Figure 2. Three sets of measures for improving access to abortion
Government policies on abortion are a longstanding topic of heated political debates. The COVID-19 pandemic shook health systems to the core adding further to the complexity of this topic, as imposed national lockdowns and movement restrictions affected access to timely abortion for millions of women across the globe. In this paper, we examine how countries within the European Union and the United Kingdom responded to challenges brought by the COVID-19 crisis in terms of access to abortion. By combining information from various sources, we have explored different responses according to two dimensions: changes in policy and protocols, and reported difficulties in access. Our analysis shows significant differences across the observed regions and salient debates around abortion. While some countries made effort s to maintain and facilitate abortion care during the pandemic through the introduction or expansion of use of telemedicine and early medical abortion, others attempted to restrict it further. The situation was also diverse in the countries where governments did not change policies or protocols. Based on our data analysis, we provide a framework that can help policy makers improve abortion access.
Policy making is said to be path dependent, so to understand how and why certain countries changed, or decided not to change their policy on abortion access, previous policy decisions need to be taken into account. Previous studies explored the topic of abortion access and its evolution in the EU and the UK before the pandemic; and certain studies analyze policy responses during the pandemics, partially covering EU countries and the UK. Keeping this in consideration, we decided to explore the following research questions: What were the reported difficulties to abortion access during the Covid-19 pandemic in the EU and the UK? How did relevant actors approach the difficulties, and what kind of policy or protocol changes were made (or not) on access to abortion? What kind of public debate followed these reported difficulties or changes?….
Regardless of the overall ease of access to abortion in the EU, the Covid-19 crisis made public health policy disparities more visible. We explore these disparities further.
As a result of further analysis, we found two dimensions by which the explored countries differed in relation to abortion access during the Covid-19 pandemic: the extent of changes to policies and protocols within the country, and the extent of difficulty in access to abortion during the pandemic. Based on these two dimensions, we identified four groups of countries: (1) Countries that initiated or implemented policy or protocol changes that facilitated access to abortion, (2) Countries that initiated or implemented policy or protocol changes that restricted the access to abortion, (3) Countries with no policy or protocol change, with no or minor reported difficulties in abortion access indicated in the sources during Covid-19, and (4) Countries with no policy or protocol change with reported difficulties in abortion access during Covid-19.
Details in this paper of the changes/lack of changes in most of the countries in the region are extensive. There is also an excellent reference list with over 100 sources.