Abortion rights and healthcare during COVID-19

Last updated July 16, 2020

During this difficult time, the Abortion Rights Coalition of Canada hopes everyone stays safe and well. Please use all precautionary measures necessary to safeguard the health of yourself, your loved ones, and friends and neighbours.

Below we have gathered some COVID-19 resources specific to abortion and other sexual and reproductive healthcare. This resource list will be kept updated.

Need an abortion during the pandemic?

Abortion is NOT an elective procedure that can be delayed or cancelled. All provinces and territories have confirmed that abortion is an essential service. Clinics in Canada may be stressed but are doing their absolute best to continue services.

Please donate to ensure access during COVID-19!

Current issues affecting access

  • A few clinics may temporarily close due to staff illness or staff shortages.
  • Some private clinics are restricting their catchment areas to abide by advice to limit travel.
  • Some hospitals have sidelined or shut down surgical abortion services so they can focus on the pandemic.
  • Patients are reluctant to travel (or unable to) due to exposure risk.
  • Travel options may be restricted due to flight cancellations and other restrictions.
  • It is difficult for patients who need a later abortion to cross the border into the United States. (Although they can bring a doctor’s letter stating their visit is for essential medical reasons, this might not be accepted by U.S. border officials.)
  • Access to blood testing and ultrasound services may be challenging in some areas (many providers require this prior to an abortion).
  • There may be shortages of Mifegymiso in coming months.
  • Many pharmacies are rationing drugs, including prescription birth control, and there may be shortages of contraceptives such as condoms in the near future. You may only be able to get a short supply of a prescription at a time.
  • Access to STI testing and other sexual and reproductive healthcare is more difficult.

Clinics that remain open are generally taking the following steps

  • Protecting staff and patients by following all necessary protective measures, including screening, disinfecting, using personal protective equipment, etc.
  • Increasing usage of medical abortion via Mifegymiso, rather than surgical abortion, to minimize physical contact
  • Implementing telemedicine options where feasible
  • Providing counselling and follow-up support over the phone if possible, or delegating to medical staff
  • Using old-school menstrual period-dating methods to date a pregnancy whenever possible instead of sending patients to get lab test or ultrasounds
  • Allowing only patients in the clinic, without support people; and enforcing social distancing in the waiting room
  • Delaying procedures for people who have been travelling (unless urgent) and delaying very early surgical abortions for a week or two
  • Adjusting or reducing hours, and staggering appointments (spacing them out)
  • Postponing other non-urgent care appointments (e.g., PAP smears)

To find out which services are operating in your area, call the 24/7 toll-free Options Hotline run by Action Canada for Sexual Health & Rights – 1-888-642-2725.

To find your nearest provider based on your needs, use the Choice Connect website.

To contact a specific clinic, please consult our List of Abortion Clinics and some hospitals, which also includes abortion support services and abortion doulas.

How to protect your sexual and reproductive health during COVID-19

Here’s a few measures you can take to reduce your risk of infection and to mitigate any shortfall in sexual and reproductive health services. For more tips and advice, please check the first story in this newsletter, Sex During Covid-19, from International Campaign for Women’s Right to Safe Abortion.

  • Limit physical sexual contact to live-in partners. But refrain from contact if either of you is in self-isolation, in a high-risk category, or feels unwell. Even though the virus might not be sexually transmitted: “If you’re close enough to have sex, you’re close enough to be exposed to COVID-19 through other means.”
  • Wash your hands before and after sex, including masturbation. Wash sex toys with soap and warm water.
  • If you don’t live with your partner or are single, refrain from in-person sex. Try adopting social distancing techniques such as sexting, chat rooms, video calls, and online dating. Masturbation is recommended by New York City Health: “You are your safest sex partner.
  • Don’t risk getting pregnant even if you were planning to. Although insufficient evidence exists to show that pregnant people or their fetuses/newborns are at higher risk of infection, there is too much unknown at this point. Further, being pregnant during a pandemic may lead to other stressors and issues, including barriers to healthcare.
  • Stock up on condoms, or any other off-the-shelf birth control you currently use.
  • If you use prescription birth control, check your supplies and try to keep at least one month’s supply on hand. Call your doctor to get your prescription and refills phoned into the pharmacy. Rely on condoms as a backup if necessary.
  • Don’t delay obtaining emergency contraception if needed.
  • Make cautious use of online services to order contraception online. Do some research to ensure the website is reputable, and don’t do anything illegal.
  • If you run out of contraception and are unable to get more, consider refraining from vaginal intercourse with your live-in partner, and substituting other sexual activity.
  • Keep checking in with family and friends, especially those older than 60, those who have any other health condition or illness, those who are pregnant or have small children, those who may be at risk of abuse at home, and anyone else you think may be vulnerable.

