Published May 2020

How to access sexual & reproductive healthcare during Covid-19

Accessing sexual and reproductive healthcare during COVID

Contraception and abortion are essential healthcare. This is true no matter what the world is going through, and thankfully, the Faculty of Sexual and Reproductive Healthcare (FSRH) have put together a complete guide to how you can access the care you need during lockdown.

We’ve summarised the guide below, but you can access it in full here. Access to care is still available, although due to the current strain on our healthcare system (coupled with the years-long systemic strain on sexual and reproductive healthcare services), it may need to be delivered in different ways. For this reason, the FSRH advises that you should only access services if your need for care is immediate.

How to access care

If you need to access care, you should contact the place where you usually go for sexual or reproductive healthcare, which might be your GP or a sexual health clinic.

You should ring the clinic first rather than visiting. Your practitioner will try to help you over the phone or direct you to another service if need be. They will determine whether you need to come in for a face-to-face appointment.

You will also be given specific advice on how you can collect any medication that you need. Most GPs are able to send an electronic prescription to a pharmacy of your choice, where you will be able to collect your medicine. Other services are mailing prescriptions or medications directly to patients.

Contraception is still available for free on the NHS, and the FSRH stresses that there is no need to panic buy or stockpile these medications.

At the end of this article, there is a list of links to relevant abortion, sexual health, and HIV services.

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Contraception | | | | | | | | |

Abortion |

Contraception

I need emergency contraception

Call your care provider and they will discuss your emergency contraceptive options with you. Services are trying to maintain the fitting of the copper coil (IUD) as much as possible, as this is considered to be the most effective emergency contraception. If you would like to access the emergency contraceptive pill, your provider will post you a prescription or send an electronic prescription to a pharmacy of your choice for you to collect.

I want to start a new contraception method

There are many reasons why you might want to start a new contraception method. First, call your care provider who will consult with you via phone or video call about your options. It may not be possible to start on a new contraceptive method during this time, but you will be provided with an effective temporary method in the meantime. You will be able to start your chosen method once the situation allows.

The FSRH advises that the progestogen-only pill (also called ‘the mini pill’) is a good ‘bridging’ method of contraception, and if you choose to use it, it can be posted to you or an electronic prescription can be sent to your pharmacy for you to pick up.

I have a repeat prescription for the mini pill, combined pill, patch, or ring

If you need a top-up on your mini pill, consult with your provider via phone or video call and a prescription will either be posted to you or sent to your pharmacy for you to collect.

The official advice has been to avoid all non-essential contact between patients and healthcare providers. You may be offered temporary contraception and the chance to have your chosen contraceptive fitted at a later date

If you need the combined pill, patch, or ring, you will need to first consult with your provider via phone or video call, who will determine whether it is possible to issue you a prescription. They will ask whether your blood pressure has been measured in the last year and whether your weight is stable — if so, they should be able to send an electronic prescription to your pharmacy. They will advise whether you’ll need to go in for a face-to-face appointment or alternatively, the mini pill may be suggested as an alternative.

I need a contraceptive injection

If you are due a contraceptive injection, it is essential that you contact your care provider to let them know. It is important that the gap between injections is not longer than 14 weeks. If it is not possible to offer you a face-to-face appointment where you can get the injection, you may be temporarily offered the mini pill.

Those who inject themselves at home with Sayana Press should be able to top-up their supply via an electronic prescription sent to their pharmacy.

I want to have a long-acting reversible contraceptive fitted (IUS/IUD or implant)

As this procedure requires face-to-face contact, it may not be possible to access it during this time. This is because the official advice has been to avoid all non-essential contact between patients and healthcare providers. If this is the case, you will be offered temporary contraception and be able to have your chosen contraceptive fitted at a later date.

There may be exceptions to this in emergency situations, so it’s important that you contact your care provider and explain your circumstances.

I need my long-acting reversible contraceptive replaced

Some types of long-acting contraceptives are safe to use and are likely to be effective for a year or more longer than is recommended, so you may be advised to hold off on replacement for now. These include banded copper IUDs, including T-Safe, IUS devices such as the Mirena and Levosert, and contraceptive implants such as Nexplanon.

