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The impact of COVID-19 on contraception and abortion care policy and practice: experiences from selected countries
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  1. Deborah J Bateson1,2,
  2. Patricia A Lohr3,
  3. Wendy V Norman4,5,
  4. Caroline Moreau6,7,
  5. Kristina Gemzell-Danielsson8,9,
  6. Paul D Blumenthal10,
  7. Lesley Hoggart11,
  8. Hang-Wun Raymond Li12,
  9. Abigail R A Aiken13,
  10. Kirsten I Black2,14
  1. 1Family Planning New South Wales, Sydney, New South Wales, Australia
  2. 2Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
  3. 3British Pregnancy Advisory Service (BPAS), Stratford upon Avon, UK
  4. 4Department of Family Practice, University of British Columbia, Vancouver, British Columbia, Canada
  5. 5Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
  6. 6Population Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
  7. 7CESP Centre for Research in Epidemiology and Population Health, INSERM (Institut National de la Santé et de la Recherche Medicale), Villejuif, France
  8. 8Department of Women’s and Children’s Health, Karolinska Institute, Stockholm, Sweden
  9. 9Karolinska University Hospital, Stockholm, Sweden
  10. 10Stanford University School of Medicine, Stanford, California, USA
  11. 11Faculty of Wellbeing, Education and Language Studies, The Open University, Milton Keynes, UK
  12. 12Department of Obstetrics and Gynaecology, University of Hong Kong, Hong Kong, Hong Kong
  13. 13LBJ School of Public Affairs, The University of Texas at Austin, Austin, Texas, USA
  14. 14Women's Health, Neonatology and Paediatrics, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
  1. Correspondence to Professor Deborah J Bateson, Family Planning New South Wales, Sydney, NSW 2131, Australia; deborahb{at}fpnsw.org.au

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No area of healthcare is immune to the impact of COVID-19. The pandemic will affect sexual and reproductive health (SRH) worldwide in positive and negative ways. Home isolation and fears of contracting the virus appear to have led to decreased uptake of SRH services, increased reports of intimate partner violence, and in some settings reduced access to contraception and safe abortion care.1 2 Vulnerable populations are disproportionately affected, including young people, Indigenous peoples, as well as refugees and asylum-seekers whose safety and care is deprioritised.3 Predictions have been made about higher rates of unintended pregnancy, unsafe abortion, short interpregnancy intervals, and untreated sexually transmitted infections.1

The pandemic has also led to rapid implementation of innovations and legal and regulatory changes that have transformed and improved care for some people. New policies, practices and even enactment of laws have removed barriers to care which could otherwise take years of bureaucracy to overturn.4–6 This editorial draws on the expertise of a range of international clinicians and researchers to examine these changes to policy and practice, many of which may have lasting community benefits.

Contraception care

Many countries have recognised continuity of contraception provision, particularly long-acting reversible contraception (LARC), as essential. Where infrastructure permits, there has been a significant shift to telemedicine, for instance in the United States (US), Canada, UK, France, Australia, Scandinavia, China, South Africa and Nepal.4 6 ,7 Some countries have been able to maintain LARC access through brief procedural visits with appropriate personal protective equipment (PPE) following a virtual …

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