Abortion service availability during the COVID-19 pandemic: Results from a national census of abortion facilities in the U.S.

Kaller, Shelly; Muñoz, Mercedes Gil; Sharma, Subeksha; Tayel, Salma; Ahlbach, Chris; Cook, Clara; Upadhyay, Ushma D.

doi:10.1016/j.conx.2021.100067

Cited by 13 publications

(14 citation statements)

References 9 publications

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“…Abortion measures in 2020 might have been affected by the COVID-19 pandemic. Factors include temporary changes that defined abortion as a nonessential service at the hospital, local, or jurisdiction level ( 54 , 55 ), clinic closures, and changes in practice (e.g., shift from surgical abortions to medical abortions, implementation, and uptake of telehealth) ( 56 – 60 ). In addition, there might have been changes in pregnancy rates because of reduced sexual activity ( 61 , 62 ).…”

Section: Discussionmentioning

confidence: 99%

Abortion Surveillance — United States, 2020

Kortsmit

Nguyen

Mandel

et al. 2022

MMWR Surveill. Summ.

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Problem/Condition: Since 1969, CDC has conducted abortion surveillance to document the number and characteristics of women obtaining legal induced abortions in the United States.Period Covered: 2015.Description of System: Each year, CDC requests abortion data from the central health agencies of 52 reporting areas (the 50 states, the District of Columbia, and New York City). The reporting areas provide this information voluntarily. For 2015, data were received from 49 reporting areas. Abortion data provided by these 49 reporting areas for each year during 2006-2015 were used in trend analyses. Census and natality data were used to calculate abortion rates (number of abortions per 1,000 women aged 15-44 years) and ratios (number of abortions per 1,000 live births), respectively.Results: A total of 638,169 abortions for 2015 were reported to CDC from 49 reporting areas. Among these 49 reporting areas, the abortion rate for 2015 was 11.8 abortions per 1,000 women aged 15-44 years, and the abortion ratio was 188 abortions per 1,000 live births. From 2014 to 2015, the total number of reported abortions decreased 2% (from 652,639), the abortion rate decreased 2% (from 12.1 abortions per 1,000 women aged 15-44 years), and the abortion ratio decreased 2% (from 192 abortions per 1,000 live births). From 2006 to 2015, the total number of reported abortions decreased 24% (from 842,855), the abortion rate decreased 26% (from 15.9 abortions per 1,000 women aged 15-44 years), and the abortion ratio decreased 19% (from 233 abortions per 1,000 live births). In 2015, all three measures reached their lowest level for the entire period of analysis (2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015).In 2015 and throughout the period of analysis, women in their 20s accounted for the majority of abortions and had the highest abortion rates; women aged ≥30 years accounted for a smaller percentage of abortions and had lower abortion rates. In 2015, women aged 20-24 and 25-29 years accounted for 31.1% and 27.6% of all reported abortions, respectively, and had abortion rates of 19.9 and 17.9 abortions per 1,000 women aged 20-24 and 25-29 years, respectively. In contrast, women aged 30-34, 35-39, and ≥40 years accounted for 17.7%, 10.0%, and 3.5% of all reported abortions, respectively, and had abortion rates of 11.6, 7.0, and 2.5 abortions per 1,000 women aged 30-34, 35-39, and ≥40 years, respectively. From 2006 to 2015, the abortion rate decreased among women in all age groups.In 2015, adolescents aged <15 and 15-19 years accounted for 0.3% and 9.8% of all reported abortions, respectively, and had abortion rates of 0.5 and 6.7 abortions per 1,000 adolescents aged <15 and 15-19 years, respectively. From 2006 to 2015, the percentage of abortions accounted for by adolescents aged 15-19 years decreased 41%, and their abortion rate decreased 54%. This decrease in abortion rate was greater than the decreases for women in any older age group.

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Section: Discussionmentioning

confidence: 99%

Abortion Surveillance — United States, 2020

Kortsmit

Nguyen

Mandel

et al. 2022

MMWR Surveill. Summ.