Resources

Canada

Jun 14 – The New Brunswick Women’s Council has launched a digital library of content on the COVID-19 pandemic that considers marginalized populations, the not-for-profit sector, or uses a social justice lens. Available in English or French.

Apr 24 – The Society of Obstetricians and Gynaecologists of Canada (SOGC) has published the following guidelines and protocols for healthcare providers, based on peer-reviewed evidence where available as well as expert consensus on best practices and strategies:
(En français : Disponsible ici)

Mar 25 – SRHR and COVID-19, by Action Canada for Sexual Health and Rights. “What does the novel coronavirus (COVID-19) mean for sexual and reproductive health and rights (SRHR) in Canada? … We’ve compiled statements and resources to provide more information on reproductive and sexual health during COVID-19.”  (En français : Disponsible ici)

Mar 20 – Joint statement on essential abortion care during COVID-19, by National Abortion Federation (NAF) Canada and Action Canada for Sexual Health and Rights. “We call on governments and health sectors to continue to ensure that abortion facilities remain open. We urge all hospitals to provide abortion care.”  (En français : Disponsible ici)

United States

Apr 21 – Reproductive Health Care and COVID-19: What You Need to Know, by Center for Reproductive Rights:

Mar 18 – Joint Statement on Abortion Access During the COVID-19 Outbreak, by the American College of Obstetricians and Gynecologists, American Board of Obstetrics & Gynecology, and six other medical groups. “…abortion should not be categorized as [a procedure that can be delayed]. Abortion is an essential component of comprehensive health care. It is also a time-sensitive service for which a delay of several weeks, or in some cases days, may increase the risks or potentially make it completely inaccessible. The consequences of being unable to obtain an abortion profoundly impact a person’s life, health, and well-being.”

Mar 18 – We’re Here for You: Coronavirus Precautions & Resources, by ReproJobs. A resource for clinics (and other workplaces) on how to protect staff and patients, and other mitigation measures.  

Mar 17 – National Abortion Federation (NAF) Statement on Abortion Provision During COVID-19 Pandemic. “Abortion care is a time-sensitive service that cannot be significantly deferred without profound consequences for women and their families. … As we navigate COVID-19, it is critical that leaders treat outpatient abortion providers as essential businesses, and that hospital systems ensure the continuation of abortion care as an essential service.”

Global

June 3 – World Health Organization: Maintaining Essential Health Services: operational guidance for the Covid-19 context . Abortion is included as essential healthcare. Page 29 features guidance on safe abortion care and post-abortion care.

Mar 31 – International Federation of Gynecology and Obstetrics (FIGO): Abortion Access and Safety with COVID-19. “The unfolding COVID-19 crisis is restricting access to contraception and safe abortion services, with the poorest and most marginalized women and girls being worst affected. … However, there are practical and easily implemented solutions that will release the pressure on the health system, free up providers and ensure access to lifesaving services are maintained.”  (En français : Disponsible ici

Mar 25 – International Campaign for Women’s Right to Safe Abortion: COVID-19: Global Health, Sexual & Reproductive  Health, Pregnancy, Abortion Care, & Contraception.  This is a comprehensive collection of resources, news, and research from reputable health agencies and groups.

