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Reproductive Planning During a State of Emergency

Pandemics and natural disasters disproportionality affect women of color. In response to the COVID-19 pandemic, state of emergencies were established; this includes economic stimulus packages and social distancing rules. However, accessibility to contraception and family planning were not emphasized in these plans. United States citizens were asked to stock up on food, water and hygiene products including contraception. The unfortunate reality for many women of color is financial constraint, as these women earn less money than their Caucasian male counterparts. Hispanic women receive the lowest wage, earning only 61.6% of Caucasian men’s weekly earnings. Similarly, black women only earn 65.3% of Caucasian males’ weekly earnings, which decreased by 2.8% after adjustment for inflation. Financial barriers affect vulnerable populations from obtaining contraceptives and reproductive support. Minority women remain vulnerable to unplanned pregnancies and sexually transmitted infections during emergencies.

During Hurricane Katrina and Hurricane Ike, reproductive health care was likewise not a priority for policymakers. The distinctive challenges faced by women ranged from interruptions in health care to physical destruction of clinics. Studies found that after Hurricane Katrina, women of reproductive age drastically changed their birth control and family planning strategies due to damaged infrastructure, lack of funds, homelessness, and displacement of families. Approximately 40% of women reported that they no longer use birth control compared to 11% prior to the hurricane, and 31% reported difficulties with accessing birth control.  Similar results were reported after Hurricane Ike in 2008, during which 11% of displaced women reported barriers to obtaining birth control. Unfortunately, race was a significant barrier to obtaining contraception during these natural disasters based on interruption of accessibility to contraceptives and family planning services. Black and Hispanic women were significantly less likely to obtain birth control compared to their Caucasian counterparts, which led to higher rates of unprotected intercourse. 

The COVID-19 pandemic presents limitations to mobility and access to health care due to disruptions in transportation and decrease in funding to reproductive health. Prior to the pandemic, over 19 million low-income women of color were forced to navigate contraceptive deserts, which are defined as counties lacking reasonable access to a health center that provides a full array of contraceptive methods. These deserts were created as a result of cuts in Obama care funding and subsequent clinic closures. Additionally, the “gag rule” slashed the Title X national family financial planning capacity by fifty percent, thus endangering approximately 1.6 million women nationwide. Title X is a federally funded program aimed at providing family planning services for low-income individuals. The “gag rule” forced clinics to leave the network of Title X providers due to its restrictive policies on family planning. These barriers make access to affordable contraception and family planning a herculean task for women and have disproportionately affected women of color during the COVID-19 pandemic

PPE shortages, mass casualties, and economic stimulus plans are definite challenges that health care workers and legislators face today. However, it is also essential that contraception and family planning are included in the national state of emergency protocols. The COVID-19 pandemic has highlighted disparities in access to affordable and quality reproductive health care nationwide, especially for women of color. Fortunately, the Pan American Health Organization has created recommendations to enhance adequate access to contraception and family planning. The recommendations ensure that contraception options are included in the supplies distributed in times of disaster and that obstetrics and gynecology doctors, nurses and medical personnel are staffed in temporary shelters and refuges. Lobbying, voting, communicating with representatives at the state and federal level and developing social media awareness campaigns are key to bringing about change. Policymakers, health care providers, and women must recognize that access to contraception is power and freedom, and continue to work towards being active advocates for all women’s health moving forward.

Image credit: square the circle1 by spentpenny licensed under CC BY-NC-ND 2.0 license.

Ritha Mera Ritha Mera (1 Posts)

Medical Student Contributor

Windsor University School of Medicine

I am a first-generation immigrant from Portoviejo, Manabi, Ecuador. Navigating and experiencing life in my community has shaped and fueled my passion for women's reproductive health and education. I firmly believe education and accessible health care are the most powerful tools against disease. I am fascinated by Family medicine and Obstetrics/Gynecology because they allow for primary prevention and education in reproductive health.