Abstract
BackgroundThe COVID-19 pandemic and the national COVID-19 measures might have increased potential barriers to abortion care and created new ones, especially for vulnerable groups. This study documents the impact of the pandemic and the lockdown measures on the profile of people going through the abortion process.MethodsUsing anonymized patient records from a Belgian abortion centre, we first compared the number of abortion requests and procedures during the first COVID-19 lockdown with the same months in the five preceding years. Next, we analysed the social profile of people requesting an abortion in those two time periods and looked at the number of long-acting reversible contraceptive devices (LARC) placed after curettage.ResultsThe abortion centre saw a drop in the number of abortion requests during the lockdown. This difference was more pronounced for people in paid employment and people using (modern) contraception. People were also more likely to request an abortion earlier in their pregnancy. The drop in abortion procedures and LARC’s placed after curettage was proportionate to the drop in abortion requests and did not differ according to clients’ characteristics.ConclusionQuestions arose concerning the potential selectivity with which COVID-19 influenced the need for abortion care and accessibility to services. Although there was a general drop in abortion requests and procedures during the first COVID-19 lockdown in the studied abortion centre, our results suggest that the profile of people requesting and receiving an abortion did only slightly change during the lockdown, and did not affect vulnerable groups visibly harder.
Highlights
The COVID-19 pandemic and the national COVID-19 measures might have increased potential barriers to abortion care and created new ones, especially for vulnerable groups
We examined whether the lockdown affected the progression to the various stages of obtaining abortion care, and whether this progression varied across different social profiles of people
Our study finds a substantial drop in the number of abortion requests during the first wave of the COVID-19 pandemic compared to the reference period
Summary
The COVID-19 pandemic and the national COVID-19 measures might have increased potential barriers to abortion care and created new ones, especially for vulnerable groups. Belgian abortion centres are located very central, the practical side of arranging abortion care might have been compromised by the COVID-19 measures; schools were closed, telework was mandated, and people were discouraged from making use of grandparents to look after children. By Belgian law, curettages require two visits to the abortion centre, while medical abortions require three visits to the abortion centre (see the ‘context’ section) Because of this additional in-person visit, some centres stopped offering medical abortions during the lockdown, reducing the options for people in need of abortion care (see [3] for more information on this change in procedure in the abortion centre which is the focus of this study). Since abortion care could not be offered to people with COVID-19 symptoms, this may have created additional barriers
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