Ethical challenges for women’s healthcare highlighted by the COVID-19 pandemic

Abstract

Healthcare policies developed during the COVID-19 pandemic to safeguard community health have the potential to disadvantage women in three areas. First, protocols for deferral of elective surgery may assign a lower priority to important reproductive outcomes. Second, policies regarding the prevention and treatment of COVID-19 may not capture the complexity of the considerations related to pregnancy. Third, policies formulated to reduce infectious exposure inadvertently may increase disparities in maternal health outcomes and rates of violence towards women. In this commentary, we outline these challenges unique to women’s healthcare in a pandemic, provide preliminary recommendations and identify areas for further exploration and refinement of policy.

The impact of COVID‐19 visitor policy restrictions on birthing communities of colour

“…The restriction of visitors likely plays a role in exacerbating disparities in experience of care for BIPOC patients, both through the actual policy itself and through biased enforcement of the policies by nurses and other health care personnel (Niles et al, 2020). While the perceived benefit from visitor restrictions includes a reduced potential for exposure to the COVID‐19 virus, providers and health care systems need to balance the ethical quandary of then increasing risk for perpetuating health disparities, particularly exposure to racism and mistreatment by providers for BIPOC communities (Bruno et al, 2020).…”

COVID-19 and Women

“…Even where reproductive health services remained open, women were less likely to seek services, possibly due to fear of contracting the virus (Kumari et al, 2020; UNFPA, 2020). Consequently, women's access to contraception, prenatal care, medical abortion, and sexual assault care has decreased, thereby increasing the risk of unwanted pregnancies, maternal and infant mortality, and sexually transmitted infections (Bruno et al, 2020; Ravaldi et al, in press; UNDESA, 2020; UNFPA, 2020). The UN Population Fund predicts that lack of reproductive healthcare during the pandemic could result in up to 7 million unwanted pregnancies and thousands of deaths resulting from birth complications and unsafe abortions (UNFPA, 2020).…”

“…COVID-19 has placed women at a further socioeconomic disadvantage as the informal economy has struggled and schools have closed (Gabster et al, 2020; Power, 2020; United Nations, 2020). Many women have also lost access to social services and healthcare (Bruno et al, 2020; United Nations, 2020; United Nations Population Fund [UNFPA], 2020). Research indicates that women are at an increased risk of violence following human-made and natural disasters, and early data suggest that rates of female exploitation have risen during the pandemic (Fraser, 2020).…”

Social Protection for Socioeconomically Vulnerable Women of Pakistan- During Covid-19 and Beyond

“…In Pakistan, there is a great possibility for postponement and neglect of treatment for women, due to cultural preference prioritizing male health (Jafree 2020). Even women from the developed world are suffering from an absence of services for elective surgeries, termination of unintended pregnancies, surgical sterilization, and clinical services for family planning and breastfeeding (Bruno, Shalowitz, & Arora 2020). We need to urgently consider not just the rights of women patients for access to health services, but also women health provider rights for safe working environments and equitable supplies of protective gear.…”