A spike in abortions among Scottish teenagers may be linked to a lack of sex education while schools were closed during the pandemic, the Scottish Covid inquiry has heard.
Catherine Murphy, executive director of the women's rights charity Engender, said that "more research and learning" is needed to understand why the termination rate among 16 to 19-year-olds in 2022 reached a 14-year high.
However, she said that "inconsistencies" around sex education and access to contraception during the pandemic could be to blame.
Statistics published earlier this year revealed that there had been a 19% year-on-year increase overall in abortions in Scotland during 2022, to 16,596 in total.
However, the uptick was even more pronounced - at 25% - for the 16 to 19 age group, with 1,899 terminations taking place.
Ms Murphy said: "Something has happened of significance. One of the things we would like to see is more research and learning in that area to see what exactly were the drivers.
"We would suggest and anticipate that the drivers partly were socioeconomic within the pandemic and the subsequent cost of living crisis: that many women lost their jobs or were furloughed and earning reduced wages, were under an enormous amount of pressure.
"Disabled women for example might have been under particular pressure because of the fear and anxiety and the unknown that existed around Covid 19.
"For young women there was a lack of, and inconsistencies, around sexual education that is delivered through schools because the education system was so disrupted.
"We would hazard our best guess based on years of working in this issue, we would imagine that these were key drivers into that increase.
"And also, of course, inconsistencies in being able to access contraception"
The sixth day of the inquiry in Edinburgh was hearing evidence jointly from Ms Murphy and Dr Marsha Scott, the chief executive of Scottish Women's Aid, as representatives of the umbrella body Scottish Women's Rights Organisations.
The group also includes Rape Crisis Scotland, Close the Gap, and Just Right Scotland.
Ms Murphy said pregnant women encountered "shifting advice" during the pandemic on shielding and, later, vaccinations.
She said one expectant mother was told by the healthcare worker administering her Covid vaccination that she was "very brave" and that "she [the healthcare worker] wouldn't necessarily have made that decision".
"We got a lot of feedback from women telling us that we had very conflicting accounts of vaccination," said Ms Murphy.
Worldwide research has consistently shown that the vaccines reduce the risk of Covid complications in pregnancy, which can include an increased risk of stillbirth or pre-term delivery.
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The inquiry was told that pandemic restrictions had caused "disproportionate harm" to women with policy decisions based on an "in-built assumption that the responsibilities of the state could just be offloaded onto women", including extra childcare, home-schooling, and other caring responsibilities.
More than 90% of single parents in Scotland are women, with this group facing "particular stress".
Dr Scott said that Scottish Women's Aid had seen a 70% increase in calls to its helpline following the first national lockdown.
She said: "There was a woman who wanted to take her children and go see her mother in England but she was worried that the British Transport Police would arrest her and send her back home."
Refuges run by Scottish Women's Aid had "in the most part" reduced to accommodating just one family due to Covid rules, with local authority housing allocations for those fleeing domestic violence "frozen or operating at a snail's pace".
For "huge swathes of time" in the pandemic, said Dr Scott, "there was no emergency accommodation for women experiencing domestic abuse".
She said that policies were repeatedly implemented without a focus on the impact on women, vulnerable children, and other marginalised groups.
She said: "I remember a discussion with a children's worker [within Women's Aid] who was talking about children who she saw regularly in school.
"When they shut the schools in her district, children who were experiencing domestic abuse were never recognised as vulnerable so they weren't even considered for being allocated to Hub schools.
"Also children living with their abuser had absolutely no access to the support that they had been getting on a weekly or biweekly basis.
"The worry and the fear for her was that that child was going to wind up dead."
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