The coronavirus pandemic has led to fundamental changes to the ways healthcare is provided and delivered across the NHS, the UK and the world. We know that many of these changes are here to stay, but their immediate and long-term implications are yet to be fully understood. When it comes to women’s* health, much of the direct and indirect impact of the pandemic has hitherto been discussed.

We also know that being a woman or a man has a significant impact on your health as a result of both biological and cultural differences. Women’s health is of particular concern, as we remain disadvantaged by discrimination across the world, a reality that exacerbates existing health inequalities and systemic prejudice.

For example:

• The WHO says that 40% of pregnant women worldwide suffer from anaemia and that women are more physically susceptible to HIV infection than men.
• Women are thought to experience different symptoms of a heart attack than men – for example the younger the woman is, the higher the chance she will not experience chest pain and thus consider herself as classically showing symptoms of a heart attack, leading to delayed treatment.
• Mental ill-health among women is on the rise, with one in five experiencing a common mental disorder, compared with one in eight men. There is clear evidence that women’s mental health is linked to their experiences of violence and abuse.

The impact of COVID-19 on women’s health is profoundly troubling and requires far greater discussion and policy action by politicians and policymakers.

For example, it has fundamentally altered the provision and delivery of all reproductive and contraceptive services. On 30 March 2020 the Department of Health and Social Care issued new guidance to enable women who need a medical abortion to have a telephone or online consultation with a doctor and take abortion pills at home. Previously women in England were always required to take the first part of their abortion pill treatment in a clinic. But now, if you meet safety criteria to allow for medical abortion without a scan, abortion medication can either be collected from a centre or posted to a home address after a remote consultation. The move by DHSC was welcomed across the sector. The Royal College of Obstetricians and Gynaecologists said allowing women to take both abortion pills at home was a "vital and necessary step”, preventing thousands of women from having to make medically unnecessary journeys to abortion clinics while travel restrictions are in place.

More widely, the sexual and reproductive health (SRH) sector understandably was forced to deprioritise all but essential provision to limit the risk of transmission of COVID-19 in the first few months of the pandemic, restricting access to the full range of contraceptive methods normally available. This led to extensive temporary closures within the SRH sector with services running at a highly reduced capacity. A survey by the Faculty of Sexual and Reproductive Healthcare found 77% of GPs and 64% of specialists have “ended or limited the provision of essential SRH services since the outbreak.”  The impact of not being able to access contraceptive services can be devastating; it is well established that reproductive autonomy has a direct impact on a woman’s mental and physical health. Even a fortnight of self-isolation and inability to access abortion provision could mean up to 8,000 women in England and Wales continuing pregnancies that they would otherwise end.

Another important area of women’s health impacted by the initial lockdown and ongoing pandemic is cancer diagnosis and provision of treatment. Every year 55,000 women are diagnosed with breast cancer, 18,000 of which are discovered as a result of screening. Upon the initial lockdown, screening was suspended with the charity Prevent Breast Cancer finding that there was a 70% drop in GP referrals since the outbreak began. Similarly, research by Jo’s Cervical Cancer Trust found that over 2 in 5 of their participants were less likely to go to their GP if they were experiencing unusual symptoms because they were worried around the NHS being too stretched, or of catching the virus. A report published by Macmillan last week found that there are currently approximately 50,000 people living with undiagnosed cancers. This is set to rise to 100,000 next year if the backlog is not tackled. The long-term implications of these delays in diagnosis and treatment will be catastrophic, and requires urgent action from the Government to mitigate a future disaster caused by delayed cancer diagnosis and treatment.  

A further concern is the virus’ impact on women’s mental health. While clearly lockdown is tough for the majority of us, a major study by UCL found that young women are the most likely group to have suffered high levels of depression, anxiety and loneliness during lockdown. Additionally, the wellbeing and mental health of new mothers and, more generally, new parents is something that requires action by the Government. More than 238,000 people have signed an e-petition that calls for the Government to extend maternity leave by 3 months, with 27,000 new parents responding to the first survey of the Commons’ Petitions Committee’s inquiry into this petition with a record 26,000 comments to their Facebook thread. They argue these unusual and unprecedented circumstances will limit the development of children and restrict the usual necessary bonding patterns.

The immediate and long-term impact of all these changes are yet to be fully understood and mitigated against effectively and comprehensively.

Join us on Tuesday 10 November at 7pm as we discuss these issues with an esteemed panel:

• Carolyn Harris, Labour MP for Swansea East, Deputy Leader of Welsh Labour and Co-Chair of the APPG on Women’s Health
• Katherine O’Brien, Associate Director of Communications and Campaigns at British Pregnancy Advisory Service
• Dr Sonia Adesara, NHS Doctor, activist and former director of 50:50 Parliament
• Dr Cheryll Adams CBE, founder and CEO of the Institute of Health Visiting
• Kate Sanger, Head of Communications and Public Affairs at Jo’s Cervical Cancer Trust

*Note on language: The terms ‘woman’ and ‘women’s health’ are used for brevity. We know that it is not only individuals who identify as women require access to these healthcare services, including trans men and non-binary individuals, and we support efforts to make healthcare services inclusive and sensitive to the needs of people who identify as a different gender than they were assigned at birth.