The already stressed healthcare segment in India is presently concentrating on saving the lives of COVID-19 patients. But the healthcare professionals like doctors and other healthcare workers, are expected to feel the pinch further when there are more abortion cases and other health issues among women -- mainly due to unwanted pregnancies, says VS Chandrashekar, Chief Executive Officer, Foundation for Reproductive Health Services India (FRHS). This unwanted pregnancy is expected to have large economic pressure among families who were not ready for a child.
Speaking to The Free Press Journal, Chandrashekar, said, "We prepared a report taking into consideration three scenarios -- best case, likely case and worst scenarios."
In the best case scenario, it is assumed that clinical family planning services will resume mid-May and will be at full capacity by July 2020. Likely case scenario assumes that clinical services will resume in a phased manner and will be at full capacity in September 2020 (60 days loss of commercial sales). Worst case scenario assumes a slower phased availability of clinical family planning services with full capacity returning in September 2020 (75 days loss of commercial sales).
Usually in India, every month there are around 11-12 lakh abortions taking place. In the chart, you can see in the worst-case scenario, there can be 1.03 million unsafe abortion which means you are putting at risk twice the number of lives only because there was no access to contraceptives.
Families will be economically burdened -- while many will be out of jobs and will be striving to make ends meet. This sudden, unplanned pregnancy will push the families into deeper economic troubles. This is going to impact around 20 million couples.
"As soon as the lockdown is lifted the influx of women coming to abort will spike -- mostly in the month of May, June and July. So, the health system will have to be prepared." There will be many who will also resort to unsafe abortions that would mean in some cases women will face some complications too. The report stated that there can be around 2,165 maternal deaths.
In many addresses, many national leaders have requested the Indian population that is under lockdown to take stock of population control. However, no access to contraceptive is a lost battle in this regard.
To meet up for the lost time, the government may have to open up new avenues to reach out to people. "Over the counter contraceptives like Condom, Oral Contraceptive Pills (OCPs), and emergency contraceptive pills (ECPs) have a severe restriction on mass media advertising. This the restriction should be removed so that private sector brands can freely advertise and increase uptake, " he added. Some the suggestion in the report issued by FRHS are expanding the contraceptive choice, increase access to abortion, increase NGO and private sector involvement among others. The report also tries to suggest to the government to enable trained nurses and AYUSH providers to offer implant that will reduce the pressure on sterilisation services.
While the government has put Inter Uterine Contraceptive Devices (IUCDs) and sterilisation procedures as elective surgery, the number of people opting for other contraceptives like condoms and oral contraceptive pills is not very high too. "Most of the over the counter contraceptives are available in the medical stores and that has to be conveyed to the general public and that is only possible by running advertisements and campaigns."
Chandrashekar informed there is 45 days stock for over the counter contraceptives in the country. But that will exhaust if there is no production of these products. "However, due to the lack of imports of some active ingredients and others; and weakening of rupee, these products are going to become dearer," he pointed out. This move is expected to hurt the family planning programme of the country further.
