Cosa fare se hai bisogno di contraccezione o assistenza per l'aborto durante il lockdown

The first step to accessing services when you need them is to remember that while the doors of GP surgeries, sexual health centres and family planning clinics may be closed, their services are still very much happening. The message is clear: whether you need contraception, abortion, sexual assault o sexual health care, you can, and should, contact your doctor. Sexual and reproductive health are integral parts of women's healthcare, and they deserve the same amount of attention as other elements of our health.

Il Faculty of Sexual and Reproductive Healthcare (FSRH), whose members include some of the most experienced sexual and reproductive health doctors and nurses in the country, has risen to the challenge of ensuring women can access their usual treatment where possible, and alternatives where necessary.

Their short, practical guide for women who need to access sexual and reproductive healthcare during the COVID-19 pandemic gives comprehensive advice on:

• What type of care to expect.

• Which services are still available.

• What you may have to wait for until services return to normal.

• What alternatives can be offered when standard treatment options aren't feasible.

• How to access these services.

Telephone access

Whether you usually attend your GP or a local sexual health or family planning clinic, you can still contact them for contraception or any other type of sexual and reproductive healthcare.

Like GP practices, sexual health and family planning clinics are currently operating a 'triage' service. To reduce the risk for patients and staff, walk-in services aren't currently available. However, you can ring or contact your clinic online to book a telephone or video consultation.

Very often, your issue can be dealt with remotely, and you will be able to have prescriptions posted to you or pick them up from your local pharmacy or clinic.

Many patients have found that a remote consultation with a doctor or nurse is more convenient than seeing them face-to-face. Nevertheless, your doctor or nurse will still assess you to see whether there is a potentially serious problem or an issue that necessitates an examination. If they decide it's necessary, they'll advise you what to do next.

You can always access contraception free on the NHS - that's your right. But it's worth bearing in mind that some forms of contraception will be easier to access than others at the moment.

Pills, rings and patches

For instance, if you are already taking oral contraception, you will often be able to get a repeat prescription posted to you, left for collection at your clinic or delivered to your local pharmacy for you to collect. It's worth bearing in mind that if you're taking the combined oral contraceptive pill, or using the contraceptive patch or ring, your doctor or nurse will want to check that you've had a blood pressure check in the last year and that your weight is stable.

Alternatively, many pharmacies now offer emergency contraception or repeat prescriptions for oral contraception, although you may have to pay for these. You'll need to have an assessment first to make sure it's suitable for you - this may be done in person or through a telephone or video consultation. You can find out about the pharmacy services in your area on Patient Access.

Coils and implants

Many women use 'long-acting reversible contraceptives' (LARCs) - this refers to IUCDs, IUS, the hormonal implant and the injection. Due to the need to reduce contact with patients, you may not be able to get a LARC fitted for the first time at the moment. If you currently have an IUCD o IUS fitting which is due for removal or replacement, you may be asked to leave this in for the time being.

The idea of using a long-acting form of contraception which is 'overdue' for replacement can be worrying for some women. However, the FSRH has looked at the evidence for effectiveness of all LARCs. According to their recommendations:

• Banded copper IUCDs, such as T-Safe®, are licensed for 10 years but don't cause health problems if used for longer, and are likely* to be effective for contraception for up to 12 years.

• 52 mg levonorgestrel intrauterine systems, such as Mirena® and Levosert®, which are licensed for five years don't cause health problems if used for longer, and are likely to be effective for contraception for six years. If fitted after the age of 45, these can be used safely for contraception until the age of 55.

• Contraceptive implants, such as Nexplanon®, which are licenced for three years don't cause health problems if used for longer and are likely to be effective for contraception for four years.

It's important to remember that your doctor will only recommend that you continue to use your LARC for longer than licensed if it's safe for you to do so. You can find more information in the FRSH guide.

Contraceptive injections

If you use a hormone injection, it's important that you don't have a gap of more than 14 weeks between injections. If a face-to-face appointment for Depo-Provera® injection isn't possible, you may be offered the progestogen-only pill in the short term.

If you are having pain or other serious side-effects from a form of long-acting reversible contraception, it's important to let your doctor know as soon as possible.

There have been some worrying headlines about abortion being restricted around the world in response to the pandemic. Thankfully, that's not the case in the UK, where abortion is recognised as essential, time-sensitive care.

If you have been pregnant for under 10 weeks in England and Wales, or 12 weeks in Scotland, you can have an abortion at home under new rules brought in by the Government.

This reduces the amount of face-to-face contact with health workers.

How you can access an abortion depends upon where in the UK you live. The FSRH guide contains full information on how to refer yourself for an abortion in England, Scotland, Wales and Northern Ireland.