Post-Covid pandemic.

THE Covid-19 pandemic may have spared many women from directly getting infected, but in many ways it has exacerbated the impact on their sexual and reproductive health. Giving birth already comes with its own set of risks but during the Covid-19 pandemic the delivery process is complicated manifold.

Many have to face a difficult decision - whether to give birth in a hospital setting or opt for a home birth. The former comes with the risk of infection, the latter may mean limited equipment if the delivery turns into a medical emergency - bleeding after giving birth is one of the leading causes of maternal deaths in Pakistan.

The United Nations Population Fund looked at three sexual and reproductive health services affected by the pandemic in 14 countries including Pakistan: births assisted by skilled healthcare providers, including midwives; births taking place in health facilities; and access to contraception. All the countries surveyed have high maternal mortality ratios - over 100 deaths per 100,000 live births.

Is family planning on the government's radar?

Even if things were fairly good, there would still be a 20 per cent decline in the use of the three key services, leading to a 17pc increase in the maternal mortality ratio, or 25,493 additional deaths this year alone. But if things were bad, it would mean a 50pc decline in the use of services, leading to 43pc increase in maternal mortality, or 68,422 additional deaths.

Experts agree the pandemic may lead to a significant increase in maternal deaths mainly due to reduced access to contraceptive services. Already the use of contraceptives by Pakistani couples is low as is the discontinuation rate.

About 45pc of women in Pakistan who use any of the modern methods of family planning (FP), get their supplies from a government health or an FP facility. A sizable proportion, particularly those in urban/semi-urban areas, get their supplies from NGO-run clinics, Lady Health Workers (LHWs) or directly from pharmacies (condoms and oral pills).

When the government announced a lockdown in April, FP services were the first casualty and women were unable to get either supplies, or antenatal or delivery care. This was particularly true for rural women relying on government facilities. With a disruption in FP services, it is not hard to imagine a spike in unexpected pregnancies, unsafe abortions, pregnancy-related complications and maternal deaths.

The country's population, already increasing at an...