Officially known as COVID-19, a new strain of coronavirus has now been detected in 159 countries around the world and has been declared a global pandemic by the World Health Organization (WHO). The illness has already caused thousands of deaths and will have a continued impact on global health systems and economies. One healthcare issue which will certainly be affected is access to safe abortion.
We already know that abortions happen every day, in every country of the world. Over half of all unintended pregnancies end in abortion, with WHO estimating that around 56 million abortions take place globally each year.
It’s possible that in places where people are required to self-isolate due to the virus, often without reliable access to contraception, unprotected sexual activity and therefore rates of unintended pregnancy could increase. Sadly, in times of crisis, and where people are forced into close contact, incidences of domestic violence and rape can increase, which may also lead to forced pregnancies and a need to seek abortion care. Those who are pregnant during these uncertain times may find that their decision about whether to continue the pregnancy is affected by factors such as loss of income, or other health concerns brought on by the crisis. Potentially more people will need abortions during this time, so how will they access them?
The Guttmacher Institute has produced a useful summary of the potential effects of the pandemic on people’s sexual and reproductive health and rights. They point out factors like a shortage of medication (contraception but also abortion pills) thanks to disruptions in global supply chains, with China being a key supplier of drugs. Resources and medical staff will also be diverted to deal with the crisis — in the most affected countries, we are already seeing a huge strain on health care services which may delay access to abortion. RPRV, a Safe Abortion Action Fund (SAAF) grantee partner in Georgia, where abortion is legally accessible but highly stigmatized, has told us there have already been delays caused by service providers going into self-isolation after returning from Italy.
Of course, in many countries where legal abortion is restricted, people are only able to access safe abortion care by travelling to another city/country or by purchasing abortion medication via the internet or pharmacies. They will, of course, be affected by quarantines, travel bans and the shutting of borders.
The Abortion Support Network (ASN) is part of a team of organizations in Europe called ‘Abortion Without Borders’, which is focused on supporting people in Poland who need to access abortions. Poland has one of the strictest abortion laws in Europe and those who need to access safe care will usually need to travel abroad or find abortion pills online. Worryingly, ASN has reported that “Poland has cancelled all flights and trains in and out of the country”. Poland is also stopping international postage, which is the main way people living there can have safe abortions — by ordering abortion medication to be posted to them.
As a global fund dedicated to funding abortion, SAAF is already starting to see the impact on the projects we support — from the actual provision of abortion services, and access to drugs and equipment, to the important work being done on education, advocacy and stigma busting. Many organizations are already reporting bans on public gatherings, and of course, advocacy meetings with health ministers are likely to be cancelled due to competing urgent matters. We’ve seen that a referendum planned to take place to change the abortion law in Gibraltar has now been postponed and our partner Católicas por el Derecho a Decidir Argentina has had to pause progress on a bill to expand the abortion law in Argentina, which will have life-saving consequences if passed.
Organizations are already showing resilience and dedication to supporting the communities they work with to stay safe — TICAH in Kenya has started online campaigns to engage artists while under lockdown, and their ‘Aunty Jane’ hotline continues to provide counselling and information to those who need it. Though there are no confirmed cases of COVID-19 in Uganda, VODA is busy sensitizing staff and volunteers on safety protocols and helping to ready schools and churches for how this might affect women’s reproductive health needs moving forward.
So what can be done? We don’t yet know the full impact of the virus but it is already highlighting the problems inherent in many countries’ restrictive abortion laws. This acts as a stark reminder that we need to remove all laws, policies and practices which prevent access to contraception and safe abortion, with effects being harshest on the most vulnerable groups.
Many have pointed out the need to consider options such as telemedicine for expanding access to medical services during this time, and this method has been shown to be effective for abortion care. WHO has also stated the importance of expanding who can provide medical abortion, noting that “it is also possible for individuals to play a role in managing some of the components by themselves, outside of a health-care facility.” Many organizations and activist groups are helping connect those seeking abortions with the medication they need to do so safely, so we can all donate to abortion funds like ASN and Fondo Maria to ensure this important work continues.
As a global fund dedicated to abortion, we will work with our partners to ensure they can still reach those most in need, and we will be flexible to any change which may be around the corner.
We will continue to fund this important work because women and others have always needed abortions, and always will, and they deserve to have them safely and with dignity, whoever they are and wherever they are.
Words by: Laura Hurley, Programme Advisor, Safe Abortion Action Fund (SAAF)