The coronavirus shutdown puts birth control and contraception at risk

The NHS is understandably under massive pressure during these uncertain times of coronavirus, with hospitals struggling to test the number of patients contracting Covid-19 and staff overworked and under-protected.

GP surgeries are doing their part to stop the spread of infection by stopping non-essential face to face appointments in favour of phone and video calls.

But in the attempt to control the virus, one group of people’s needs could be neglected.

People on birth control are being denied appointments as GP surgeries go into lockdown.

Many people who need implants or coils replacing or their next contraceptive injection administering are being told the treatment is not essential and are not being allowed to go into surgeries for appointments.

People who already had appointments scheduled, unless in at risk groups, have suddenly found their appointments cancelled with no sign of them being rescheduled. When expressing the need for the appointment people with coils and implants are told the life span of the drugs have been extended.

The Faculty of Sexual and Reproductive Health (FRSH) has issued guidance about contraception during the time of COVID-19. These recommendations give a very basic, sweeping generalisation of birth control users facilitate and assume that most forms of contraception can be being issued after a telephone or a video consultation.

The guidelines state:

• Combined pill usersno longer need a blood pressure reading for a 6-month repeat supply ofpills. 
• For a new pillstarter, a BP reading should be obtained and given to the doctor or nurse overthe phone.
• The length of timean IUD and an implant can be left in place have been extended by one year.

When approached for comment on this article, a Department of Health and Social Care spokesperson told Metro.co.uk: ‘Even in these unprecedented times, it is essential that the public receive the best possible birth control and contraception services.

‘The Faculty of Sexual and Reproductive Healthcare have published clinical advice to support ongoing provision of effective contraception and we ask that health professionals supplying contraception to work to this advice.’

Those who need injections have found themselves suddenly prescribed the pill or mini pill, as though all birth control methods work in the same way and are suitable for all people.

The assumption that all birth control methods work for all people and are interchangeable could be dangerous, as it’s not just stopping pregnancy that the medication is used for.

Many use birth control to deal with heavy periods, acne, PMDD, stress, thyroid problems and depression. Birth control is not just something that prevents pregnancy.

Gynaecologist Dr Shree Datta told Metro.co.uk: ‘Changing to the pill can lead to side effects, for example, a change in period duration and heaviness.’

She warns that not all pills are suitable for everyone and that the sudden prescribing without an assessment appointment can be dangerous to patients

‘Women who have high blood pressure, previous breast cancer or have had a DVT or blood clot in their lungs may not be suitable for the combined contraceptive pill,’ Shree says. ‘So a risk assessment before prescribing the pill, the pill type and dose is very important.’

For many it’s a long battle to find a birth control that works best for them and their body, with some still experiencing painful, long-lasting, heavy periods and just as bad ovulation.

Having to plump for anything they can get their hands on could make their periods and lives worse. Different birth control methods could lead to an increase in different hormones and chemicals, which could bring a lot of pain and new symptoms.

Victoria Bruce had the Mirena coil fitted in January, but by 3 March was sick of the side effects – constant bleeding and mood swings – and began seeking a removal. She was told she couldn’t have it removed until 26 March.

But that was before the pandemic reached the UK. By 25 March the country was in lockdown.

Victoria tells us: ’23 hours before my appointment I received an unhelpful and unsympathetic phone call to inform me that due to Covid-19 my appointment (a non-emergency) would be cancelled and would remain so for the foreseeable.

‘I literally sat on my couch hysterically crying. I genuinely couldn’t handle the mental health side effects for much longer.’

After another phone call with her doctor her step-dad drove her to A&E.

‘I waited an hour to be seen before I was directed to gynaecology where I was met with criticism again,’ Victoria says. ‘The nurse told me I was a non-emergency and should’ve dealt with the side effects while we’re in a state of medical emergency, but I couldn’t cope any longer. I pleaded and finally got it removed.’

While IUDs and implants are viewed as an easier method of birth control due to how long they last, they sometimes come with debilitating side effects.

When patients reach their wit’s end they request to have the coil or implant removed, a procedure which is usually easy to do, but in these times is deemed non-essential and patients have found such appointments cancelled.

I struggled through many different birth control methods before finding the right one. Some, such as the mini pill, made me bleed repeatedly for three weeks. I’d have a two-week break then be straight onto the next one.

From there I was given the injection, which was the perfect birth control method for me, but I was taken off it as it can make bone density worse and I have osteoporosis.

At a loss for what to do next I was left with no choice but to have the Mirena Coil (IUD), whose symptoms included constant breast pain, pelvic and ovary pain and a massive downward spiral for my mental health. I was near suicidal when I had it removed. After that experience I had reached my breaking point and started lobbying for a hysterectomy. It was only after this irreversible operation that I discovered my bone density scans had been out of date and I could have continued with the injection.

A spokeswoman for the Royal College of Obstetricians and Gynaecologists said: ‘It is essential that contraceptive services are still accessible to women and their partners during this time.’

While it’s understandable that the focus of the NHS is on the pandemic, it is vital to ensure access to birth control and contraception remains.

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