Access to later abortion in the United States during COVID-19: challenges and recommendations from providers, advocates, and researchers

Ruggiero, Samantha; Brandi, Kristyn; Mark, Alice; Paul, Maureen; Reeves, Matthew F.; Schalit, Odile; Blanchard, Kelly; Key, Katherine; Chandrasekaran, Sruthi

doi:10.1080/26410397.2020.1774185

Cited by 17 publications

(23 citation statements)

References 6 publications

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“…In the US, one in four women will use abortion services by the age of 45 [37]. Despite statements in support of continued abortion care by the American College of Obstetrics and Gynecologists (ACOG) and the American Medical Association (AMA), thirteen states (Alaska, Alabama, Iowa, Indiana, Kentucky, Louisiana, Mississippi, Ohio, Oklahoma, Texas, Tennessee, Utah, and West Virginia) have attempted to halt abortion services by deeming abortions "non-essential" or "elective" procedures [38]. With fewer providers available, patients, especially those seeking later abortion, may have to travel further for care.…”

Section: Barriers To Access Of Contraception In Developed Countries Dmentioning

confidence: 99%

Contraception access during the COVID-19 pandemic

Aly

Haeger

Christy

et al. 2020

Contracept Reprod Med

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, over 7 million confirmed cases and over 400,000 deaths had been recorded across 213 countries and territories [3]. In outbreaks, epidemics, and pandemics, epidemiologists aim to quantify the spread of a disease within a population across space and time. In addition, epidemiologists aim to quantify the rate of disease transmission. This information is then used to inform prevention and mitigation strategies. Although aggressive prevention strategies may be disruptive and costly, such measures may ultimately reduce the burden of morbidity and mortality within a population, as has been demonstrated in previous pandemics, such as the 1918-1920 influenza and the 2009 influenza A (H1N1) pandemics [4, 5]. The first tier of response is containment to prevent the spread of disease before it has a chance to take hold in the community [6]. This may include contact tracing, surveillance in the community through widespread testing, and quarantine measures. However, once a disease has spread through the community, the second tier, mitigation strategies, are necessary to reduce transmission. Interventions include social distancing measures; closure of schools, workplaces, and community facilities; travel restrictions; and individual-level hygiene measures, such as wearing a mask and washing hands [6]. Without mitigation efforts in place, healthcare systems risk being stretched beyond capacity in, for example, intensive care unit (ICU) beds, personal protective equipment (PPE), and ventilators for treating patients with COVID-19. This is why countries who were in the mitigation phase of the pandemic conducted communication campaigns imploring individuals to engage in behaviors to "flatten the curve." Beyond the mitigation tier, state-level actors may put lockdowns in place to further curb transmission. Scope of the problem Asia Countries across Asia were some of the first to experience the outbreak of COVID-19. Many had already had previous experiences dealing with epidemics, including severe acute respiratory syndrome (SARS) from 2002 to 2003, H1N1 flu in 2009, and Middle East Respiratory Syndrome (MERS) in 2014, 2015 and 2018 [7]. Such experiences had prepared governments to respond and made their populations more receptive to restrictive public health measures. Some entities, including South Korea, Mongolia, Hong Kong, and Singapore, initially succeeded in containing the virus through aggressive preemptive measures: transparency in communication, ubiquitous testing, strict quarantine, and thorough disinfectant protocols [7, 8]. South Korea used such measures without ever putting a lockdown in place. After failures in communication during the MERS epidemic in 2015, new standard operating procedures were put in place. By the time COVID-19 arrived, Koreans were willing to

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Section: Barriers To Access Of Contraception In Developed Countries Dmentioning

confidence: 99%

Contraception access during the COVID-19 pandemic

Aly

Haeger

Christy

et al. 2020

Contracept Reprod Med

View full text Add to dashboard Cite

show abstract

“…Abortion providers and seekers have also faced legal restrictions, especially in the South. Already experiencing hostile environments before the pandemic, clinics faced the possibility of closing their doors as 12 state governments attempted to stop abortion services in March and April 2020, declaring the service to be "nonessential" during coronavirus business closures (Ruggiero et al, 2020). The inclusion of abortion on the list of nonessential services was inappropriate and legally contested, with court orders blocking these bans in some of the states (including Alabama, Ohio, Oklahoma, and Tennessee) and allowing abortions to continue (ACOG, 2020b;Baker, 2020).…”