The FSRH recommends leaving in your existing contraception in the short term — do not try to remove it yourself

However, if you have a copper IUD that is licensed for 5 years of use, you should not rely on this contraception after that time has passed. The exception to this is if you had your IUD fitted after the age of 40, in which case it will be effective until you reach menopause.

If you are worried about your device, contact your service provider, who may prescribe you the mini pill as a temporary measure. Either way, the FSRH recommends leaving in your existing contraception in the short term — do not try to remove it yourself.

It can be stressful to change your care plan, particularly if that means using a new method of contraception. But this ‘new normal’ requires that we reduce face-to-face contact with NHS professionals as much as possible, including reducing ‘routine’ procedures that can safely be delayed. This time has been difficult for everyone, especially healthcare workers, so it’s important to understand the limitations they are working with.

I’m having problems with my current contraceptive

Contact your care provider and discuss your circumstances with them, who will determine whether a face-to-face appointment is required. Women’s experiences with contraceptives vary wildly, so your clinician is best-placed to give you specific advice on the way forward.

If your clinician suggests using the pill, but you feel this isn’t a suitable option for you — perhaps due to past experience — then mention this, but it’s unlikely that they will be able to provide you with an alternative in the short term.

I’m planning a pregnancy and want to stop contraception

There is very little currently known about Covid-19 in pregnancy. The Royal College of Obstetricians and Gynaecologists (RCOG) currently advises that pregnant individuals appear to be no more likely than the general population to contract the infection, that intrauterine infection with Covid-19 is unlikely, and that that the risk of miscarriage and fetal abnormality are not expected to be increased.

It is important to remember that Covid-19 is a novel situation and that evidence is still emerging, which means that advice can change over time

However, if you are pregnant, and particularly if your pregnancy is further along than 28 weeks, the RCOG advises that social distancing is especially important. You should also continue to attend routine and specialist antenatal care.

It is important to remember that Covid-19 is a novel situation and that evidence is still emerging, which means that advice can change over time. Those who are pregnant should continue to look after their health and take any necessary medication.

Removing a long-acting reversible contraceptive requires direct contact with a clinician and carries a risk of transmitting the infection. For this reason, it may not be possible to have yours removed in the short term.

I’ve been a victim of sexual assault

Sexual assault care is classified as essential and you should receive priority care. You should contact the same provider you usually access sexual health care from — they won’t tell anyone that you’ve accessed sexual assault care unless you would like them to.

You can find your nearest service provider for sexual assault care here.

I need an abortion

Abortion care is also considered essential and you will still be able to access it without difficulty during lockdown. Your GP and other healthcare providers will be able to refer you to an abortion care provider, or you can self-refer by contacting them directly.

You will have an initial consultation remotely, via phone or video call, where your abortion care provider will talk through your options with you and address any questions or concerns you might have about the procedure.

If your pregnancy is under 10 weeks and you live in England, Scotland, or Wales, you may be able to have a medical abortion at home by taking medication (mifepristone). Mifepristone is medically safe and means that you won’t need to come into contact with any clinic staff. If you are further along in your pregnancy then you will need to attend the clinic to have the abortion.

Useful links

Abortion services

Sexual health services

HIV services

Patient information

Featured image features materials from the Faculty of Sexual and Reproductive Health. The faculty’s logo is in the top-left corner, while their signature orange brand design of three overlapping triangles covers the bottom of the frame. There is a cartoon speech bubble placed on top of the triangle design, in the centre of the image, that reads: “Can I still access abortion services?”

Page last updated May 2020

Monica Karpinski

Founder & Editor, The Femedic

Monica is the Founder and Editor of The Femedic. Against a journalism background and after years of leading content marketing projects in the healthcare space, it became clear that health information out there for women simply wasn’t good enough. No-one had bothered to look deeper into the ways women were searching for information, or consider the depth of what they actually needed to know. Instead of waiting for the perfect publication to approach her, she created The Femedic.

Monica has been named one of The Drum’s 50 under 30 for influential women in digital 2018 and was shortlisted for Female Entrepreneur of the Year in the 2018 British Business awards. She speaks and writes widely on gender and health inequality.

View more

References

  1. FSRH, Advice for women seeking contraception, abortion, and other sexual and reproductive healthcare during the COVID-19 pandemic, Faculty of Sexual and Reproductive Healthcare, 22 April 2020, [online] (accessed 13 May 2020)