The Committee on the Elimination of Discrimination against Women states that:
Acts such as forced sterilization, forced abortion, forced pregnancy, criminalization of abortion, denial or delay of safe abortion <…> could constitute forms of gender-based violence against women.
Despite the fact that the sexual and reproductive rights of women have been one of the points on the agenda of the entire world community for many years, the women’s right to abortion is still taboo in many countries. Such a sensitive, and in some situations, the forbidden topic has obviously been touched upon by the coronavirus. This piece explores the options of safe abortions during the pandemic in different countries.
It is necessary to remember that the coronavirus is still a global public health problem that took the lives of many people, and still frightens and affects our lives. However, we should pay attention to the fact that according to some estimates, COVID-19 related disruptions will lead to 1.5 million additional unsafe abortions, 900.000 additional unintended pregnancies, and 3.100 additional maternal deaths.
Some countries have taken information about the coronavirus seriously, but at the same time have been able to provide the necessary access to legal and safe abortion.
The UK’s Department of Health and Social Care has confirmed it will allow women in England temporarily to manage medical abortions at home in light of the lockdown imposed due to the COVID-19 pandemic. Women were able to turn to telemedicine for termination of pregnancy, and this became a unique opportunity to stay safe from the coronavirus, but at the same time exercise their rights to safe abortions.
Dr. Jonathan Lord, Medical Director for Marie Stopes UK (an international non-governmental organization providing contraception and safe abortion services), said:
Telemedicine is the single biggest enhancement in abortion care for years and has allowed tens of thousands of women across the UK, from those caring for children and elderly relatives to women at risk of violence if they leave the house, to receive the healthcare they need and deserve during the pandemic.
Therefore, in this case, the state authorities heard the women’s voices, but not simply ignored their needs and requirements.
In France and Italy, the health authorities have clearly declared that access to safe abortions is a health care service that has to be maintained during the pandemic and cannot be deferred. Particularly, the French authorities have extended the time limit for performing medical abortions at home from seven to nine weeks. They also temporarily made it possible to buy contraception pills in pharmacies on the basis of a previous prescription without having to renew it.
In the Netherlands, the Court of The Hague has refused to allow pregnant women to obtain the abortion pill outside of abortion clinics. Other states where the abortion procedure was previously accessible but where women now face various obstacles are Albania, Azerbaijan, Ireland, Spain and Turkey.
Meanwhile, Germany, which requires mandatory counseling before abortions, has allowed this preliminary step to take place over the phone or by video, following pressure from abortion rights groups.
Particular attention in this matter should be paid to the USA, since several states at once made abortion in the category of non-urgent operations during the COVID-19, completely disregarding the fact that abortion remains an essential and time-sensitive procedure.
For instance, Alabama had ordered a postponement of medical procedures except in cases of a medical emergency or “to avoid serious harm from an underlying condition or disease, or necessary as part of a patient’s ongoing and active treatment”. Abortion providers won a temporary restraining order on March 30, 2020, in federal district court, which the Court of Appeals for the Eleventh Circuit affirmed. At the end of April 2020, an amended order permitted surgical procedures that included abortion care.
Alabama is currently one of the seventeen states of America which currently require the prescribing clinician to be physically present when medication abortion is dispensed, effectively banning the use of telehealth. Thus, if the statement that abortion was not an urgent procedure was not challenged, women would not have access to safe and legal abortion. In fact, they ended up in this trap while the litigation took place.
It can be assumed that in this case, a women’s reproductive right to a safe and legal abortion became the subject of political games since Alabama politicians tried to pass a law that prohibited abortion for any reason (including the ban on termination of pregnancy, which occurred in as a result of rape) in 2019. However, a federal judge blocked Alabama’s near-total abortion ban from taking effect and called the law clearly unconstitutional.
In this way, one can see how differently states deal with the problem of access to abortion during the pandemic. Some of the countries are trying to find the key to solving the problem by offering access to telemedicine, weakening the requirements of the laws that concern abortion. By doing so, they protect women’s health from possible coronavirus infection during visits to medical facilities. Moreover, they take into account the fact that the prohibition of abortion will most likely lead not to an increase in the number of saved pregnancies, but to attempts to get rid of the pregnancy on one’s own without the help of health professionals. Such “self-contained” procedures can lead not only to irreparable consequences for a woman’s health but also to her death.
States that have already pursued ambiguous policies towards abortion in “peacetime” did not change their position on this issue, but only further restricted access to safe abortions during the pandemic, driving themselves into a trap consisting of a likely increase in female mortality as a result of a failed clandestine abortion. It is one thing if the branches of government in a country adhere to the principle of separation of powers. And what about women in states where there is simply no opportunity to change the decisions of the authorities? Many questions around safe abortion during the pandemic will remain unanswered.