Mar 21 – UK Royal College of Obstetricians and Gynaecologists:
Coronavirus (COVID-19) – Information for women requiring abortion

Mar 13 – World Health Organization, Clinical management of severe acute respiratory infection (SARI) when COVID-19 disease is suspected, page 11:

  • Remark 1: All pregnant women with or recovering from COVID-19 should be provided with counselling and information related to the potential risk of adverse pregnancy outcomes.
  • Remark 2: Women’s choices and rights to sexual and reproductive health care should be respected regardless of COVID-19 status, including access to contraception and safe abortion to the full extent of the law.

News

Canada

July 16 – Island abortion services not interrupted by COVID-19, View Royal women’s clinic says. Abortion care remains essential service during pandemic. By Shalu Mehta. “While some medical services were on hold or disrupted due to the COVID-19 pandemic, access to abortion care in Greater Victoria and on Vancouver Island has not been impacted, although the way it is delivered has changed.

July 2 – BC’s Online Abortion Services Increasing Access in Pandemic, by Moira Wyton, TheTyee.ca. “Two clinics that began offering online abortion services during the pandemic are seeing a surge in patients, highlighting the lack of reproductive health services available for patients outside the Lower Mainland.”

May 4 – L’angoisse d’avorter seule en temps de pandémie, par Alix Dufresne:
Les hôpitaux, CLSC et cliniques privées du Québec qui offrent des services d’interruption de grossesse exigent dorénavant que les accompagnateurs attendent à l’extérieur de l’établissement. « C’est pas le fun d’aller là seule, s’inquiète pour sa part Karine*. Mon conjoint, faut qu’il attende dans l’auto. Il peut pas rentrer dans la clinique. Je sais pas à quoi m’attendre. C’est l’inconnu. Je fais beaucoup d’anxiété. »

Apr 29 – Why the abortion pill is more important than ever during the coronavirus, by Michelle Cohen. “There could be an increase in unintended pregnancies just as abortion becomes less available, putting women who are self-isolating in abusive situations at higher risk.”

Apr 14 – COVID-19 reaffirms that abortion is an essential service, by Martha Paynter and Françoise Baylis. “For now, and in anticipation of increased demand, we need to keep protecting access to abortion services. Doing so includes talking about abortion as a normal, common and essential part of reproductive health care. Even, and especially, in a pandemic.”

Apr 9 – Abortion Is An Essential Service, But The Pandemic Is Making It Harder To Access. By Maija Kappler. “…reproductive health advocates say existing barriers to abortion access have become even more significant now. Calls to a 24-hour info line provided by Action Canada for Sexual Health and Rights increased by 30 per cent in the last two weeks of March.”

Apr 9 – New Brunswick directing women to receive abortions at hospitals dealing with COVID-19, By Alexander Quon and Megan Yamoah, Global News. “In the midst of a global pandemic, women in New Brunswick are being instructed to access abortion services at the same hospitals used to treat those who are ill from COVID-19.”

Apr 9 – Feds penalize province for lack of abortion access, but reimburse payments because of COVID-19, by Hadeel Ibrahim, CBC News. “The federal government took away $140,000 in transfer payments to New Brunswick as a penalty for not providing adequate abortion access. … However, because of the pressure on the health system caused by the novel coronavirus, the federal government has decided to reimburse that amount…”

Apr 7 – Barriers to abortion access rise higher amid COVID-19 crisis, by Julia Hansen. Abortions are funded only in three hospitals in two cities in New Brunswick, and pregnant patients are still required to travel long distances to access care.” But the hospitals only do abortions up to 13 weeks 6 days, while Clinic 554 goes up to 15 weeks but is not funded for surgical abortions by the province.

Apr 2 – Advocates sound alarm over COVID-19 limiting access to contraceptives, abortion, by the Canadian Press. “Limited access to contraceptives and services because of COVID-19 is likely to lead to a surge in unintended pregnancies, according to sexual health advocates. … One advocate said it is also already limiting access to abortions for some people.”

Mar 31 – COVID-19: ease the burden on hospitals by supporting clinic abortions, by Judy Burwell. “Clinic 554 offers alternatives to hospital procedures. Travel is reduced as only one appointment is necessary. The clinic follows the strict safety protocols of the National Abortion Federation Canada. During these difficult times it makes sense to shift abortion procedures out of hospitals and into the community.  It frees up hospital staff, reduces costs, and lessens the risks to patients.”

