Legal restrictions imposed on access to sexual and reproductive health services during the first COVID-19 emergency state in Latvia

The overall objective of this paper is to characterize legal restrictions that had been posed on sexual and reproductive health care services in Latvia during the Covid-19 restrictions lasting from March 12 to June 9, 2020 as well as to identify major challenges in respect to protection of sexual and reproductive health (SRH) during pandemic. Study was a part of the NRP project “Impact of COVID-19 on health care system and public health in Latvia; ways in preparing health sector for future epidemics” (VPP-COVID-2020/1-0011). Legal research was done by combining normative legal research methods with empirical research methods. In doctrinal legal research statutes and regulations had been reviewed. Empirical data were collected by using semi-structured interviews which were analyzed from a legal perspective. The combination of research methods secured the building of a comprehensive picture concerning protection of human rights in SRH. During the emergency state legal restrictions on provision and access to SRH care services were imposed by the Minister of Health and by the health care institutions. Most restrictive period lasted from March 27 to May 12. Emergency services were available as well as the treatment of HIV/AIDS/sexually transmitted infections, prenatal health care services as well as those services provided by general practitioners. Provision of all other SRH services including out-patient and day-care consultations and treatments by gynecologists, urologists, midwifes etc. was legally banned. Restrictions imposed were not issued in line with constitutional requirements particularly in respect to limits on human rights, were lacking scientific evidence or reasoning in the epidemiological data. Access to SRH services during the first wave of Covid-19 in Latvia was difficult due to numerous restrictions often contradicting human rights and existing legal regulations. Legal expert should be part of a team developing the regulations nationally as well as in the health care facilities.