Pandemic-Related Changes to Sexual and Reproductive Health Services in the United States Offer Lessons for Innovation

New Study Tracks Impact of COVID-Related Policies on Family Planning Providers

Family planning providers in the United States adapted their operations to continue providing sexual and reproductive health care during the COVID-19 pandemic, according to a new Guttmacher Institute study published in Perspectives on Sexual and Reproductive Health. This analysis, part of Guttmacher’s larger Reproductive Health Impact Study, reports findings from in-depth interviews conducted with family planning clinic staff at 55 health care facilities in Arizona, Iowa and Wisconsin in late 2020 and early 2021.

“The changes family planning clinics implemented during the COVID-19 pandemic brought challenges and opportunities for innovation,” says Alicia VandeVusse, senior research scientist at the Guttmacher Institute. “Lessons learned during the pandemic could shape the future of sexual and reproductive health care provision.”

The three main types of changes family planning clinics reported were:

  • Implementation of COVID-19 safety protocols
  • Shifts in service delivery and staffing to meet patient needs
  • Expansion of telehealth services

Study respondents reported that these innovations have the potential to increase access to sexual and reproductive health care, including contraceptive services, for many patients. For example, telehealth visits and access to contraceptive methods over the counter and via mail delivery and curbside pickup increase individuals’ options for getting care and may address time and logistical barriers. Reducing barriers to sexual and reproductive health care is particularly important for Black, Latinx, people of color and people living with low incomes. Because of persistent systemic inequities, these groups are more likely than others to use publicly funded family planning services, to have experienced delays in accessing care during the pandemic and to have been directly affected by COVID-19.

Providers also described the limitations of expanding telehealth services, including patients’ lack of internet access, literacy and translation challenges, patients’ lack of access to private spaces for telehealth appointments and providers’ reduced ability to build rapport with patients. The authors recommend that quality standards be established to ensure that telehealth care is focused on the needs and preferences of each patient, and that the government and health insurance companies continue to support telehealth by providing sustainable reimbursement rates for providers.

A separate but complementary Reproductive Health Impact Study analysis of patients at publicly funded clinics in Arizona, Iowa and Wisconsin, released in February 2022, found that the COVID-19 pandemic prevented or delayed as many as half of family planning patients from getting birth control or related sexual and reproductive health care, and those who experienced financial hardship were particularly affected. Together, the two analyses describe how patients struggled to access sexual and reproductive health care during the COVID-19 pandemic while their providers shifted their service delivery to try to meet their needs.

The article “Disruptions and opportunities in sexual and reproductive health care: how COVID-19 impacted service provision in three US states,” by Alicia VandeVusse, senior research scientist at the Guttmacher Institute, and colleagues, is published in Perspectives on Sexual and Reproductive Health.


About the Reproductive Health Impact Study

The Reproductive Health Impact Study analyzes the effects of federal and state policy changes on publicly funded family planning care in the United States. The study focuses on Arizona, Iowa, New Jersey and Wisconsin, and the Guttmacher Institute works with research, policy, grantee and provider partners in each state to document the impact of policies implemented from 2017 to 2022 on family planning service delivery and the patients who rely on this care.

Emerging findings from this study are building a robust evidence base that demonstrates the disruptions to care stemming from ideologically motivated policy attacks on reproductive health services and the detrimental impacts of these attacks on patients and providers. The study findings also significantly enhance the body of evidence regarding the impacts of the COVID-19 pandemic on sexual and reproductive health service provision.