31 mars – La crise sanitaire menace l’accès à l’avortement au Canada, selon des organismes, par Louis Gagné.

Mar 30 – Canada experiencing shortage of abortion pill amid COVID-19 outbreak, by Rachel Gilmore, CTVNews.ca.

Mar 28 – Save Clinic 554 Campaign: the fight continues (aussi en français), by Save Clinic 554 Campaign. “The clinic had been closed for a week or two due to COVID and were unable to see patients via video conference during that time. They are working to set up capacity for tele-health to see patients this week and are still performing abortions.”

Mar 26 – Letter to Minister of Health on Sexual and Reproductive Rights during COVID-19, by Action Canada for Sexual Health and Rights. (En français.) The letter asks Minister Patty Hajdu to: “Publicly affirm that sexual and reproductive health services are essential and need to remain accessible; extend the prescribing limit of medical abortion to 12 weeks/84 days; and engage all Provinces and Territories to provide 100% cost coverage for all contraceptive options, allow pharmacists to prescribe contraception, ensure timely access to abortion care, and create a telemedicine billing code for medical abortion.”

Mar 26 – Abortion access will be maintained across Canada amid COVID-19 outbreak, by Rachel Gilmore, CTVNews. “As hospitals across Canada begin cancelling and postponing surgeries to contend with the spread of COVID-19, provinces and territories have deemed abortions an essential service.”

Mar 26 – How COVID-19 Is Making It Harder To Get An Abortion In Canada, by
Leah Rumack, Refinery 29. “…clinics across the country are hustling to put new protocols in place so they can keep their doors open.”

Mar 25 – Action Canada for Sexual Health and Rights: “Provincial, territorial and federal governments in Canada need to step up to meet their human rights obligations by ensuring people can still access the essential sexual and reproductive healthcare they need.

“We are asking the federal government to:

  1. Publicly support sexual and reproductive health services as essential
  2. Extend the medical abortion limit to 12 weeks (84 days) 

“We are asking the provincial and territorial governments to:

  1. Provide 100% cost coverage for all contraceptive options
  2. Allow pharmacists to prescribe contraception
  3. Ensure timely access to abortion care
  4. Create a telemedicine billing code for medical abortion”

Mar 25 –  Abortion classified as an essential service in Nova Scotia. The women’s choice clinic and provincial helpline will continue to operate. Nova Scotia’s abortion services phone number: 1-833-352-0719. Calls are answered between 8am and 3pm, and any messages left will be responded to. (By Caora McKenna, The Coast.ca)

Mar 20 – How COVID-19 self isolation could be a ‘catalyst for unplanned pregnancies’, by Kelvin Gawley, NEWS 1130 (Vancouver). Options for Sexual Heath urges the public to not stop taking birth during self isolation. Otherwise, we could see a rise in sexually transmitted infections and unwanted pregnancies in the coming months.

Mar 18 – From custodians to abortion providers, how coronavirus is changing our lives, By Jane Gerster, Global News. (Note: The section on abortion provision starts halfway down the article.)  “…even in times of crisis, abortion access is essential. As a spokesperson for Women’s College Hospital in Toronto said: ‘We are continuing to offer these services as we normally do’.”

United States

Apr 13 – Abortion clinics see increased demand amid coronavirus: ‘The calls … are frantic’, by David Crary, Associated Press. “Some clinics are seeing patients who traveled hundreds of miles from states such as Texas, which has banned abortions during much of the pandemic on grounds they are nonessential.” Other providers predict that demand for abortions will continue to increase during the pandemic.

Apr 9 – Abortion during the Covid-19 Pandemic — Ensuring Access to an Essential Health Service, by New England Journal of Medicine. “Because access to safe abortion care is time-sensitive and vitally important, the American College of Obstetricians and Gynecologists (ACOG) and other reproductive health professional organizations issued an unequivocal statement on March 18, 2020, that they ‘do not support Covid-19 responses that cancel or delay abortion procedures’.”

