The worrying statistics for working mothers throughout the pandemic.

The UK government has had to make many changes to its healthcare system in the last year to stop the spread of coronavirus, including asking people to stay home when possible, prioritising higher-risk patients and putting many routine appointments on pause. Despite the NHS doing everything in its power to keep people safe, The Care Quality Commission warns there was 26.7 million fewer NHS appointments between March and August 2020 compared to the previous year overall.

Now, growing evidence suggests that these necessary shifts have particularly caused women’s health issues to fall by the wayside and its working mothers who have been hit the hardest. With confounding factors including delays in check-ups, lack of access to sexual health services, taking on more childcare duties than men, and having higher levels of anxiety around attending appointments, many predict the pandemic’s repercussions to working mothers health could be catastrophic. Bolt Burdon Kemp have investigated this further, with exclusive commentary from Hannah Travis (Senior Solicitor in the Medical Negligence team at Bolt Burdon Kemp) and Hugh Adams (Brain Tumour Research’s Head of Stakeholder Relations).

One million women in the UK may have missed lifesaving NHS breast screening, while 600,000 cervical cancer tests failed to go ahead 

• 1 in 8 women will be affected with breast cancer in their lifetime
• 1 million breast cancer mammograms have been missed due to pauses between March to July 2020
• It is estimated that 8,600 women caught in the backlog could be living with undetected breast cancer – and that their diagnosis could be delayed due to the impact of COVID-19
• Jo’s Cervical Cancer Trust found up to 600,000 smear tests failed to go ahead in the UK across April and May 2020 (in addition to 1.5 million appointments missed annually)

Thankfully, both breast cancer and cervical cancer screenings have now restarted across the UK, and it is vital that women do what they can to attend screenings. However, a survey by gynaecological charity The Eve Appeal found that, of those that had have received invitations to smear tests this year, 28% have not attended them. Hannah Travis sheds more light on why this could be the case:

“The Covid pandemic has had a significant impact on reducing the uptake of cervical screening rates even further. Firstly, there was a short period of time where screening was not taking place and secondly, there was the understandable fear from women attending a medical setting for screening because of the pandemic and risk of being infected.”

Finally, there are some other cancers which many don’t realise most often affect females more so than males. As Hugh Adams of Brain Tumour Research explains, meningioma is one of these.

“This is the most commonly diagnosed brain tumour, and it is more prominent in adult females than adult males, with research suggesting hormone replacement therapy may contribute to its increased risk.”

Because the symptoms of meningioma can be very broad – from headaches to hearing problems –its likely many women would attribute these to something less sinister.

The UN Population Fund predicted 7 million unintended pregnancies globally in the months after the first lockdown 

• A report by Marie Stopes International says 1.9 million fewer women around the globe accessed reproductive health services between January and June 2020, compared to the year before.
• The organisation predicts this could lead to 900,000 unintended pregnancies, 1.5 million unsafe abortions and 3,000 maternal deaths.
• The World Health Organisation reported that out of 103 countries, two-thirds reported reproductive health services had suffered disruption between May and July 2020.
• As a result, the UN Population Fund are expecting 7 million unintended pregnancies globally.

Within the UK specifically, limited access to Genitourinary Medicine (GUM) clinics meant many were unable to access vital contraception. In fact, a study carried out by the British Association for Sexual Health and HIV since the Covid outbreak found 86% of clinics could not offer the most effective contraceptive choices of a coil or an implant, with one-third unable to fit a coil for emergency contraception.

Extra pressures mean working mothers are even less likely to put their own health first 

• In the UK, nearly three in five of all key workers are women
• 77% of healthcare workers are women, and 83% of social care workers are women
• 1.2 million working women within the UK have no sick pay eligibility
• Pre-pandemic, women already shouldered around 60% more unpaid work than men
• The Office for National Statistics found women have had to balance 47% of their working hours with childcare, vs 30% for men

Aside from many health services having been paused, there are other contributing factors as to why women’s health issues may be neglected. A survey by Zegami – a data visualisation platform for medical imaging analysis – found women (34%) were more likely to miss seeing a medical professional than men (24%) due to anxiety surrounding the virus.14 Aside from this, other contributing factors have affected women’s abilities to put their own health first.

