Impact of COVID-19 on termination of pregnancy

Abstract

Objective: To evaluate the impact of COVID-19 pandemic on termination of pregnancy. Methods: This was a retrospective study aimed to assess the impact of COVID-19 pandemic on termination of pregnancy in a single center in Italy. Consecutive data on pregnant women who requested induced termination of pregnancy (I-TOP) from February 2018 to December 2021 were included in a dedicated database. The data were divided into two groups according to the COVID-19 outbreak. Women who requested I-TOP from February 2018 to January 2020 were included into the group ‘before COVID-19 pandemic’. Women who requested I-TOP from February 2020 to January 2022 were included into the group ‘during COVID-19 pandemic’. Indications for I-TOP included elective abortion and therapeutic for fetal or maternal indication. Results: A total of 2578 women were included in the study. Of them, 1637 had I-TOP before COVID-19, and 941 had I-TOP during COVID-19. During the pandemic, the request for elective abortion decreased from 76.2% to 67.7% (p<0.01). Therapeutic abortion were performed in 141/693 cases in the first trimester, and in 552/693 cases in the second trimester. Overall, 91 were for maternal indications and 602 for fetal indications. No differences were noticed between before and during pandemic (p=0.99). Follow-up visits two weeks after abortions were offered to all women. However, only 35.5% women visited for follow-up during pandemic vs. 65.0% before COVID-19 (p<0.01). Conclusion: The COVID-19 pandemic had impact on access to abortion services, reducing request for elective abortion and post-abortion follow-up visits.

A Retrospective Observational Study to Assess the Effect of the COVID-19 Pandemic on Spontaneous and Voluntary Abortivity in the Apulia Region of Italy

“…In Ethiopia, the government approved a pilot program to allow voluntary abortions directly at home during the lockdown period. In Italy, on the other hand, this alternative route did not appear to have been sufficiently followed, given the decrease in voluntary abortions [ 45 ], in accordance with our data. Although limited to the pandemic period, these declines can reduce the impact on these services which are offered by the INHS and could dampen the future effectiveness of family planning and health education programs, especially in the maternal–child area.…”