Pandemic widens existing gaps in access to abortion services across Europe

The coronavirus pandemic has widened existing gaps in access to abortion services across Europe and has found a national policy change review in response to COVID-19 published in the journal. BMJ sexual and reproductive health..

However, forced innovations adopted in some countries, such as telemedicine and the provision of abortion at home, could reverse that trend and drive long-term changes in this essential healthcare service. The researchers suggest.

Abortion is one of the most common procedures for women of reproductive age in Europe, ranging from 6.4 / 1000 women aged 15-44 in Switzerland to 19.2 / 1000 in Sweden. Researchers say the need for COVID-19 is likely to have increased as a result of financial uncertainty, increased exposure to sexual violence, and restricted access to contraception.

In the light of the widespread public health measures that limit freedom of movement during the heyday of the pandemic, they wanted to know how they affected access. Abortion service All over Europe.

Therefore, they have compiled information on practices in 46 countries / regions. Survey information entered by experts across the country was collected for 31 and the remaining 15 were desk surveyed.

The data show that European countries have taken a variety of approaches in response to pandemics, from imposing restrictions to relaxing certain requirements.

New restrictions included delaying or refusing abortion care for women with COVID-19 symptoms, or living with women with those symptoms, and reduced availability of surgical abortions. In some countries, the availability of abortion has been expanded through telemedicine and restrictions on the use of drugs to induce abortion have been relaxed.

Specifically, abortion was banned in six countries (Andorra, Liechtenstein, Malta, Monaco, San Marino and Poland) and suspended in one country (Hungary).

Access to surgical abortion was restricted in 12 countries / regions, and services for 11 COVID-19 symptomatic women were either completely unavailable or delayed: Netherlands, Belgium, Germany, Iceland, Latvia, Luxembourg, Montenegro, Slovenia, England, Wales, Scotland. No country has increased abortion pregnancy restrictions.

Changes have been made to reduce face-to-face consultations in 13 countries / regions (Belgium, Estonia, Ireland, Finland, France, Germany, Norway, Portugal, Switzerland, England, Wales, Scotland and Northern Ireland).

However, only seven countries / regions provided telemedicine abortion. In two, it was already offered before the pandemic (Stockholm region of Denmark and Sweden) and was adopted in five other countries (England, Wales, Scotland, France and Ireland).

Eight countries / regions provided home care abortions with mifepristone and misoprostol for more than 9 weeks (up to 11 weeks + 6 days), while 13 countries / regions provided up to 9 weeks.

Pharmacy access to prescribed mifepristone was granted in two countries / regions: Denmark, which was previously granted COVID-19, and France, which was not previously granted. And these medicines can be delivered by mail in England, Wales, Scotland, Georgia, or at home in England, Wales, Scotland, Ireland.

“Abortion is an integral part of women’s sexual and reproductive care. It is very safe under the recommended procedures, but if women do not have access to safe abortion care, the substantial morbidity and mortality of pregnant women. “It causes the abortion,” the researchers emphasize.

They point out that abortion services are particularly vulnerable to movements that limit their offerings, as “politics often takes precedence over evidence.” “Every week of political inaction, thousands of women are denied undeferred treatment and face the possibility of carrying unwanted pregnancies to maturity or receiving unsafe treatment,” they add. It was.

“Overall, the diversity of pre-COVID-19 rules governing abortion, coupled with an inconsistent response to the COVID-19 crisis, exacerbated the uneven situation of abortion provision in Europe,” the study said. Is writing.

“The lack of political will to lift unnecessary regulations is discouraging, but the coordinated efforts of several governments and providers to act swiftly to maintain abortion treatment during the COVID-19 turmoil. I admit, “they point out.

And they conclude that: “The lack of a unified policy response to COVID-19 restrictions has exacerbated abortion access inequality in Europe, but several innovations, including telemedicine deployed during the outbreak, have continued and fairness in abortion care. May serve as a catalyst to ensure.

“We believe that these advances are primarily considered as a temporary response to the health crisis and may serve as a catalyst to’liberalize’the provision of abortion and should become the standard of care. I will. “

Dr. Edward Morris, president of the Royal College of Obstetrics and Gynecology (RCOG), which co-owns the journal, commented: “This review sheds light on some of the shocking inequality in access to abortion care that women face across Europe. During the COVID-19 pandemic.”

He continues. “Abortion telemedicine routes introduced in England, Scotland and Wales have given thousands of women access to safe abortion care during the COVID-19 pandemic.

“We have found that this simple yet effective innovation can bring significant benefits to women. It reduces the waiting time for women requesting an abortion, reduces clinic visits and limits COVID infections. Was 19 viruses in both Female And staff, and abortion-related complications have decreased. “

He adds: “We welcome government measures that ensure that abortion care continues to be provided in a safe, timely and compassionate way, and especially commend new and innovative methods. abortion Providing care, including the introduction of telemedicine in several countries, including the United Kingdom. We urge the government to ensure that these positive changes continue beyond the pandemic. ”