Abortion during the Covid-19 Pandemic — Ensuring Access to an Essential Health Service

Bayefsky, Michelle J.; Bartz, Deborah; Watson, Kathleen B.

doi:10.1056/nejmp2008006

Cited by 104 publications

(100 citation statements)

References 3 publications

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“…The decision to end a pregnancy could be due to the perception of risk posed by COVID-19, reduced access to pre-natal care, and limited social support during lockdowns. 23 Additionally, decision-making could be influenced by the economic downturn COVID-19 has precipitated, with many people facing unemployment or financial losses. 24 It has also been suggested that social distancing policies may increase rates of unintended pregnancy due to increased time spent at home with a partner or reduced access to contraception.…”

Section: Discussionmentioning

confidence: 99%

Demand for Self-Managed Online Telemedicine Abortion in Eight European Countries During the COVID-19 Pandemic: A Regression Discontinuity Analysis

Aiken

Starling

Gomperts

et al. 2020

Preprint

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Objectives: In most European countries, patients seeking medication abortion during the COVID-19 pandemic are still expected to attend healthcare settings in person despite lockdown measures and infection risk. We assessed whether demand for self-managed medication abortion provided by a fully remote online telemedicine service increased following the emergence of COVID-19. Design: We used regression discontinuity to compare the number of requests to online telemedicine service Women on Web in eight European countries before and after they implemented lockdown measures to slow COVID-19 transmission. We examined the number deaths due to COVID-19, the degree of government-provided economic support, the severity of lockdown travel restrictions, and the medication abortion service provision model in countries with and without significant changes in requests. Setting: Eight European countries served by Women on Web. Participants: 3,915 people who made requests for self-managed abortion to Women on Web between January 1st, 2019 and June 1st, 2020. Main Outcome Measures: Percent change in requests to Women on Web before and after the emergence of COVID-19 and associated lockdown measures. Results: Five countries showed significant increases in requests, ranging from 28% in Northern Ireland (p=0.001) to 139% in Portugal (p<0.001). Two countries showed no significant change in requests, and one country, Great Britain, showed an 88% decrease in requests (p<0.001). Countries with significant increases in requests were either countries where abortion services are mainly provided in hospitals or where no abortion services are available and international travel was prohibited during lockdown. By contrast, Great Britain authorized teleconsultation for medication abortion and provision of medications by mail during the pandemic. Conclusion: These marked changes in requests for self-managed medication abortion during COVID-19 demonstrate demand for fully remote models of abortion care and an urgent need for policymakers to expand access to medication abortion by telemedicine.

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Section: Discussionmentioning

confidence: 99%

Demand for Self-Managed Online Telemedicine Abortion in Eight European Countries During the COVID-19 Pandemic: A Regression Discontinuity Analysis

Aiken

Starling

Gomperts

et al. 2020

Preprint

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“…The reduction in access to these essential services due to safety concerns about exposure to the coronavirus and travel restrictions poses short‐ and long‐term risks to women and girls, while also increasing the burden of care on health workers now and in the future 13 . Some restrictions on service provision of healthcare services for women, for example, access to family planning and abortion care in some states in the United States, have been put in place despite opposition from health workers and medical associations 14 . The Guttmacher Institute, a US‐based think tank focusing on sexual and reproductive health and rights, estimates that a 10% decline in the use of reversible contraception (a conservative estimate as some areas report reductions as high as 80%) in low‐ and middle‐income countries due to service restrictions because of coronavirus could result in “49 million women with an unmet need for modern contraceptives and an additional 15 million unintended pregnancies over the course of a year” 15 .…”

Section: Providing Access To Sexual Reproductive and Family Planninmentioning

confidence: 99%

Providing women’s health care during COVID‐19: Personal and professional challenges faced by health workers

Green

Fateen

Gupta

et al. 2020

Intl J Gynecology & Obste

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“…We need to recognize the importance of access to reproductive care for all of our patients, given the significant impact of pregnancy on systemic rheumatic diseases. As such, we should consider joining with other medical associations, including the American College of Obstetricians and Gynecologists and the American Medical Association, to advocate in support of continued access to abortion as an essential health service and not as a political issue (). We must fight to ensure that all of our patients, regardless of race/ethnicity, immigration status, income level, employment status, and insurance status, are able to access their medications and timely, high‐quality, essential care.…”

Section: Collect and Release Sociodemographic Data In Both The Clinicmentioning

confidence: 99%

Widening Disparities Among Patients With Rheumatic Diseases in the COVID‐19 Era: An Urgent Call to Action

Feldman

Ramsey‐Goldman

2020

Arthritis & Rheumatology

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serve as an urgent call to action.(1, 2) As rheumatologists, we are acutely aware of the higher morbidity and mortality, and for a number of our diseases, the higher incidence and prevalence among racial/ethnic minorities and individuals of lower socioeconomic status (SES).(3-6) Comorbidities are frequent, timely access to subspecialty care is limited, receipt of high quality care is less common, and care is more often fragmented with frequent, avoidable acute care use.(7, 8) Among patients with systemic lupus erythematosus (SLE) where these disparities have been shown to be particularly pronounced, prolonged glucocorticoid use and delayed or lack of standard-of-care immunosuppressive use is common, and hydroxychloroquine, the backbone of SLE therapy to prevent flares and organ damage, is under-prescribed and adherence is suboptimal.(9) In addition, despite at least two-tothree-fold higher prevalence of SLE and significantly poorer outcomes, black individuals compared to white, are much less likely to be enrolled in clinical trials.(10, 11) Structural racism, historical Accepted Article

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Abortion during the Covid-19 Pandemic — Ensuring Access to an Essential Health Service

Cited by 104 publications

References 3 publications

Demand for Self-Managed Online Telemedicine Abortion in Eight European Countries During the COVID-19 Pandemic: A Regression Discontinuity Analysis

Demand for Self-Managed Online Telemedicine Abortion in Eight European Countries During the COVID-19 Pandemic: A Regression Discontinuity Analysis

Providing women’s health care during COVID‐19: Personal and professional challenges faced by health workers

Widening Disparities Among Patients With Rheumatic Diseases in the COVID‐19 Era: An Urgent Call to Action

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