Section: Barriers and Restrictions During The Pandemicmentioning

confidence: 99%

Abortion During the COVID-19 Pandemic: Racial Disparities and Barriers to Care in the USA

Wolfe

Rodgers

2021

Sex Res Soc Policy

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This article draws on first-hand experience as well as scholarly research to illuminate how COVID-19 has impacted an already-embattled medical service in the USA, subsequently affecting the reproductive health and experiences of diverse individuals navigating an unfamiliar health and economic environment. COVID-19's introduction into a landscape of abortion restrictions has intensified the barriers that providers and communities already face, with disproportionate impacts on Black and Hispanic abortion seekers. Relaxing existing restrictions on medication abortions and telemedicine delivery models may be one way to ease the tension between keeping people home and getting them the treatment they need. Went to clinic two days ago after a one month absence. In June when many states in this part of the country had not eased their shutdown restrictions, there were at least 10 older white protesters when usually there are 3-4. One large sign that was propped up on the busier street next to the clinic angrily asked why abortion mills were still open when everything else was closed. Today, as I am walking into the clinic with a co-worker, an older white man who is a frequent protestor cautioned us against going inside to kill our Black babies, while a sign proclaiming all lives, black lives, and babies lives matter floated in the background. This clinic is lucky. The escorts-people who guide patients past protest lines-are still here. At other clinics, the lack of escorts has meant protesters are able to walk right up to patients to spew their rhetoric. As I walked into the entryway there were patients and support people sitting in the hallway, which has never happened in the almost ten years I have been working here. The need for social distancing has made clinics think of new ways to service patients who need abortion. I have seen the implementation of pager systems so that patients can wait in their cars, the exclusion of support people in waiting rooms, and fewer patients being scheduled as we adjust to this different, and hopefully temporary, time. (Excerpt from Author's Personal Journals, August 2020).

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“…The consequences of interrupting the provision of abortion services will be disastrous in both the short and long terms. It will be even worse to the most vulnerable women -black, indigenous, Latin, immigrants, especially those without documents, minors, people with some type of disability, women in rural contexts, and victims of intimate partner violence 43,44 -who will suffer the consequences of this curtailing of services. Finding access to the procedure impeded, they will experience an increase in cost and risk, or even need to resort to unsafe abortion 30,35,45,46 .…”

Section: The Covid-19 Pandemic and Legal Abortion Services Worldwidementioning

confidence: 99%

Abortion and the COVID-19 pandemic: insights for Latin America

et al. 2021

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The COVID-19 pandemic may accentuate existing problems, hindering access to legal abortion, with a consequent increase in unsafe abortions. This scenario may be even worse in low- and middle-income countries, especially in Latin America, where abortion laws are already restrictive and access to services is already hampered. Our objective was to understand how different countries, with an emphasis on Latin Americans, have dealt with legal abortion services in the context of the COVID-19. Thus, we conducted a narrative review on abortion and COVID-19. The 75 articles included, plus other relevant references, indicate that the pandemic affects sexual and reproductive health services by amplifying existing problems and restricting access to reproductive rights, such as legal abortion. This impact may be even stronger in low- and middle-income countries, especially in Latin America, where access to legal abortion is normally restricted. The revision of sources in this article underlines the urgent need to maintain legal abortion services, both from women’s perspective, in support of their reproductive rights, but also from that of the international commitment to achieving the Millennium Development Goals. Thereby, Latin American countries must place reproductive rights as a priority on their agendas and adapt legislation to accommodate alternative models of abortion care. Furthermore, our results underscore the need for clear information on the functioning of sexual and reproductive health services as essential for understanding the impact of the pandemic on legal abortion and to identify the groups most affected by the changes.

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Access to later abortion in the United States during COVID-19: challenges and recommendations from providers, advocates, and researchers

Cited by 17 publications

References 6 publications

Contraception access during the COVID-19 pandemic

Contraception access during the COVID-19 pandemic

Abortion During the COVID-19 Pandemic: Racial Disparities and Barriers to Care in the USA

Abortion and the COVID-19 pandemic: insights for Latin America

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