Travis states, 

“Many were working on the front line with their time available to attend routine appointments significantly reduced. [As well as this,] some women may have been prohibited from attending due to their childcare and or carer responsibilities, and at a time when schools or nurseries were closed – respite care was unavailable, and childcare bubbles were non-existent.”

Add to that the fact that 133,000 more women than men were placed on the furlough scheme between March-August 2020, it’s possible that women are even more likely to be the designated carer in a household, while men continue to work

What to do about your upcoming appointments 

The NHS have issued guidance around what to do regarding appointments: 

• Get medical help if you need it
• Do not change any appointments or procedures unless advised by your doctor
• Go to the hospital if you’re advised to
• Call your GP surgery, or visit their website instead of going to the surgery in person

Adams acknowledges it can be tempting to ignore our symptoms, particularly when trying to help the NHS. However, as he explains in the context of cancers such as meningioma,

“While 80-90% of tumours are benign, they can still be problematic, so anyone worried about symptoms should continue to attend appointments or seek advice.”

Travis also explains that a new solution from the NHS could help those unable to go for screenings and smear tests in person: 

“When it comes to cervical cancer, home trials of HPV swab testing will be vital, and this trial will see that 31,000 women who are overdue their smear tests by 15 months are sent one.”

“These new initial swab tests will help increase uptake of cervical screening for those women who face legitimate barriers”, Travis goes on to say. “Testing for high-risk HPV can be done in the comfort of your own home at any time of day and is therefore much more accessible to many. If this test is positive, it can be followed up by an invitation for the full smear screening test by the GP surgery.”

However, Travis says: “It’s key to remember this is merely the first step in identifying risk of cervical cancer, but is nonetheless vital as, if caught early on, it could mean the difference of life and possibly death for some women.”

Looking out for symptoms at home 

When it comes to women’s cancers, there are some early signs that you can check for at home. The Eve Appeal explains there are 21,000 gynaecological cancer diagnoses in the UK every year, but many aren’t aware of key symptoms that could ensure an earlier diagnosis, and a better outcome. Below are some potential signs and symptoms of cancers given by the Eve Appeal, the NHS and Brain Tumour Research:

• Ovarian cancer: Persistent bloating; persistent pelvic/abdominal pain; difficulty eating; feeling full quickly or feeling nauseous; change in bowel habits; needing to urinate more.
• Womb cancer: Bleeding in between periods, after menopause or after sex; heavier periods; vaginal discharge (pink/watery/brown/prune colour).
• Cervical cancer: Bleeding between periods or after sex; pain during sex; unpleasant smelling vaginal discharge.
• Vulval cancer: A lasting itch; pain or soreness; thickened, raised, red, white or dark patches of the skin of the vulva; a lump on the vulva.
• Vaginal cancer: Bleeding between periods, post-menopause, and/or after sex; bad-smelling/blood-stained discharge; pain during sex; a vaginal lump; persistent vaginal itch.
• Breast cancer: A change in the size or shape of one or both breasts; discharge from either nipples, which may be streaked with blood; a lump or swelling in either armpits; dimpling on the skin of your breasts; a rash on or around your nipple; a change in appearance of your nipple, such as becoming sunken.
• Brain cancer: Some of these symptoms may be very subtle at first, but may include changes in vision, worsening headaches, hearing loss or tinnitus, memory loss, loss of smell, seizures, or weakness in arms or legs.

As with all symptoms, many of these may not always point to cancer, but it is essential to call your GP and make them aware of anything you’ve noticed, as soon as you’ve noticed it.