable death and injury”. We need a new understanding of reproductive health that shifts the balance, which positions the issue as a security threat when access is denied, defunded and rescinded.
Pandemics have the power to undermine and invalidate advancements in access to sexual and reproductive health. States have the tools to stop it.
Sara E Davies , Sophie Harman