With the rapid spread of COVID-19, state and federal health authorities are trying desperately to get people to stay at home to buy time for the healthcare system to build capacity to respond to the growing number of infections. But there is one threat that health officials are ignoring.
Here are ten ways in which politically motivated, medically unnecessary restrictions on access to abortion care are jeopardizing the safety of pregnant people (particularly those with low incomes), providers and the public during the COVID-19 crisis.
1. Lost Wages. Restrictions on funding and insurance coverage for abortion, compounded by lost wages, make it nearly impossible for many to access care. For those who lose wages as a result of having to stay home from work, abortion care will be even less affordable.
2. Loss of Childcare Coverage. Loss of childcare coverage, coupled with restrictions on funding and insurance coverage for abortion care, make it more difficult and more costly to obtain care. The majority of abortion patients already have at least one child. Even if they can find childcare, the cost may prevent them from being able to pay for the care they need.
3. Scheduling. Even before the COVID-19 pandemic, medically unnecessary regulations severely limited access to abortion care in many states. The State of Idaho, for example, has only three clinics that perform abortions, and only on a limited basis. The clinic in Idaho Falls offers care only two days per month. Those who cannot make it on one of those two days because they are sick or caring for a loved one, may have to wait another month for an appointment. But for patients seeking abortion care, even a short delay can mean a more invasive and expensive procedure—or no procedure at all.
4. Limited Providers. Many states empower advanced practice clinicians (nurse practitioners and physicians assistants) to perform a wide range of complex medical procedures including delivering babies, but single out abortion, a far simpler procedure, as the one service they cannot provide. These unnecessary restrictions on who can offer care have led to a shortage of providers in many states. The COVID-19 crisis will only make this problem worse. Bans on travel may prevent doctors from getting to the many states where no physicians who provide care reside. And there is the possibility that the few providers that do offer care will become sick themselves, which may force clinics to close altogether.
5. Short-Staffing at Clinics. Low reimbursements rates for Medicaid services and the loss of public funding means that many providers are already short-staffed. Again, the impact of COVID-19 will only exacerbate this problem as staff members may need to stay home to care for themselves or others.
6. Telehealth Restrictions. Telehealth could enable providers to offer medication abortion (the abortion pill) via telemedicine were it not for a medically unnecessary FDA rule that requires providers to dispense that medication in person. To respond to the COVID-19 pandemic, the department of health and human services and other public health authorities are taking steps to expand the use of telehealth. Meanwhile, the FDA has done nothing to relax or lift this nonsense requirement. That means that even during this pandemic, patients will have to visit their providers, who may be hundreds of miles away, just to pick up their pills. This is particularly unsafe as hordes of abortion protesters across the country continue to crowd together outside clinics and ignore the risk that such gatherings pose to public health.
7. State bans on Telemedicine. Even if the FDA were to relax its rules regarding medication abortion, many states have laws that prohibit the use of telemedicine to provide abortion, and impose other requirements that would necessitate one or more in-person appointments such as in-person consent, lab testing, ultrasounds. Once again, this means that many patients will have to travel long distances for multiple in-person visits for a service that could be provided safely by telemedicine.
8. Public Transportation. Public transportation during a pandemic is a particular problem for patients who, because of unnecessary abortion restrictions, must travel long distances (sometimes on multiple occasions) in order to access care. Many pregnant people with low incomes rely on public transportation, which may be operating on a more limited schedule. Even where public transportation is readily available, many people prefer not to use it because it may increase their risk of contracting coronavirus.
9. Clinic Closures and Diversion of Scarce Medical Supplies for “Non-Elective” Services. The Ohio Attorney General has already ordered clinics that provide abortions to close, arguing that abortion is a non-essential service. Reproductive health advocates are concerned that this could happen elsewhere. Along the same lines, if states decide to treat abortion as an “elective” service, there is a risk that scarce medical supplies could be diverted away from abortion providers.
10. Court Closures. Parental consent and parental notification laws may operate as a total ban on abortion for those under eighteen if the courts are not open to them. Courts around the country are closing except for emergency cases, and some of them do not consider judicial bypass proceedings to fall within that category. This may prevent teens in some states from seeking judicial bypass of parental consent and notification requirements.
The COVID-19 crisis brings into stark focus the immense burden that restrictions on access to abortion impose on patients and their families. In some states, as the infection spreads, these restrictions will operate as a near ban on abortion care (if they do not already). This is especially galling at a time when access to preventative reproductive healthcare is under attack by the federal government and many state governments, and the United States faces a crisis in maternal mortality unprecedented in the developed world.
Regardless of viewpoint, this is a matter that should concern us all. Requiring multiple in-person visits for services that could be provided safely via telemedicine puts us all at risk during a pandemic the likes of which the world has not seen for at least a century. Anyone who believes that the extremist political agenda behind these restrictions is worth that risk should re-examine what it means to be “Pro-Life.”