Belgium | Changes in abortion care during COVID-19 depended on facility type and region.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).
| Recommendations were not endorsed by the government’s Department of Health but were implemented by abortion centres in mid-March (1 week after lockdown) | Unsure |
Estonia |
| Recommendations by Estonian Society of Gynaecologists and Clinicians not officially approved | Some changes will be permanent |
Finland |
| Change in local practice | Temporary but possibly to become permanent |
France |
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.
| Guidelines by National Society (CNGOF) 26 March 2020 Guidelines by National Health Agency 10 April 2020 Law 15 April 2020 | Upper limit of 9 weeks gestation may be permanent, other measures temporary |
Germany |
| Ministry No official guidelines for abortion | Unsure |
Hungary |
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.
| Officially, no change | Temporary |
Ireland |
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.
| Revised Model of Care for Termination in Early Pregnancy issued by the Health Service Executive and Department of Health on 7 April 2020 | Temporary |
Norway |
| Decision by the Directorate of Health | Temporary |
Portugal |
| Recommendations by Portuguese Society of Contraception and Clinicians not officially approved but implemented by Obstetrician Services | Temporary |
Switzerland |
| Recommendations were not officially approved | Unsure |
UK (Wales and England) |
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.
| Department of Health of the Wales Government on 31 March 2020 Department of Health of the English Government on 30 March 2020 | Unsure |
UK (Scotland) |
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.
| Department of Health of the Scottish Government on 30 March 2020 | Unsure |
UK (Northern Ireland) |
| The provision of abortion services following Northern Ireland’s October 2019 legislation was implemented by the Department of Health of the Northern Ireland Government on 9 April 2020 | Permanent |