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Declare abortion a public health issue during pandemic, WHO urged

The World Health Organization is being urged to declare abortion an essential health service during the coronavirus pandemic.

In guidance notes issued last week, the WHO advised all governments to identify and prioritise the health services each believed essential, listing reproductive health services as an example.

Clinical guidelines published by the organisation last month said that women’s right to sexual and reproductive healthcare “should be respected irrespective of Covid-19 status, including access to contraception and safe abortion”.

Simon Cooke, the CEO of Marie Stopes International (MSI), said a stronger pronouncement by the WHO would be “immensely helpful as it would help countries to see abortion from a public health perspective”.

There have been growing calls for governments to protect abortion services during the crisis. On Wednesday, 100 NGOs issued a joint statement imploring European states to find new ways to help women access services during lockdown, such as through online consultations and, as introduced in the UK introduced last month, by allowing them to take abortion pills at home.

In the US, the Center for Reproductive Rights has filed emergency lawsuits in five states to thwart moves by legislators to ban abortion during the pandemic.

“For us and for women who have unplanned pregnancies, it’s a very worrying time and [abortion] is time critical,” said Cooke.

Last week, MSI warned that up 9.5 million women and girls would not access family planning services this year because of the pandemic, which could result in as many as 3m unintended pregnancies and 2.7m unsafe abortions.

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“It’s clear the majority of abortions are done in the first trimester, which makes them extremely safe. As countries go into lockdown or mobility is reduced, women will have to wait longer and the procedure becomes more complex,” said Cooke.

“In the UK that’s one thing, where we have the infrastructure to deal with late terminations, but in many countries we operate in that’s not an option. Therefore it becomes critical and there’s a risk of unsafe abortion and complications.”

He said abortion was “absolutely essential” to save lives. Unsafe abortionsaccount for between 4% and 13% of maternal deaths.

Dr Jeanne Conry, president elect of the International Federation of Gynecology and Obstetrics, said

“Abortion access is critical. Women need access or we will see more unintended pregnancies, more maternal mortality and more unsafe abortion,” said Conry.

“Abortion is not an elective procedure, it’s an essential part of women’s healthcare. It’s absolutely time dependent.”

She said telemedicine, where women can speak to doctors over the internet, was “critical right now” .

On Thursday, the International Planned Parenthood Federation said 23 of its member associations have had to reduce their abortion services because of Covid-19, with 5,600 clinics across 64 countries already closed.

There were also reports of shortages of contraceptives and HIV medicines.

“These figures show that millions of women and girls across the world now face an even greater challenge in trying to take care of their own health and bodies,” said the IPPF’s director general, Dr Alvaro Bermejo.


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