Lately, we’ve been joking about a lockdown baby boom. The joke may turn sour a few months on when stay-at-home rules and boredom-induced intimacy between couples start resulting in the arrival of coronababies, coronials or quaranteens. It might sound cute and joyful, but it’s making many couples insecure — because it’s not the best time to get intimate.
“Men are spending more time at home these days. They are under no pressure from work and in no hurry to wake up early in the morning. This is making women wary of their reproductive wellbeing,” says Saima Malik, a community midwife, who runs the Healthcare Centre and Maternity Home in Tando Haider, Sindh. “Initially, when my clinic was closed because of the lockdown, women visited me at home to acquire short-term contraceptives, like pills and condoms. They were desperate, because general stores that stock birth control items were closed. Some locals cannot even afford to purchase these items. We provide them for free.”
The government has not declared birth control an essential service in the times of coronavirus. This has critically limited people’s access to family planning services and commodities.At age 24, a mother of two children, “Rehana” wanted to end her seven-week unwanted pregnancy. She was stressed. She took the first dose of four misoprostol tablets; she waited for bleeding or uterine contraction, nothing happened; she took two more, no signs showed up; she took two more and then two more… a total of 10 tablets of misoprostol.
“She was bleeding excessively,” says Dr Nadeem Khalid, a gynaecologist associated with the Family Health Hospital run by Rahnuma-Family Planning Association of Pakistan in Lahore’s Johar Town.
Dr Khalid fears an influx of similar cases of unsafe abortion in the near future. “The signs are worrying,” he says.
The lockdown has put thousands of women out of reach of birth control and other reproductive and sexual health needs. Family clinics are closed, and outreach services, the key to reaching women, have stopped.The lockdown has put thousands of women out of reach of birth control and other reproductive and sexual health needs. Family clinics are closed, and outreach services, the key to reaching women, have stopped. MSS runs a total of 450 family planning service delivery points – 50 in urban and the rest in rural areas, where inter-personal communication, door-to-door mobilization and mohalla meetings are important for creating awareness. “Easily, activities at 40 percent of these points have been suspended,” says Asma Balal. The organisation’s 400 field health educators, who go door-to-door to mobilise people for family planning, are unable to reach out because of the contagion. “We are presently relying on walk-in clients and some mobilisation via phone,” she adds.
Government family planning services are also restricted. “The mobile service units run by the Punjab Welfare Department are presently being used by the Health Department for Covid-19 screening, which obviously means that this service is on hold,” says Syed Kamal Shah, the CEO of Rahmuna-Family Planning Association of Pakistan.
Even when clinics and reduced reproductive healthcare services are allowed to resume, they are likely to run short on their stock of vital commodities. Of the three not-for-profit partners of the governments in Pakistan – Greenstar Social Marketing (GSM), Marie Stopes Society (MSS) and Rahnuma-Family Planning Association of Pakistan (FPAP) – Rahmuna-FPAP has stocks to last for the next six months, GSM for eight months and MSS for only a few months.
There is an acute shortage of IUDs. “Six out of nine manufacturers of IUDs are based in India. Pakistan procures IUDs mainly from India. But, since the blocking of trade between Pakistan and India, the import of this vital commodity has been suspended,” says Dr Syed Azizur Rab, the Greenstar Social Marketing CEO.
Already there is a shortfall of 100 million condoms globally after the coronavirus lockdown forced the condom manufacturing companies to shut down. Malaysia’s Karex Bhd makes one in every five condoms globally. The Malaysian government last month closed it down to stop the spread of the virus.