As hospitals around the globe direct their attention and resources toward helping COVID-19 patients, other medical needs are, inevitably, getting less attention. One of those is women's reproductive health and access, in particular, to abortion, as evidenced in a recent study by the advocacy group Marie Stopes International. In a recent report, the organization noted that between January and June, in 37 countries, nearly two million fewer women received abortions than in the same period last year.
• Travel restrictions and bans have had an impact as well, limiting options for women in places ranging from the United States to Poland, as they are unable to access abortions in other states or countries where it is considered an essential procedure.
• The United Nations estimates, furthermore, that approximately 47 million women around the globe have been unable to obtain modern contraception, and that because of the pandemic, there have been upwards of 7 million unintended pregnancies.
No exceptions allowed: The situation is especially dire in countries where abortion is outlawed. One of those is Madagascar, where abortion is illegal even in cases of rape, incest or when the pregnancy puts the mother's health at risk. Women found guilty of having an abortion risk being jailed for up to two years, and the person performing the abortion can be imprisoned for between five and 10 years.
• Abortions that do take place are done clandestinely — sometimes with grave consequences. In fact, abortion is the second leading cause of maternal mortality in Madagascar, where an average of three women die each day from induced and spontaneous abortions.
• The pandemic has complicated matters even more, causing a 40% decrease in new family planning users at basic health centers, according to Céline Lesavre, coordinator of the reproductive and sexual health program at Médecins du Monde.
• "It is obvious that stay-at-home orders have had an impact on gender-based violence, which has increased, and its correlate: unwanted pregnancies," Lesavre told the French daily Le Monde.
"My body, my choice" placard at a Paris demonstration in Nantes, France — Photo: Estelle Ruiz/NurPhoto/ZUMA
Waiting for a referendum: Like in Madagascar, abortion is also banned in the British territory of Gibraltar, where women who undergo the procedure can technically be imprisoned for life. As a result, people with means have traditionally gone to Spain or the United Kingdom for abortions, while those without have taken unsafe approaches to ending pregnancies.
• A referendum was planned for March to give Gibraltarians the opportunity to decriminalize abortion, but because of the pandemic, the vote was canceled. Since then, the tourist destination has largely reopened (and has had no recorded deaths from coronavirus). And yet, there's no plan right now to reschedule the referendum.
• "The lockdown showed just how outdated our legislation really is," pro-choice activist Tamsin Suarez told the London-based daily The Guardian. "The UK has been legally allowed to have abortions at home, whereas Gibraltarians have found themselves alone and desperate with no means of reproductive health care."
• And even when women in the small, Roman Catholic-dominated community of approximately 34,000 are able to receive a safe abortion abroad, there can be real social and psychological repercussions. One such woman, Rosalina Oliva, told the British paper that she left the territory for an abortion in 2008 after becoming pregnant by an abusive partner. "I sobbed the whole time," she recalled. "I had no one to turn to. No one knew what I had just done. I was alone; alone with the weight of the world on my shoulders."
When telemedicine helps: Even in countries that allow abortions, the coronavirus crisis has, for the most part, made things more difficult for women seeking to undergo the procedure. But there have also been some exceptions to the rule: places where the pandemic has actually been a impetus for implementing telemedicine procedures and laws around medication that make abortions easier to facilitate.
• In Scotland, for example, women are now allowed to take an abortion pill at home up to the first 10 weeks of pregnancy without having to consult a doctor in person beforehand. The policy shift came in response to the COVID-19 situation, but the government is now considering making this a permanent change, the first of its kind in the UK.
• Elsewhere in Europe, Spain's equality minister is seeking to allow 16- and 17-year-olds to get abortions without parental consent. And in France, the National Assembly recently extended the legal deadline for abortions from 12 to 14 weeks.
Takeway: The coronavirus pandemic has revealed inequalities in medical care systems around the world. As we rethink how these structures should function, we have the opportunity to not only make them more equitable but also put the focus on health over political, societal or religious motivations. While some of these abortion measures might be temporary, they prove that the solutions to women having more control over their body were available all along.
