Conflicts of Interest
The authors report no conflicts of interest.
The COVID‐19 pandemic has led to increased demand for pregnancy options counselling, more women presenting at later gestation and increased referrals for telehealth early medical abortions. Evidence for this is provided by changes to the number and nature of calls to the Victorian‐based 1800MyOptions a government funded telephone information service, operated by Women's Health Victoria, about contraception, pregnancy options and sexual health. 1 We undertook an audit of de‐identified data routinely collected by this service between March and July 2020. The nature of services requested, the gestation of pregnant callers and the major concerns of callers in relation to accessing sexual and reproductive health (SRH) services are recorded using standardised forms. All callers are aware that any data collected will be used for reporting purposes, but that no identifiable information is stored.
Increased Demand for Pregnancy Options Counselling
Between March and July 2020, there was a significant increase in demand for pregnancy options counselling (n = 26/385, 7%), after an initial drop in March (n = 6/365, 1.6%, P < 0.001).
Increased Proportion of Callers at Later Gestation
More women were exploring their options at 18+ weeks gestation than prior to COVID‐19 with an increase from 2.5% in March 2020 (9/365) to 8.8% in July 2020 (25/283, P < 0.001). Women described COVID‐19 related factors impacting their decision making in the form of loss of employment, increased responsibilities associated with home schooling and feeling nervous about seeking health care.
Increased Barriers to Accessing SRH Services
Comparing data between calls received between March and August in 2019 and 2020, a significant increase in financial insecurity was reported from 18.1% (n = 403/2221) of calls in 2019 vs 45.5% (n = 886/1948, P < 0.001) of calls in 2020, often directly as a result of income loss due to COVID‐19. Reports of family violence almost doubled from 5% (n = 58/1150) in 2019 to 9.5% (n = 93/978, P < 0.001) in 2020 between May and July. Although no significant increases were observed for calls relating to Medicare ineligibility (for international students, tourists and those on working visas), housing insecurity and complex medical conditions, still comprised a substantial proportion of calls (312/1971, 16%) between March and August 2020.
Referrals to Telehealth Services
1800MyOptions referrals to telehealth abortion providers, for callers under nine weeks gestation, increased to 6.9% (n = 99/1429) between March and August in 2020 as compared to 4.1% (n = 260/6274, P < 0.001) between March 2018 and February 2020. This change may have reflected the availability in Australia for the first time of Medicare‐funded telehealth abortion consultation services 2 with the introduction of telehealth services on to the Medicare Benefits Schedule. Telehealth use has been one of the major positive changes in delivering abortion care during the pandemic globally. 3 As abortion is an essential health service, publicly funded services have a duty of care to ensure individuals can access affordable abortion care. 4
These 1800MyOptions data provide evidence of increased demand for pregnancy counselling, increased presentation at later gestation and increased demand for virtual SRH consultations. These data highlight the impact of the pandemic on women’s SRH and the ability of telehealth to respond to women’s needs. Telehealth provision of essential SRH services can play a large role in achieving equitable SRH service provision for all Australian women, particularly those belonging to vulnerable groups 5 and should therefore continue to be supported.
Acknowledgements
This study was funded by the National Health and Medical Research Council (NHMRC), Australia (1153592) Centre of Research Excellence in Sexual and Reproductive Health for Women in Primary Care (SPHERE).
Conflicts of Interest: The authors report no conflicts of interest.
References
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