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“…Prior studies evaluated the impact of COVID-19 on abortion services. [36][37][38][39][40] Tu et al showed that the pandemic was associated with increased intention of seeking induced abortion due to social factors. [38] Kaller et al [39] showed that the COVID-19 pandemic caused several disruptions to abortion service availability in India, including lockdowns.…”

Section: Discussionmentioning

confidence: 99%

“…[36][37][38][39][40] Tu et al showed that the pandemic was associated with increased intention of seeking induced abortion due to social factors. [38] Kaller et al [39] showed that the COVID-19 pandemic caused several disruptions to abortion service availability in India, including lockdowns. To reduce in-person visit time, some clinics shifted to offering medication abortion (versus procedural) or telehealth.…”

Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 on termination of pregnancy

Ferrara¹,

Sglavo²,

Morra³

et al. 2022

Perinat J

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Objective: To evaluate the impact of COVID-19 pandemic on termination of pregnancy. Methods: This was a retrospective study aimed to assess the impact of COVID-19 pandemic on termination of pregnancy in a single center in Italy. Consecutive data on pregnant women who requested induced termination of pregnancy (I-TOP) from February 2018 to December 2021 were included in a dedicated database. The data were divided into two groups according to the COVID-19 outbreak. Women who requested I-TOP from February 2018 to January 2020 were included into the group ‘before COVID-19 pandemic’. Women who requested I-TOP from February 2020 to January 2022 were included into the group ‘during COVID-19 pandemic’. Indications for I-TOP included elective abortion and therapeutic for fetal or maternal indication. Results: A total of 2578 women were included in the study. Of them, 1637 had I-TOP before COVID-19, and 941 had I-TOP during COVID-19. During the pandemic, the request for elective abortion decreased from 76.2% to 67.7% (p<0.01). Therapeutic abortion were performed in 141/693 cases in the first trimester, and in 552/693 cases in the second trimester. Overall, 91 were for maternal indications and 602 for fetal indications. No differences were noticed between before and during pandemic (p=0.99). Follow-up visits two weeks after abortions were offered to all women. However, only 35.5% women visited for follow-up during pandemic vs. 65.0% before COVID-19 (p<0.01). Conclusion: The COVID-19 pandemic had impact on access to abortion services, reducing request for elective abortion and post-abortion follow-up visits.

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“…At any rate, this could mean that abortion could become extremely hard to get in at least 26 of the 50 States in the United States, marking the growing conservative radicalization of the country ( 47 ). We already see some of this happening: the pandemic has caused several disruptions to abortion service availability, including clinic closures ( 48 ) driven by unreasonable governmental requirements or bans specifically targeting abortion services (e.g., forbidding the use of telemedicine for home abortions in some States) giving rise to what we now call “the politics of abortion exceptionalism” ( 49 ).…”

Section: Discussionmentioning

confidence: 99%

Abortion as an Essential Health Service in Latin America During the COVID-19 Pandemic

Michel¹,

Navarrete²,

Chávez³

2022

Front. Glob. Womens Health

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BackgroundThe rapid increase in demand for health services as a result of the COVID-19 outbreak has created significant challenges for health systems. National and international health authorities have declared reproductive health services as essential, particularly those related to prevention, care during pregnancy, delivery and postpartum, as well as abortion services. This research was conducted by a regional team in cooperation with nine local organizations that are members of the Latin American Consortium against Unsafe Abortion (Consorcio Latinoamericano Contra el Aborto Inseguro, CLACAI).ObjectivesOur research aimed to examine the provision of reproductive healthcare services, with a focus on abortion, in nine countries during the first few months of the pandemic (March to September 2020).MethodsOur research design developed a set of quantitative and qualitative indicators to monitor the availability and accessibility of abortion services during the COVID-19 pandemic. Researchers collected the quantitative data by reviewing regulations and other documents, government and civil society reports, and official statistics; the qualitative data was acquired through interviews with key actors, and non-representative surveys completed by healthcare professional and end users of reproductive services.ResultsAlthough six of the nine countries we researched deemed reproductive health services essential, only two of these six countries considered abortion services to be essential, and all nine countries reported difficulties in accessing abortion services. Restrictive abortion laws remained in place in the majority of countries (seven), and as a result access to abortion services became even more limited than it had been before the pandemic. At the same time, good practices to facilitate access to abortion services in healthcare facilities, updated regulatory frameworks, and collaboration between civil society and government agencies were identified and should continue to be promoted even after the pandemic crisis has subsided.ConclusionsThe pandemic catalyzed what was already happening in each country, and as such abortion services have become more accessible in countries like Argentina, where the so-called green wave has been generating social, legal and policy changes, whereas in countries such as Ecuador, where abortion is legally restricted and opposed to by the government, access to safe abortion became even more difficult than it was before the pandemic. However, the general trend has been a lack of adequate adaptation in order to guarantee quality in abortion care. That said, there have also been some interesting and positive service provision initiatives, such as telemedicine, implemented in at least two countries, which, if maintained long-term, could improve access to safe abortion.

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Abortion service availability during the COVID-19 pandemic: Results from a national census of abortion facilities in the U.S.

Cited by 13 publications

References 9 publications

Abortion Surveillance — United States, 2020

Abortion Surveillance — United States, 2020

Impact of COVID-19 on termination of pregnancy

Abortion as an Essential Health Service in Latin America During the COVID-19 Pandemic

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