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Abortion clinics overcame unique challenges during the COVID-19 pandemic

All health care providers have faced significant challenges during the COVID-19 pandemic. The need for in-person services had to be weighed against the need to protect patients and staff from the virus. Facilities that provide abortion experienced unique burdens on top of these challenges. ANSIRH researchers talked to abortion providers across the US to explore how stigma and excessive regulation of abortion impacted them during the pandemic.

Several themes emerged:

Clinic closures: Clinics faced uncertainty and even chaos in 12 states whose governors ordered them to shut down early in the pandemic, arguing that abortion is not an “essential service.” Legal challenges overturned those bans and allowed closed clinics to reopen, but closures were the greatest cause of stress. Vague orders about what procedures are “elective” caused confusion and anxiety.
Staffing issues and traveling doctors: Keeping up staffing levels was challenging, as staff faced childcare issues, became sick, were exposed to COVID or were too afraid to come to work. Clinics also grappled with a chronic physician shortage that predated the pandemic. Due to stigma around abortion, many clinics rely on doctors who fly in from out of town. Travel restrictions made it difficult for physicians to get to the clinics and provide care.
No support people in the clinic: Changes to limit exposure to the virus meant that clinics had to suspend their practice of encouraging people to bring a support person like a partner or a parent. Clinic staff felt that could no longer touch patients except when absolutely necessary. The lack of support could be even more consequential due to perceptions of abortion as a stigmatized and controversial act.
Protesters and COVID-19: Many clinics rely on volunteers to shield patients from anti-abortion protesters. Early in the pandemic, clinics told escorts to stay home to protect their health. That left protesters with more opportunities to harass patients. They were often unmasked and ignoring safety protocols.

Despite these challenges, there were bright spots. Clinics were heartened by community support, including people sending food and personal protective equipment. The pandemic also prompted clinics to innovate new, more efficient ways to provide abortion care by eliminating unnecessary medical tests and increasing the use of telemedicine. The article, COVID-19, health care, and abortion exceptionalism in the United States, is available in Perspective on Sexual and Reproductive Health.