Changes in Abortion in Texas Following an Executive Order Ban During the Coronavirus Pandemic

Abstract

In response to the coronavirus disease 2019 pandemic, Texas Governor Greg Abbott issued an executive order on March 22, 2020, postponing surgeries and procedures that were not medic ally necessary. 1 Texas officials interpreted this to prohibit most abortions until the order expired on April 21, 2020, contrary to medical associations' recommendations. 2 The objective of this analysis was to assess changes in abortions following the executive order. We also hypothesized that abortions performed at 12 weeks' gestational age (GA) or more would increase after the order expired.

Factors Associated With Use of an Online Telemedicine Service to Access Self-managed Medical Abortion in the US

“… 35 These innovations also have the potential to expand access for those living below the FPL by negating the costs of in-person clinic attendance and medical tests. However, other states have kept in place laws that prohibit telemedicine consultation and, in some cases, have moved to further restrict clinic access, 36 with associated increases in demand for self-management. 37 For clinicians, this increased demand for self-managed abortion means being equipped to provide follow-up to those patients who might require it, including being informed on the American College of Obstetricians and Gynecologists' position on self-management of abortion 38 and the lack of reporting requirements to protect patient confidentiality.…”

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

“…Consistent with a recent report [3] , several clinics closed or stopped providing abortion due to COVID-19 and related abortion bans. Research showed that an abortion ban in Texas during the pandemic resulted in a decline in the number of abortions in Texas, and an increase in the number of abortions in surrounding states and at later gestations within Texas [2] . In our study, some clinics shifted to offering medication abortion only because it reduced risk of COVID-19.…”

“…The COVID-19 pandemic has exacerbated barriers to abortion access in the United States (U.S.), forcing abortion facilities to close or modify services and shift to models of abortion care that do not require in-person visits for ultrasounds, pelvic exams, or laboratory tests. In response to the pandemic, 11 U.S. states enacted policies categorizing abortions as non-essential procedures by May 2020, decreasing access and types of abortion care available [ 1 , 2 ]. These restrictions, as well as other pandemic-related challenges, have disrupted abortion clinics’ staffing, financial stability, and service delivery [ 1 , 3 , 4 ].…”

Coronavirus Disease 2019 (COVID-19) and Access to Abortion

“…Abortion access has become increasingly limited in the U.S. Midwest and South. 1 , 2 Before the coronavirus disease 2019 (COVID-19) pandemic, several states, including Kentucky, Mississippi, and Missouri, had only one abortion facility. 3 Contrary to the recommendations of the American College of Obstetricians and Gynecologists and other medical organizations during the pandemic ( https://www.acog.org/news/news-releases/2020/03/joint-statement-on-abortion-access-during-the-covid-19-outbreak ), governors in 11 states attempted or succeeded in prohibiting abortion using executive orders, including Alabama, Alaska, Arkansas, Iowa, Louisiana, Mississippi, Ohio, Oklahoma, Tennessee, Texas, and West Virginia.…”

“…A recent study in Texas found that abortions declined in the state while executive orders were in effect but increased in neighboring states. 2 Abortions at 12 weeks of gestation or more increased after the orders expired. 2 Another study demonstrated that lack of abortion access in Texas disproportionately affected Latinx patients, who had to travel an increase of 100 or more miles to access abortion care.…”