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Women’s health has been left behind

Considering women make up half of the UK’s population, it is high time that we put their wellbeing back on the priority list

Much has been said about the physical and mental cost of lockdown, as well as the effects of Covid-19 on BAME communities, the elderly, and the clinically vulnerable. We are also yet to fully comprehend how many unnecessary deaths will occur due the backlog of non-Covid treatment.

One NHS doctor recently revealed the devastating impact of the NHS’s transformation into a Covid-only service and recalled how patients have been neglected in the midst of the coronavirus pandemic:

A woman who had a very large breast lump diagnosed in hospital just before lockdown was somehow neglected to be assessed for 5 weeks, presumably because of lockdown. Here’s where it got more distressing. She said the consultant would not be able to see her for at least 3 months.

However, the impact on women’s health has not been limited to delays on breast cancer screenings or cervical cancer swabs, and coverage is seriously lacking on how national lockdown measures have specifically affected women and their bodies.

For example, recent research has shown that the prevalence of stillbirth was significantly higher during the lockdown period (data indicates that the number of stillbirths nearly doubled between April-June 2020), and this news has prompted an investigation by the Healthcare Safety Investigation Branch.

If you have the money to do so, you can quite easily bypass the rules

It is important to note that, in research conducted by Asma Khalil (a Professor of Obstetrics and Maternal-Fetal Medicine at St George’s University Hospital) in The Journal of the American Medical Association, none of the stillbirths from the pandemic period were among women with Covid-19, and thus may be attributed to “indirect effects such as reluctance to go to the hospital when needed (e.g. with reduced foetal movements), fear of contracting infection, or not wanting to add to the National Health Service burden”.

Considering that pregnant women were placed–and remain–in a vulnerable category by the Chief Medical Officer on 16 March as “a precautionary measure”, it is unsurprising that many expectant mothers felt they must remain at home after being bombarded with daily messages and press conferences telling us to do just that.

It is, quite frankly, a disgrace that the culture of fear surrounding the pandemic has led to so many pregnant women feeling as though they are unable to utilise the NHS for support. Covid-19 has been a persistent thorn in the side of public health for the best part of a year, but that does not mean that the world stops spinning for women, their babies, or anybody else, for that matter.

Many women have been left to endure pregnancy and childbirth very much on their own

Furthermore, while unemployment, psychological stress and domestic abuse are all factors which have increasingly reared their ugly head since the start of the pandemic, new research conducted by Tommy’s Manchester Research Centre found that expectant mothers are 2-4 times more likely to experience a stillbirth when going through such ordeals.

Isolation has been a key feature of this pandemic and, similarly, many women have been left to endure pregnancy and childbirth very much on their own. A recent feature in The Independent details how many women experienced scans, birth and miscarriages alone in the first lockdown, with little reassurance from the government that a second lockdown would prevent further instances of this. I spoke to Jess – a 26-year-old first-time mum from West London – who explained how this isolation affected her mental health:

My first pregnancy should have been an exciting time for me, my partner and my family. But due to Covid and my family all living in the North East, I spent the majority of my pregnancy alone in our house in London, unable to share the special experience with the ones I love. The fact my partner could not attend the appointments with me made me feel quite alone in my pregnancy and I was terrified I would receive some bad news during my scans without my partner there to support me.

Jess told me that, due to her partner having to leave the hospital not long after the birth of their son, she discharged herself early against advice so that she could be with her partner. I also spoke to Lette – another soon-to-be first-time mum from North London – about how she feels Covid-19 has affected her pregnancy. Lette told me that while phone communication with nurses and midwife has been excellently maintained throughout lockdown, the lack of face-to-face appointments exacerbated some of her anxieties around giving birth for the first time:

I was diagnosed with an incarcerated uterus, which I think sounds scarier than it is, but that was quite a scary thing to think about because you do google things and you see that it can lead to quite serious complications … I had to talk to my midwife about all of this over the phone, and it would have been more reassuring to see her face-to-face.

