Experiences in Reproductive Health Services in COVID-19 Era: A Nightmare

With consistent efforts for the last four decades in the area of family planning, it had been a rare instance to receive emergencies with uterine perforation, gut injury, septicaemia, and multiorgan failure with unsafe surgical intervention. But Coronavirus Disease 2019 (COVID-19) pandemic has caused major disruption to the family planning information and services globally. These gaps have been due to breakdown in contraceptive supply chains, closure of primary healthcare and abortion clinics, diversion of staff from family planning services to COVID-19 response team and the poor response was also due to fear of infection in hospital. As a result, many unsafe abortions in the form of near-miss mortality nightmares were revisited. The present series is of five cases, done at a tertiary care teaching hospital wherein there was mismanagement of the abortion due to lack of expert services during the COVID-19 pandemic. Uterine perforation with sepsis was observed in all the patients with bowel injury in three and broad ligament haematoma in one patient. A comprehensive, women's sexual health system response to address family planning services provision during pandemics is the need of the hour for India to avoid unwanted pregnancies and prevent additional mortality and morbidity in women.