Transient rise in medical abortions at Michigan clinic during SARS-CoV-2 “stay-at-home” order

Abstract

Background In response to the SARS-CoV-2 (COVID-19) pandemic, the State of Michigan enacted a “stay-at-home” executive order detailing social distancing guidelines on March 24, 2020, with an expiration date of June 1, 2020. Objectives Given that medical abortions allow for pregnancy tissue to be passed in the privacy of one’s home, the authors hypothesized that there would be an increase in medical abortions over first trimester surgical abortions in 2020 compared to 2019 due to social distancing guidelines. Study Design Retrospective data was collected from an abortion clinic in Southeastern Michigan between January 1, 2019 and December 31, 2020 (n=4,703). A negative binomial statistical model compared the number of medical abortions in 2019 to 2020. Each year was divided into quartile (Q) periods of three consecutive months. Analysis focused on the frequency and percentage of medical abortions in 2020 compared to 2019, with a focus on the relationship between quartiles. Results Medical abortions increased from a count of 702 in 2019, to 979 in 2020 (p-value=0.00499). There were statistically significant differences between 2019 and 2020 for Q2 (31.47% to 40.89%, p-value<0.001) and Q3 (33.15% to 53.70%, p-value<0.001), as well as a return-to-baseline in Q4, which is demonstrated by pre-executive order 2020 Q1 at 33.91% and post-executive order 2020 Q4 at 37.19%. Conclusions Statistically significant differences between 2019 and 2020 for Q2 and Q3 support the hypothesis that an increase in preference towards medical abortions over surgical abortions coincided with Michigan’s stay-at-home mandates; it was further supported by insignificant differences in 2019 and 2020 for Q1 and Q4. Understanding trends in patient choices for abortion access provides vital information for policymakers and healthcare providers to expand medical abortion care using remote options.