As someone who often googles their own symptoms for random ailments under the conviction I am on the brink of grave peril, I cannot begin to comprehend the level of anxiety and isolation that pregnant women across the UK must have been feeling these past few months, and just how little has been done about it.

Despite feeling supported over the phone, Lette was unable to meet her midwife in person until her 25-week check-up and was left wondering for months if her and her baby were progressing healthily. Further to this, Lette’s partner has been unable to join her for any of her NHS appointments, which she says has been a real concern. Lette and her partner said they are anxious about other fathers missing out on what is “an important bonding experience for dads”. The couple eventually paid for a private scan so that they could find out the gender of their child together, but acknowledge that doing so was a “real privilege” that many parents may not be able to afford.

More than a third of women in the UK have been unsure how to access contraception during the pandemic

It must be immensely disappointing for so many couples to have had what is meant to be the most exciting time of their life completely overshadowed by Covid-19. And yet, if you have the money to do so, you can quite easily bypass these rules; yet again demonstrating that this virus is no great equaliser after all. Let us also not forget the wider effects of these restrictions; grandparents unable to bond with their grandchildren and help with child-rearing will doubtless have a collective effect on the mental health of the extended family as well as new parents.

Another no less important area which has been hard-hit by Covid-19 has been women’s accessibility to sexual and reproductive health services. Already a severely underfunded aspect of women’s heath, data released in September revealed that more than a third of women in the UK have been unsure how to access contraception during the pandemic – yet another indication that women’s needs have been neglected and that young women in particular are taking the brunt of it.

Julia Hogan, lead contraceptive nurse for Marie Stopes UK, said:

Women’s need for contraception does not stop during an emergency, but once again, women and girls have been disgracefully neglected. Many have been left confused about where they can access contraceptive services during Covid-19, unable to use the method of their choice or, worryingly, unable to access a service at all … and with no end in sight to the pandemic, it is more important than ever that women know how and where to access the contraception that is right for them.

While telemedicine has undoubtedly been an important lifeline for many by enabling women to receive the healthcare they need and deserve during the pandemic, there are still questions hovering over the standard of aftercare which is offered over the phone or through Zoom. For example, Jess also told me that her 6-week postnatal appointment with the GP was cancelled and replaced with a phone call. She explained that normally this appointment would involve important physical checks, but that all aftercare was overlooked despite the fact that she had to have an operation three weeks postpartum to fix several issues relating to the birth.

As face-to-face appointments become less of a priority within the NHS, these services are instead delegated to charities and are no longer prioritised under government healthcare policy. There has been a chronic lack of investment in women’s health services over the past decade, and vulnerable women across the UK cannot afford to have these services further obliterated once the pandemic is over.

Finally, but no less significantly, women’s access to gender-based domestic violence charities have been severely disrupted by the pandemic. We have already seen that women experiencing domestic violence are more likely to experience stillbirth, but according to Julie Bindel in the November issue of The Critic: 

Every three days, a woman dies at the hands of her partner or ex-partner, and under the Covid-19 lockdown that number has dramatically increased. Five weeks into lockdown, the number of women killed by men was almost twice that during the same time period in the past 11 years.

Women were being let down before the pandemic and they continue to be let down now

In April, over three quarters of victims living with their abuser (78 per cent) told domestic abuse charity Women’s Aid that they felt they could not leave their homes as a result of the pandemic, and it is likely that a second lockdown could yield similar unfortunate results where women are unable to escape abuse. A domestic abuse bill is currently undergoing parliamentary scrutiny, but concerns persist over its shortfalls and lack of commitment to any long-term funding or solution.

The government conceded that those living in domestic abuse situations were exempt from the “Stay at home” order, as if governmental consent would make any difference as to whether someone living in a domestic abuse situation would or would not be able to leave their home.

The UN Population Fund warned us in April that the coronavirus pandemic could have serious implications for women, yet despite this early warning there has been little concerted effort applied to address any of the above issues affecting women’s physical and mental wellbeing. Women were being let down before Covid-19 and they have continued to be let down throughout the pandemic – emergency provisions are not enough. Considering women make up half of the UK’s population, it is high time that we put their health and wellbeing back on the priority list.

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