Abortion services during the COVID-19 pandemic: a systematic review

Abstract

Evidence suggests that COVID-19 may impair access to sexual and reproductive health services and safe abortion. The purpose of this systematic review was investigating the changes of abortion services in the COVID-19 pandemic era. We searched PubMed, Web of Science and Scopus for relevant studies published as of August 2021, using relevant keywords. RCT and non-original studies were excluded from the analysis and 17 studies of 151 included in our review. Requests to access medication abortion by telemedicine and demand for self-managed abortion were the main findings of identified studies. Women requested an abortion earlier in their pregnancy, and were satisfied with tele-abortion care due to its flexibility, and ongoing telephone support. Presenting telemedicine services without ultrasound has also been reported. Visits to clinics were reduced based on the severity of the restrictions, and abortion clinics had less revenue, more costs, and more changes in the work style of their healthcare providers. Telemedicine was reported safe, effective, acceptable, and empowering for women. Reasons for using tele-abortion were privacy, secrecy, comfort, using modern contraception, employing of women, distance from clinics, travel restrictions, lockdowns, fear of COVID-19, and political reasons (abortion prohibition). Complications of women using tele-abortion were pain, lack of psychological support, bleeding, and need to blood transfusions. The results of this study showed that using telemedicine and teleconsultations for medical abortion in the pandemic conditions may be extended after pandemic. Findings can be used by reproductive healthcare providers and policy makers to address the complications of abortion services.Trail registration This study is registered in PROSPERO with number CRD42021279042

Analysis of the impact of COVID-19 pandemic on women´s care in an abortion situation in Latin America and the Caribbean

“…Women assisted in sentinel centers located in countries with a moderate legal context were more likely to have complications both in the legal termination of pregnancy and in post-abortion care. This finding is in line with previously published studies, which indicate that women residing in countries that impose restrictions on abortion have a higher incidence of complications (15,28). We believe that the finding of greater chance of complications in post-abortion care in countries with a liberal context when compared to countries with a restrictive context is due to the very low number of complications reported by countries with a restrictive context during the entire period.…”

“…At the current stage, when we are approaching the end of this global health crisis, it is important to know its secondary effects. Some recent reviews of the literature have found discrepant results depending on the location and context in which women are assisted (14,15). With many cases included over 5 years, we https://doi.org/10.17566/ciads.v12i4.1024 aggregated data to help understand the effects that changes in the external and internal context of health institutions can have on comprehensive post-abortion care.…”

Post-abortion needs-based education via the WeChat platform to lessen fear and encourage effective contraception: a post-abortion care service intervention-controlled trial

“…In the context of the rapid development of the Internet and the popularization of mobile phone WeChat today, requiring access to medical help via telehealth and requiring self-managed abortion are the key findings of the identified studies. Women request termination of pregnancy and are satisfied with remote abortion care due to the flexibility and ongoing telephone support available [ 19 ]. The purpose of this research is to explore the application effect of the PAC service model based on the WeChat platform and the post-abortion needs of women with early termination of pregnancy, so as to improve the effective contraceptive measures after abortion, avoid unintended pregnancy and bad emotions again [ 20 , 21 ].…”

Maintaining essential health services during COVID-19 in Ghana: a qualitative study

“…Recognising barriers and adapting strategies is crucial for future pandemic responses. Studies show diverse COVID-19 health strategies have been employed to maintain EHSs, including telemedicine, home drug delivery, extended working hours 14–16. While research often focuses on developed nations,15–17 understanding challenges in developing nations is crucial 18.…”