Apr 8 – It’s Time For A Revolution In At-Home Abortion, by Melissa Jeltsen, HuffPost US. “The coronavirus pandemic has exposed the fiction that most abortions need to be performed in a clinic setting.”

Apr 4 – There’s nothing pro-life about exploiting a pandemic to further a political agenda, by Arwa Mahdawi. “It’s already apparent a small minority of zealots will do everything they can to use the coronavirus crisis to eradicate the right to an abortion.”

Apr 3 – ‘Constantly Preparing for the Next Crisis’: How Independent Abortion Clinics Are Faring With COVID-19, by Sarah Anne Lloyd. “Patients think clinics are closed; there is increased panic due to patient’s fear of being turned away.”

Mar 28 – Abortion is a human right. A pandemic doesn’t change that, by Serra Sippel and Akila Radhakrishnan. Cnn.com. “Access to abortion is an essential service and a fundamental human right. Period. The denial of it, including in times of global crisis like the Covid-19 pandemic, constitutes cruel, inhuman and degrading treatment.”

Mar 26 – Telemedicine Abortion: What It Is and Why We Need It Now More Than Ever, by Carrie N. Baker, MS. Magazine. “The arguments attempting to close clinics based on conserving personal protective equipment are not based in evidence. What we should be doing is expanding access to telemedicine provision of abortion during this pandemic,” said Dr. Daniel Grossman.

Mar 23 – Texas and Ohio Include Abortion as Medical Procedures That Must Be Delayed, by Sabrina Tavernise, New York Times. Texas and Ohio have included abortions among the nonessential surgeries and medical procedures that they are requiring to be delayed.

Mar 20 – Coronavirus Is Endangering Abortion Access. Telemedicine Could Solve it. By Melissa Jeltsen, HuffPost US. “Almost 40% of abortions take place in the privacy of one’s home. Why must pregnant women to go to the clinic at all?”

Mar 19 – Even in Places With Accessible Abortion Care, the Coronavirus Is Drastically Affecting Services, by Steph Black, Rewire News. “For people seeking abortion care in the D.C. area, support systems won’t be readily available during the COVID-19 pandemic.”

Mar 17 – Your Questions About Reproductive Health During the COVID-19 Pandemic, Answered. by Rewire.News staff. “The effect [of the COVID-19 outbreak] on people accessing abortion care is considerable, especially in those states that have limited access.”

Global

Apr 17 – European Parliament passes its Coordinated Action to Combat the COVID-19 Pandemic and its Consequences (in French):

  • Section 48…”Calls on the Member States to guarantee effectively that all women and girls have safe and rapid access to reproductive and sexual health and associated health rights and services during the Covid-19 pandemic, including access to contraception, emergency contraception and abortion;
  • Strongly opposes any attempt to backtrack on reproductive and sexual health and rights as well as the rights of LGBTI people, and condemns, in this context, attempts to further criminalize abortion, to stigmatize people with HIV and to hamper young people’s access to sex education in Poland, as well as violations of the rights of transgender and intersex people in Hungary…

Mar 24 – Self-managed abortions should be universally available, by Sam Rowlands, The Conversation. “Self-managed medical abortions can now be carried out anywhere in the world. But to keep yourself safe make sure the information you use is accurate, the drugs genuine, and that local medical back-up is on hand. And, importantly, don’t break the law.”

Mythbusting

Anti-choice people have a tendency to minimize the pandemic, claim it’s a hoax, or spread myths and conspiracy theories about it (such as here). Know the facts!

Coronavirus disease (COVID-19) advice for the public: Myth busters, by World Health Organization.

The conspiracy theories about the origins of the coronavirus, debunked (Mar 12), by Eliza Barclay. “There’s a rumor the coronavirus started in a Chinese lab. And a scientific consensus it didn’t.”

Misinformation related to the 2019–20 coronavirus pandemic, from Wikipedia – A comprehensive catalog and refutation of misinformation around the COVID-19 virus and pandemic.