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

Abstract

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.

The Impact of the COVID-19 Pandemic on the Care of Women Experiencing Abortion in a University Hospital in Brazil

“…This result differs from those of national data, which showed that only 55% of the 76 hospitals in our country that provide legal abortions were operating in 2019. 12 Our multivariate analysis showed that the variables significantly related to complications were failure of the contraceptive method, higher gestational age, and no preparation of the uterine cervix with misoprostol.…”

“…The hospital follows the laws of Brazil regarding the legal termination of pregnancy, in which abortion is allowed only in cases of risk of maternal death, sexual violence, and fetal anencephaly. [7][8][9][10][11][12][13][14][15][16][17][18][19] The sentinel centers of the MUSA network regularly provide information on maternal morbidity in early pregnancy loss, termination methods for uterine evacuations, incidence of complications related to pregnancy termination, incidence of preoperative antibiotic use and prescription of contraception before hospital discharge. Through SIP, it is possible to carry out epidemiological monitoring and comparisons between different sentinel centers over time.…”

Desigualdades raciais nas tendências da maternidade adolescente e no acesso ao pré-natal no Brasil, 2008-2019

“…Ao mesmo tempo, com a reorientação dos serviços de saúde para a atenção prioritária à pandemia, observou-se a restrição do acesso aos serviços de saúde sexual e reprodutiva, provocando a diminuição da dispensação de insumos contraceptivos, da cobertura do pré-natal e dos serviços de aborto legal, colocando os direitos reprodutivos e sexuais das mulheres e meninas em último plano. Este cenário aponta para gravidez não pretendidas, com maternidades oriundas deste contexto, assim como a realização de abortos inseguros (Pilecco et al,2021;Reis et al,2021) . No Brasil, em particular, vivencia-se um momento político de retrocesso nas agendas de direitos humanos e nos direitos sexuais e reprodutivos, em que Research, Society andDevelopment, v. 12, n. 1, e8312139404, 2023 (CC BY 4.0) | ISSN 2525-3409 | DOI: http://dx.doi.org/10.33448/rsd-v12i1.39404 mulheres e meninas vítimas de violências sexuais sofrem inúmeras barreiras morais, estigmas e preconceitos e, em especial, institucionais, para acessar os serviços de aborto legal.…”

Delays in obtaining hospital care and abortion-related complications within a context of illegality

“…In settings such as Brazil and other Latin American countries where access to these services is already difficult due to restrictive legislation, the pandemic compounded these difficulties. Abortion care, which is considered an elective procedure even in cases in which the procedure is legal, was relegated to the background in order to prioritize measures to combat Covid-19 [ 57 ]. Therefore, it has become even more urgent to review the current protocols of abortion care under these circumstances, including the implementation of new technologies such as telemedicine, which is known to be effective and safe [ 58 – 60 ].…”