The new coronavirus has spread rapidly in cities around the globe. Some believe that pandemics will become endemic or part of our daily lives – vaccination disparities will cause that many countries will not reach herd immunity and other variants will develop.

If pandemics linger, what will we do differently in healthcare, specifically contraception?

What did we learn in these past 12 months? If there was ever a good time to take control of our health and future, the time has come – and it is now!

So what options are out there?

Looking beyond the pill for effectiveness

Choosing birth control that fits our body and lifestyle requires time and consideration. It can be a daunting task. First, it’s key to be aware of the various options. Modern contraceptives fall under two categories:

• Long-Acting Reversible Contraception (LARC) is widely recognized as the most effective and reliable form of reversible contraceptives, being more than 99% effective. This category includes intrauterine devices (IUDs) as well as implants.
• Short-Acting Reversible Contraception (SARC) works for short time intervals with an efficacy of about 85%. The most popular SARCs are condoms, pills, diaphragms, and contraceptive rings.

Short-Acting Reversible Contraception like condoms or pills are the most popular birth control methods. Will Covid-19 change our approach towards contraception?Image:Pexels.com

Today, the most used birth controls are condoms and pills. In the light of our new reality,  shall we think differently about family planning options?

Perhaps by favoring options that both don’t require regular face to face medical visits and are also highly effective at preventing unplanned pregnancies without being exposed to user’s compliance.

Women’s attitudes towards contraception changed in 2020

Findings from the 2020 Guttmacher Survey of Reproductive Health Experiences revealed that women’s attitudes toward contraception have changed because of the pandemic.

For some women, the crisis appears to have promoted a shift to more effective contraceptive methods and more consistent use.

• 34% of women agreed with the statement “Because of the pandemic, I am more careful than I used to be about using contraception every time I have sex.”
• 23% of women reported thinking more about getting a longer-acting contraceptive method (such as an IUD) because of the pandemic. This interest was driven in great part due to reduced access to healthcare providers.

Findings from The European Contraception Atlas 2020 confirm that access to contraceptives remains a challenge – especially during the Covid crisis.

Some practices are revamping their contraceptive care 

The Primary Care Practice at Harvard Medical School is betting on telehealth.

“This pandemic has demonstrated that the great majority of contraceptive initiation, management, and discontinuation can be managed via Telehealth or perhaps without clinician interaction at all. Evidence-based practical resources like the The Centers for Disease Control and Prevention (CDC) Selected Practice Recommendations for Contraceptive Use can be used to implement telehealth workflows to determine which tests are needed before initiation of contraceptive methods, how to be reasonably certain that a person is not pregnant, and when to start using specific methods.”

                                                                   Is Covid-19 the tipping point that will accelerate remote healthcare? Image: Istock.com

Telehealth visits are designed to maintain social distancing and to reduce COVID-19 exposures. Having staff available via telehealth helps:

• Empower patients regarding social distancing.
• Provide person-centered contraceptive counseling, method initiation and continuation, as well as method switching.
• Avoid unnecessary exposure to illness.

The trend towards Telehealth is clear but it will take a while before it goes mainstream. In the meantime, women and couples will need to inform themselves about the best and most effective options.

IUDs – small devices with a big impact

It is not surprising that interest in Intrauterine devices has increased by 23% among women in 2020. So, what is the main benefit of this type of birth control beyond being 99% effective?

Experts agree – the IUD requires a one-time insertion rather than repeated medical visits and there is no need to keep track of taking daily doses like with pills.

“An IUD is a great form of contraception, as it is low maintenance and requires no doctor visits after insertion,” says Dr.Jessica Shepherd, an OB-GYN and Media Health Expert from the USA.

In London, Dr. Toni Hazell explains – in an extensive article – why seizing the opportunity to offer long-acting reversible contraception is more important now than ever.

Discussion

The entire ecosystem around family planning is being reshaped from the ground up. We are encouraged by the Guttmacher institute’s survey showing a positive change in women’s attitude towards contraception.

Being intentional about family planning as well as using effective contraceptives is a giant leap towards tackling the unplanned pregnancy “epidemic”. How has Covid changed your gynecology practice as a clinician or your contraceptive choice as a woman? We would love to hear from you.

Sources: 

1. How effective are IUDs?
2. Short Acting Contraception
3. Early Impacts of the COVID-19 Pandemic: Findings from the 2020 Guttmacher Survey of Reproductive Health Experiences
4. The European Contraception Atlas 2020
5. Contraception During the COVID-19 Pandemic
6. Best Practices and Resources for Contraception During COVID-19
7. Covid-19 Has Interrupted Reproductive Health Care. IUDs Are Providing a Solution
8. Should You Get an IUD Now Before Everything Shuts Down Again?
9. Top tips: contraception and COVID-19