The effects of the pandemic have been devastating for women in Colombia. According to the Observatory of Public Health and Epidemiology of the Universidad de los Andes, during 2020 early maternal mortality increased by 50%. At least 405 women died during pregnancy or within 42 days postpartum from causes related or aggravated by the pregnancy or its care. The main cause of death is uterine bleeding.
The numbers are the worst since 2012, when there were 438 maternal deaths. Experts warn that it is an invisible fact of the coronavirus pandemic. In 2019, there were 106 more cases and affected the poorest women.
The reasons for the increase are varied, but the main one is that the barriers to access to safe abortions increased during the pandemic, which led women to unsafe procedures, Luis Jorge Hernández, who is part of the team of the Observatory. Hernández, also a professor at the Los Andes University School of Medicine, recalls that uterine bleeding is the leading cause of maternal deaths in the world and is related to unsafe abortions.
In Colombia, the Voluntary Termination of Pregnancy (IVE) has been a right since 2006 and can be accessed under three grounds: when there is a fetal malformation, the pregnancy is the result of sexual violence or when the continuation of the pregnancy constitutes a danger to your health physical or mental or for your life. However, during the pandemic, and in the absence of medical services, many women went to illegal sites or did so at home.
Profamilia, the private entity that provides the service and does sex education pedagogy, conducted the I-Share Study, between December 2020 and January 2021, and found that 29% of women who needed an abortion during the pandemic experienced obstacles to access this right. Of them, 8% faced barriers imposed by the Health Promotion Institution, another 8% said that they could not access the IVE during the most restrictive measures due to the covid due to the lack of means of transport to get to the place where they would be performed. the procedure and 5%, who could not do it because they were afraid of catching it when attending a health center.
“All these reasons added to the fact that they put the pregnant population at risk due to lack of access to medical services focused on sexual and reproductive health could have influenced the increase in maternal mortality due to the effects of the pandemic,” Juan Carlos told EL PAÍS Vargas, Scientific Advisor to Profamilia.
Unwanted pregnancies will increase
But this is not the only cause of the increase, which is also associated with the lack of prenatal check-ups and consultations, which decreased during 2020. In many cases, appointments were canceled or delayed due to the hospital situation or the women themselves avoided going to the hospital. fear of contagion.
“Without purchasing power, because this affected the poorest, quarantined and with a health service that did not offer early prenatal care, women were left in the worst of worlds,” adds Hernández. For him, the public health services lowered their guard. It is a matter of inequality, he explains, since some pregnant women could pay private services for their deliveries or private gynecologists, but the poorest faced a greater risk.
According to the Observatory, in the registered cases, the increase in deaths was seen in all ages and the victims were indigenous and peasant women, victims of the armed conflict and migrants. The deaths of foreign women, mostly Venezuelan, are also worrying: it went from four deaths in 2018 to 43 in 2020. Even more so if one takes into account that 10% of births in Colombia are of women from this country .
The deterioration of sexual health during the pandemic was also evidenced in the decrease in access to contraceptives. 80% of the sexually active women surveyed in the Profamilia I-Share Study use a contraceptive method. “However, 14% of them faced barriers to access their alternative in contraception for fear of contagion from leaving their home, long lines and waiting times in medical centers and a shortage of the contraceptive method of their choice due to preventive measures against covid-19 ”, adds Vargas, from Profamilia.
The consequences will be seen soon. “A large number of pregnancies are expected due to these access difficulties. The worst thing is that these programs are still neglected, ”says Professor Hernández.
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