While outpatient abortion centres (84% of abortions in Belgium) continued to provide regular abortion care, some hospitals stopped offering abortion care or reduced facility-based abortion by

○ promoting medical abortions up to 9 weeks+6 days with home use of misoprostol

○ referring later abortions to outpatient abortion centres,

French-speaking abortion centres promoted medical abortion up to 8 weeks with misoprostol at home (with phone supervision).

Flemish abortion centres provided the first consultation online with a one-step visit for surgical abortion after the mandatory 6-day waiting period (nearly no medical abortions).

Fewer visits to clinic.

Remote consultation (usually by phone).

Use of misoprostol at home is encouraged (available before COVID 19).

Home use of misoprostol extended up to 10 weeks+0 days (previously 9 weeks+0 days) in Helsinki.

Gestational limit of medical abortion at home raised from 7 weeks to 9 weeks+0 days.

Medical abortions all performed by telemedicine without mandatory in-person consultation.

Pharmacy access to mifepristone and misoprostol through a medical order directly sent to the pharmacy by the provider.

Mandatory counselling can be performed via telemedicine, but most abortions are performed surgically (very small number of medical abortions).

In the public sector, surgical abortions (only method available in Hungary) were ceased, as a result of the government ban on non-life-saving procedures.

With the closing of most of the private clinics during the pandemic, abortion was unavailable in the private sector.

Remote consultation with a medical practitioner for medical abortion, with face-to-face consultations only in exceptional circumstances.

Both mifepristone and misoprostol are taken at home up to 9 weeks.

Informed consent may be obtained verbally or by confirmatory email from the patient to the doctor.

The guidance states that arrangements must be made for the collection of medical abortion medications.

The need to administer anti-D to a patient with a Rhesus-negative blood group whose pregnancy is less than 9 weeks' gestation was suspended.

Introduction of non-facility-based abortion by allowing gynaecologists outside of hospitals to conduct abortion up to 12 weeks’ gestation (pre-COVID, abortions were only facility-based).

Omit the waiting period.

Only one visit with a doctor for ultrasound and abortion.

Postponement of follow-up visit when possible or follow-up visit by telemedicine.

Some clinics have extended the gestational age limit for medical abortion from 7 to 9 weeks due to difficulties accessing surgical abortion.

Use of telemedicine and approval for home use of both mifepristone and misoprostol up to 9+6 weeks as per guidelines.

The new guidelines support non-use of ultrasound at this gestation for example if LMP is certain and no significant risk of ectopic pregnancy.

Approval for home use includes postal delivery of medication.

Use of telemedicine and approval for home use of both mifepristone and misoprostol up to 11 weeks+6 days as per Scottish guidelines. The new guidelines support non-use of ultrasound at this gestation, for example, in the case LMP is certain and there is no significant risk of ectopic pregnancy.

Approval for home use includes postal delivery of medication.

The need to administer anti-D to a patient with a Rhesus-negative blood group having medical abortion at 10–12 weeks has been suspended.

Abortion services started to operate in April 2020 for first-trimester abortions.

Use of misoprostol at home currently up to 10 weeks.