Pandemic abortion bans threaten women’s health and equity

As Americans experience their third month of the coronavirus pandemic, access to abortion currently remains limited in at least 11 states, including Alabama, Alaska, Arkansas, Iowa, Kentucky, Louisiana, Ohio, Oklahoma, Tennessee, Texas and West Virginia, according to a recent opinion piece from the Guttmacher Institute. the commentary, published in the June 2020 issue of Perspectives on Sexual and Reproductive Health, noted that these restrictions are short-sighted and harmful as they limit women’s economic, physical and mental health for years to come.

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Lawsuits help thwart attempts to curtail women’s rights

While abortion remains the law of the land in the United States, legal efforts to restrict it continue. Efforts deepened in March as the Coronavirus pandemic jumped in the United States and around the world. However, “after states wasted precious time and resources trying to restrict access to abortion amid a pandemic, most of the decrees have expired or have been lifted since early April,” said Rachel Sussman, vice president of state policy and advocacy for Planned Parenthood Federation of America. “In most of these states, the courts have sided with abortion providers and blocked the entry into force of these nefarious restrictions.”

Citing the pandemic to ban abortion is just the latest tactic of anti-choice politicians, said Jennifer dalven, director of the American Civil Liberties Union (ACLU) Reproductive Freedom Project. “This spring we have seen politicians in the South and the Midwest use the COVID-19 crisis to prevent people from having abortions,” she said. “This tactic was new, but these same states have for years used every trick in the book, from banning abortion to shutting down clinics to try to push abortion out of reach. Anti-abortion politicians continue to put roadblocks in the way of people who have decided that abortion is the best decision for themselves and their families.

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Access to abortion was restricted during some stays

“But due to a handful of hostile courts and politicians playing games with health care during a pandemic, abortion services were unavailable in some states, like Texas, for long periods of time,” said Sussman. “And because of years of attacks on sexual and reproductive health care, access to already vulnerable abortion services has become completely inaccessible in South Dakota during the pandemic.”

According to NPR, South Dakota women have typically only gone to one state clinic for treatment, but due to the anti-choice movement’s “legal restrictions and social stigma”, local providers have not proceed with the procedure. So, for the past 25 years, Planned Parenthood has flown suppliers around the state several times a month, but has not been able to do so since the coronavirus pandemic has limited air travel.

The reasons for limiting access to abortion

Restricting access to abortion appears to be a political effort rather than a medical or scientific one. Citing research on past efforts to ban or limit abortion, researchers Rachel K. Jones, Laura Lindberg, and Elizabeth Witwer, all scientists or researchers at the Guttmacher Institute, a reproductive health and policy research company based in New York, wrote in their recent commentary, “The COVID-19 Abortion Ban and Their Public Health Implications.” The article, which was published online on May 15, 2020, will appear in the June issue of Perspectives on Sexual and Reproductive Health. They claim that “abortion is essential health. Claims that it is “non-essential” contradict the advice of leading medical experts and public health organizations, “such as the American College of Obstetricians and Gynecologists (ACOG) and the American Medical Association (AMA).

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The health and economic risks of abortion restrictions

Those who wanted to limit access to abortion as the coronavirus continued to spread argued that abortion services are not essential and “strain the provision of personal protective equipment (PPE)” , wrote the authors. However, “first trimester clinical procedures require very little PPE, and the provision of a medical abortion, which accounts for at least one-third of all abortions in the country, can be offered safely with virtually no use. of PPE ”. they added.

Instead, in states where access to abortion is restricted or prohibited, the authors wrote, “the options are for individuals to travel out of state for the procedure, to continue the pregnancy and to continue with the pregnancy. ‘hope they can access abortion care when the ban is no longer in effect. instead, try to manage an abortion yourself outside of an official medical setting (for example, by buying abortion medicine on the Internet), or bring the pregnancy to term. “

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Economic hardship contributes to health care barriers

But in light of the many layoffs and leaves that occur during the pandemic, having the funds to pay for gasoline and other travel costs can be a problem for those who want a surgical abortion. Loss of employment is often accompanied by loss of health insurance, and many women who wish to have an abortion no longer have children in school, posing additional challenges in finding time, funds. and child care necessary to obtain an abortion in a location away from home.

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Despite the growth of telemedicine, the limits of medical abortion persist

Some of these difficulties may be alleviated with the advent of a drug procedure, especially as more and more healthcare providers have expanded their access to telemedicine during the pandemic. Two drugs, mifepristone and misoprostol, can be prescribed by a health care provider, mailed to a person’s home, and taken according to the provider’s instructions to terminate an unwanted pregnancy.

Yet, as of May 1, this practice has been restricted in 18 states due to a law requiring providers to be in the same room as the patient in order to get and not to take the drug themselves, according to Guttmacher. There is a group 21 attorneys general, as well as several United States senators, who are asking the United States Food and Drug Administration (FDA) to allow sending of mifepristone via online pharmacies during the pandemic. The ACLU, May 27 filed a complaint challenge the FDA rule requiring that patients receive the drug in person only and not by mail order prescription. The complaint was filed on behalf of ACOG and several other medical groups, including the New York State Academy of Family Physicians.

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According to a story in the Philadelphia Inquirer, “The FDA has not budged, even though its own review says: “Medical abortion is increasingly used as its efficacy and safety have become well established by research and experience, and serious complications have been shown to be extremely rare.”

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What will be the impact of the restrictions on women’s health and public health?

Ultimately, limiting access to abortion is shortsighted and deals a direct blow to improving women’s reproductive and sexual health, the authors of Guttmacher’s commentary noted. “The new abortion laws will result in fewer abortions, an increase in second trimester abortions and, for those who ultimately cannot access care, more births as a result of unwanted pregnancies. To complicate this situation, there is the potential that increased economic instability will actually increase the number of people desiring to have an abortion if women feel they don’t have the money to support a (further) child, as it is. is a frequently reported motivation for abortion, even in better economic circumstances. time.”

Denial of abortion can hurt future financial health

According to a National Bureau of Economic Research May 2020 Report and one February 2018 report of American Journal of Public Health, “Compared to people who terminated a pregnancy, those who were refused an abortion and had to complete it were more in debt, had lower credit scores and were more likely to have an income. of poverty level four years or more later, ”the authors wrote.

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Abortion bans highlight systemic racism in healthcare

Ultimately, these issues underscore what Sussman of Planned Parenthood called systemic racism in America’s healthcare system.

“This pandemic – and what happened during the pandemic – has once again exposed the pervasive inequalities and systemic racism that exist in our country’s healthcare system,” she said. “Many blacks and Latinxes are just trying to survive this crisis – both because of increased exposure to the virus and an increase in law enforcement and violence masked as a response to COVID-19. These inequalities are not new and do not live in a vacuum, and we continue to see how communities of color also face insurmountable barriers to accessing sexual and reproductive health care.

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