Disruptions and opportunities in sexual and reproductive health care: How COVID‐19 impacted service provision in three US states

Abstract

Context The COVID‐19 pandemic abruptly disrupted the provision of sexual and reproductive health care in the United States. Methods We conducted interviews with family planning clinic staff at 55 health care facilities in Arizona, Iowa, and Wisconsin in late 2020 and early 2021. We asked respondents about the challenges they faced and ways they adapted their service provision as a result of the pandemic. We conducted content and thematic analyses of the interview transcripts using an inductively developed qualitative coding scheme. Results Family planning clinics and providers made a variety of changes to their clinic operations and service delivery. The three major areas of change for these facilities were implementation of COVID‐19 safety procedures, shifting service delivery and staffing to meet patient needs, and the rapid uptake and expansion of telehealth. Conclusion While providers faced many challenges, they also described opportunities to innovate and rethink standard of care protocols that may continue to shape sexual and reproductive health care even after the pandemic abates.

COVID‐19 and abortion in the Ohio River Valley: A case study of Kentucky, Ohio, and West Virginia

“…Research from other facilities across the US showed similar adaptations, with providers using telemedicine, replacing in-clinic ultrasounds with at-home pregnancy tests, and distributing medication abortion drugs via curbside pickup or mailing. 12,59 While facilities in these three states were not able to take full advantage of the US FDA's temporary lifting of the in-person dispensing requirement of Mifepristone Risk Evaluation and Mitigation Strategy (REMS) Program, 60 a move toward telemedicine appointments for pre-abortion counseling, medication information dissemination, and post-abortion care could add needed flexibility in scheduling and managing patient volume during emergencies such as the pandemic or rapid policy changes such as those following Dobbs. While the FDA later announced that it would permanently lift the in-person dispensing requirement for mifepristone, 61 full telemedicine for abortion remains unavailable to patients in this region.…”

“…Rather, facilities in these states adapted their service delivery in part based on public health guidance. Research from other facilities across the US showed similar adaptations, with providers using telemedicine, replacing in‐clinic ultrasounds with at‐home pregnancy tests, and distributing medication abortion drugs via curbside pickup or mailing 12,59 …”