Covid-19 has upended every aspect of our lives, in ways both seen and unseen. Each day, we witness the damaging effects of the pandemic on our economies and healthcare systems, as businesses shut down and hospitals struggle to meet an overwhelming demand for intensive care services. But inside homes across the country, families are bearing witness to another impact of the epidemic, its effect on the sexual and reproductive health of women.

new report from the Guttmacher Institute released this week is shining first light on the plight of women in America in the midst of the Covid-19 pandemic. The institute surveyed 2,009 women over a two week period in late April and early May, asking questions related to their health, their physical and emotional safety, and their desire to have children. The responses give us a better understanding of the true scope of the impact of Covid-19 and a sense of the ripple effects that we will be navigating over generations to come.

One of the most significant findings is that, because of the pandemic, one third of women surveyed now say they want to delay having children or they want fewer children overall. It has long been understood that a woman’s desire to have children is shaped in large part by the broader socioeconomic context in which she lives and the increase in financial and job-related worries created by today’s pandemic is already having an impact. Not surprisingly, the same percentage of women surveyed said their attitude towards contraception has also shifted because of the pandemic, with one third saying that they are now more careful than they used to be about using birth control.

Unfortunately, the pandemic has created new challenges for women in need of contraception. One in three women surveyed said the pandemic has made it harder for them to access birth control or has delayed or forced cancellations of their doctor visits. Black and Hispanic women, two groups that have historically borne the brunt of social inequalities, continue to face greater challenges to timely care than white women, with 38% of Black women and 45% of Hispanic women reporting issues with access to care, compared to 29% of white women. There were similar discrepancies in access to care for other marginalized groups like queer women (46%) when compared to straight women (31%).

It is hard to imagine any other global event having such an important impact on women. In the wake of the 2008 recession, the Guttmacher Institute conducted a similar survey which showed similar results. But those results appeared after a year of struggle and financial hardship. Today, the impact of the crisis has appeared much sooner and continued job losses and a slow economic recovery over the months to come is likely to compound the problem even further.

Already, more than half of the women in the survey said they or someone in their household had lost their job or had their hours cut. And more than forty percent said they worried whether they would still be able to properly take care of their children.

The challenges the survey exposes today will have an important effect on the America of tomorrow. As we begin to think about how we can rebuild from this crisis, which still has us firmly in its grasp, we must think about how we can create healthcare systems and social support systems that better meets the needs of women. Today’s outbreak has already had a disastrous effect on women’s sexual health and their physical wellbeing, reinforcing the disparities that already existed among marginalized communities. We need to do more and do better as we look ahead to the future.