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Amid COVID-19 disruptions to care, abortion facilities adapted to telehealth

Barriers to abortion access were exacerbated during the COVID-19 pandemic, particularly in areas of the U.S. with more restrictive policies toward abortion, with 11 states enacting policies categorizing abortions as non-essential procedures by May 2020. ANSIRH researchers aimed to investigate national abortion service availability from May 2020 through August 2020 by using the Abortion Facility Database and found that the COVID-19 pandemic—along with state-level restrictions—caused several disruptions to abortion service availability, like closures, and also increased reliance on telehealth care protocols.

Key Findings

Among 751 facilities, 24 – located primarily in the South and Midwest – closed temporarily due to the pandemic, with nine still closed by August 2020.
Some facilities described suspending abortions, referring abortion patients to other facilities, or limiting services to medication abortion.
Some clinics shifted to offering medication abortion only because it reduced risk of COVID-19, but researchers found no evidence of a trend of encouragement of medication abortion versus procedural abortions.
While most facilities required in-person visits for reasons like state abortion restrictions, 22% offered phone or telehealth consultations, no-test visits, or medication abortion by mail to reduce or eliminate patient time in the clinic.

Study Design

From May through August 2020, research staff updated ANSIRH’s Abortion Facility Database to track the number of facilities that closed, limited, or stopped providing abortions, and provided telehealth options for patients during the COVID-19 pandemic. The research staff collected this data on all publicly-advertising abortion facilities in the U.S. through online searchers and mystery shopper phone calls.


ANSIRH’s study is the first to thoroughly look at changes in abortion services due to the COVID-19 pandemic among all publicly advertising abortion providers across the U.S., including independent, hospital-based, and Planned Parenthood facilities. Though the pandemic and related abortion restrictions reduced abortion service availability, some facilities used creative strategies to provide safe care for their patients, like allowing patients to wait for visits in their car or offering drive-through medication pick-up. Abortion clinics shifted their models of care in response to increased barriers, proving their resiliency and flexibility.

“Even in non-pandemic times, individuals face many barriers to abortion, including distance and cost barriers. Continued availability of abortion care is essential because abortion is a time- sensitive service. This study found that the COVID-19 pandemic disrupted abortion services at some clinics which may have exacerbated barriers for patients, particularly in areas of the country with more restrictive policies toward abortion. We also found that while the pandemic and abortion restrictions disrupted abortion service availability, abortion facilities were resilient and adapted to provide safe care for their patients.”

The article, Abortion service availability during the COVID-19 pandemic: Results from a national census of abortion facilities in the U.S., is available in Contraception: X.

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