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NEW DELHI Millions of women and girls globally have lost access to contraceptives and abortion services because of the coronavirus pandemic. Now the first widespread measure of the toll says India with its abrupt, months-long lockdown has been hit especially hard.

Several months into the pandemic, many women now have second-trimester pregnancies because they could not find care in time.

Across 37 countries, nearly 2 million fewer women received services between January and June than in the same period last year, Marie Stopes International says in a new report 1.3 million in India alone. The organization expects 900,000 unintended pregnancies worldwide as a result, along with 1.5 million unsafe abortions and more than 3,000 maternal deaths.

Those numbers will likely be greatly amplified if services falter elsewhere in Latin America, Africa and Asia, Marie Stopes director of global evidence, Kathryn Church, has said.

The World Health Organization this month said two-thirds of 103 countries surveyed between mid-May and early July reported disruptions to family planning and contraception services. The U.N. Population Fund warns of up to 7 million unintended pregnancies worldwide.

Lockdowns, travel restrictions, supply chain disruptions, the massive shift of health resources to combat COVID-19 and fear of infection continue to prevent many women and girls from care.

In Indias megacity of Mumbai, one woman was unable to find a pregnancy testing kit after the lockdown started in March, and then couldnt find transport to reach care in time, said Dr. Shewetangi Shinde, who attended to her in a public hospital. By then, medical abortion wasnt an option since the pregnancy was too advanced.

India listed abortions as essential services under lockdown but many werent aware, said Shinde, who is part of the India Safe Abortion Youth Advocates organization.

The pandemic has highlighted how difficult it already was for many women to safely access abortion services, said Dr. Suchitra Dalvie, a gynecologist in Mumbai and coordinator of the Asia Safe Abortion Partnership.

All these people ... the marginalized groups, the vast invisible majority. This is how life is, she said.

In January, India began amending laws to allow certain women to obtain abortions up to 24 weeks instead of 20. But the pandemic interrupted it.

No one expected the lockdown to continue for months, Dalvie said. Now many women face second-trimester abortions, which are more expensive and complicated, especially because everyone who is involved needs to wear PPE.

Abortion access has improved in India, but the pandemic resulted in abortion pill shortages in several states surveyed by Foundation for Reproductive Health Services India. Only 1% of pharmacies in northern states like Haryana and Punjab had them, 2% in the southern state of Tamil Nadu and 6.5% in the central state of Madhya Pradesh. In Delhi it was 34%.

Some contraceptives are still delayed by supply chain disruptions, said Chris Purdy, CEO of the DKT International social marketing organization for family planning products. Production is back online, but shipping routes are crowded and ports clogged with back orders, he said.

Meanwhile, womens health providers have scrambled to find solutions such as telemedicine, home deliveries of contraceptives and home-based medical abortions.

But even now, were hearing everywhere that numbers are down as public health facilities struggle because thousands of staffers have been infected with the virus, said Marion Stevens, director of the South Africa-based Sexual & Reproductive Justice Coalition. Her group and others wrote to the health minister about women turned away from care.

The real global measure of lockdowns effects will come when health ministries report annual data, experts say.

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Millions of Women Lose Access to Contraceptives, Abortion Services in COVID-19 - India West