RT Journal Article
SR Electronic
T1 Abortion regulation in Europe in the era of COVID-19: a spectrum of policy responses
JF BMJ Sexual & Reproductive Health
JO BMJ Sex Reprod Health
FD British Medical Journal Publishing Group
SP e14
OP e14
DO 10.1136/bmjsrh-2020-200724
VO 47
IS 4
A1 Caroline Moreau
A1 Mridula Shankar
A1 Anna Glasier
A1 Sharon Cameron
A1 Kristina Gemzell-Danielsson
YR 2021
UL http://jfprhc.bmj.com/content/47/4/e14.abstract
AB Background Unprecedented public health actions restricting movement and non-COVID related health services are likely to have affected abortion care during the pandemic in Europe. In the absence of a common approach to ensure access to this essential health service, we sought to describe the variability of abortion policies during the outbreak in Europe in order to identify strategies that improve availability and access to abortion in times of public health crises.Methods We collected information from 46 countries/regions: 31 for which country-experts completed a survey and 15 for which we conducted a desk review. We describe abortion regulations and changes to regulations and practice during the pandemic.Results During COVID-19, abortions were banned in six countries and suspended in one. Surgical abortion was less available due to COVID-19 in 12 countries/regions and services were not available or delayed for women with COVID-19 symptoms in eleven. No country expanded its gestational limit for abortion. Changes during COVID-19, mostly designed to reduce in-person consultations, occurred in 13 countries/regions. Altogether eight countries/regions provided home medical abortion with mifepristone and misoprostol beyond 9 weeks (from 9 weeks+6 days to 11 weeks+6 days) and 13 countries/regions up to 9 weeks (in some instances only misoprostol could be taken at home). Only six countries/regions offered abortion by telemedicine.Conclusions The lack of a unified policy response to COVID-19 restrictions has widened inequities in abortion access in Europe, but some innovations including telemedicine deployed during the outbreak could serve as a catalyst to ensure continuity and equity of abortion care.All data relevant to the study are included in the article or uploaded as supplementary information. The data collected for this study are displayed in the tables.