Clinician Perspectives on Ethics and COVID-19: Minding the Gap in Sexual and Reproductive Health.

Abstract

In the United States, policies and practices enacted in response to the COVID-19 pandemic— such as social distancing, sheltering in place, shifting to telemedicine and limiting care to ‚essential‛ procedures—are widening gaps in sexual and reproductive health (SRH) outcomes and access to services. As obstetricians-gynecologists, pediatricians and adolescent medicine specialists who are frontline providers of SRH services, we are seeing firsthand the documented decreases in access to SRH education, abortion and contraceptives (particularly long-acting reversible contraceptives, or LARCs), and increases in reports of gender-based violence.1–4 These trends have disproportionately affected minoritized and marginalized groups, including adolescents, people of color, those living in poverty, immigrants and undocumented individuals, and those living in rural areas.5,6 In this viewpoint, we provide a clinician’s perspective on the gaps in services and outcomes between these and more privileged groups, and make recommendations to narrow these gaps, both now and in the future. In some cases, the gaps in access to SRH services have been an unintended effect of COVID-19–related policies. For example, access to SRH services at federally qualified health centers and community-based clinics has been limited because of budgetary constraints, A cc ep te d A rti cl e