Potential Impacts of Delaying “Non-Essential” Reproductive Health Care

What services have been deemed essential by leading medical societies?
Health Care Need Statements by leading medical societies
Pregnancy Prenatal care: considered essential, but may consolidate number of visits (ACOG). Prenatal ultrasound and fetal surveillance should continue as medically indicated, but consider postponing/canceling some testing or examinations if risk outweighs benefits. (ACOG) Amniocentesis may be delayed a few weeks (ACS)
Cesarean sections: emergent, do not delay (ACS)
Postpartum care: consider expediting discharge after delivery (ACOG)
Ectopic pregnancy: emergent, do not delay (ACS)
Contraception Contraception considered essential health care (ACOG, SFP)
Prescription methods: use telehealth to conduct visits and prescribe (AOCG)
IUDs and Implants: continue to offer in-person insertion when possible, postpone removals (ACOG)
Sterilization: Procedures can be delayed several months (ACS). Considered elective, unless done during a cesarean section (ACOG)
Emergency contraception: continue to provide prescriptions and counseling on over-the-counter methods (ACOG)
Abortion ACOG opposes COVID-19 responses that cancel or delay abortion procedures. Delaying abortions may cause significant harm (ACS).
Infertility Infertility procedures can be delayed several months (ACS) Initial recommendation to suspend new fertility treatment/diagnostic procedures, unless treatment cycle already started. Some care now resuming (ASRM Update 1, Update 4)
Pregnancy Loss Emergent, do not delay (ACS)
Gynecologic Cancer Most gynecologic cancer procedures considered non-elective (SGO) Surgery for gynecologic cancer delay may cause significant harm (ACS).
Diagnostic evaluations for uterine/cervical cancer may be delayed a few weeks to months (ACS, ASCCP)
Benign Gynecologic Conditions Surgeries for fibroids, endometriosis, pelvic pain, and benign ovarian masses can be delayed several months (ACS)
Recommended Preventative Care (e.g. STI and cervical cancer screenings, HPV vaccination)
Potentially defer until after COVID-19 outbreak (ACOG). Reduce or postpone visits for preventative services (AAFP)
Notes: Info current as of 5/13/2020. Recommendations may change as COVID-19 emergency evolves.
ACOG = American College of Obstetricians and Gynecologists; ASRM = American Society for Reproductive Medicine; ACS = American College of Surgeons; AAFP = American Academy for Family Medicine (AAFP); SGO = Society of Gynecologic Oncology; SFP = Society of Family Planning.
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