Article Text

Download PDFPDF

Ethical challenges for women’s healthcare highlighted by the COVID-19 pandemic
  1. Bethany Bruno1,
  2. David I Shalowitz2,
  3. Kavita Shah Arora3,4
  1. 1School of Medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, USA
  2. 2Department of Obstetrics and Gynecology, Division of Gyncologic Oncology, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, USA
  3. 3Department of Obstetrics and Gynecology, MetroHealth Medical Center, Cleveland, Ohio, USA
  4. 4Department of Bioethics, Case Western Reserve University, Cleveland, OH, United States
  1. Correspondence to Dr Kavita Shah Arora, Department of Obstetrics and Gynecology, MetroHealth Medical Center, Cleveland, Ohio 44109, USA; Kavita.Shah.Arora{at}


Healthcare policies developed during the COVID-19 pandemic to safeguard community health have the potential to disadvantage women in three areas. First, protocols for deferral of elective surgery may assign a lower priority to important reproductive outcomes. Second, policies regarding the prevention and treatment of COVID-19 may not capture the complexity of the considerations related to pregnancy. Third, policies formulated to reduce infectious exposure inadvertently may increase disparities in maternal health outcomes and rates of violence towards women. In this commentary, we outline these challenges unique to women’s healthcare in a pandemic, provide preliminary recommendations and identify areas for further exploration and refinement of policy.

  • applied and professional ethics
  • clinical ethics
  • distributive justice
  • obstetrics and gynaecology
  • reproductive medicine

This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.
View Full Text

Statistics from


  • Twitter @BethanyABruno, @@KavitaShahArora

  • Contributors BB and KSA conceived of the manuscript. BB, DIS and KSA conducted the normative ethical analysis. BB took the lead in writing the manuscript. DIS and KSA revised the manuscript. KSA supervised the project. All authors have approved of the final version submitted.

  • Funding KSA is funded by the Clinical and Translational Science Collaborative of Cleveland, KL2TR0002547 from the National Center for Advancing Translational Sciences (NCATS) component of the National Institutes of Health and NIH roadmap for Medical Research.

  • Disclaimer This manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement There is no data in this work.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.