It’s no secret that women are bearing the brunt of the pandemic. From increased childcare responsibilities, to a higher chance of furlough and job loss, it’s thought that the fallout from lockdown restrictions will have a long-lasting impact on the lives of women around the UK.
Now, women’s healthcare is the latest 'collateral damage' to emerge as a result of the pandemic. A new survey undertaken by the charity Breast Cancer Now revealed that 47 per cent of women do not check their breasts regularly for signs of breast cancer, and one in 10 never do. When asked why they didn’t check for changes, 46 per cent of those who had not been diagnosed with breast cancer said they “forget” to do so. Others cited embarrassment or a desire not to bother their GP.
This adds to fears thousands of cancer cases are going undiagnosed as a result of the pandemic. Just last month, Breast Cancer Now warned that more than half a million women have missed vital breast screenings due to the halt in services during the first wave of the pandemic. The charity now calculates that around 8,600 women will now have undetected breast cancer.
It's not just cancer; access to contraceptive services, smear tests and maternity appointments have all been severely disrupted as a result of Covid-19. “The impact of this is really worrying,” says Dr Balvinda Sagoo, an obstetrician gynecologist. “In my practice, we haven’t done emergency hysterectomies for a long time but we’ve done 3 or 4 these last couple of months.”
But why are so many women neglecting their health? According to Sagoo, it's partly because GP services aren't currently able to provide women with the services they need in a timely fashion. "Women may be putting off their appointments, and when they do go they have to wait for a referral appointment. Then the hospital has to triage them appropriately, which can be difficult when there’s a backlog of cases.”
38-year-old Meinir Thomas, a translator from Carmarthen, was booked in for a smear test in mid February. In the past, Thomas' smear tests had found abnormal cells, so she was sure to never miss an appointment. However, when the smear test hurt and the nurse couldn’t get the results she wanted, Thomas was advised to come back in two weeks time.
At that appointment, Thomas was told she had to wait a further twelve weeks, due to rules about the speculum being used twice in close proximity. When she rang the surgery in May, she was told that the Welsh government had stopped appointments. She would have to wait until further notice.
“Because I’d had abnormal cells before, I was so anxious; I kept bursting into tears, thinking that I might have cancer. I just couldn’t get the fact I was overdue for a smear test out of my mind,” she says.
When pubs and restaurants began to open, Thomas says she still wasn’t able to get a smear test: “I kept seeing pictures of people out and about and thinking; if they’re allowed to do that, why can’t I get my test?”
Eventually, she was booked in to have her test in June, and got the all clear. While she describes the feeling as “utter relief”, Thomas says she’s worried that other women are still going through the same - particularly now Wales is in another lockdown.
Kate Sanger, of the charity Jo’s Cervical Cancer Trust, says the delays in smear test appointments or reduced services are just an additional barrier on top of the ones that already exist; namely, fear of pain, embarrassment and worry about placing additional strain on the NHS.
“Our research found that in groups of women who are more at risk of coronavirus, there’s a lot of confusion and anxiety about attending appointments. Many are worried about catching the virus from sitting in a waiting room with people they don’t know,” she says. “At a time when health anxiety is already at a high, there’s a lot of confusion; many women are put off by the idea of having to deal with a cervical screening appointment.”
Sanger adds that some women are even using the pandemic as an excuse not to attend a smear test. “Women need to know that if they are invited to a cervical screening, then they are safe to go. If their GP is busy, it’s worth ringing your sexual health clinic, as they might have an available appointment,” she says.
It’s a similar story for other cancers. According to the charity Target Ovarian Cancer, women are worried about seeing their GP because of fears of catching the virus, or being a burden to the health service. A survey by the charity found over half of women had been unable to access treatment and, in particular, surgery. “At the moment, we’re seeing more advanced stages of cancer that would have been picked up months ago if it wasn’t for lockdown,” says Sagoo.
She adds that the impact of restrictions on women’s mental health must not be forgotten either. “The pandemic has had a huge impact on women’s emotional well being; anxiety and depression have both dramatically increased since the start of lockdown,” she says. Indeed, stark new findings from a study called Understanding Society revealed that more than a third of British women have suffered psychological distress during the pandemic.
Reproductive health has been affected too. According to a report by Marie Stopes International, 1.9 million fewer women around the globe were able to access their services between January and June, in comparison to 2019. The organisation predicts this will lead to 900,000 unintended pregnancies, 1.5 million unsafe abortions, and more than 3,000 maternal deaths.
The organisation puts this down to three key factors; a reduced availability of abortion services; the requirement for these services remaining the same; and barriers to accessing services. During the initial restrictions in March, many women were confused about whether they could leave their homes to access services with just 21 per cent thinking that they were still open during lockdown.
Historically women have been better at finding the time to attend routine appointments and screening than men. A further reason for women neglecting their health could be lack of time, as a result of additional housework or childcare responsibilities - a subject widely discussed as part of the Telegraph’s Equality Check campaign.
As Sagoo sees it, there’s been less of a drive to promote health awareness during the pandemic, because more women are staying at home. That means that posters reminding women to attend a screening, or to check their breasts, aren’t being seen.
“It’s vital that women continue to access these services as best as they can to prevent any more collateral damage from Covid-19,” adds Sagoo.