Covid-19: for full access to abortion and reproductive health services during the crisis
Róise McCann, North London Socialist Alternative
Millions of women and girls across the globe may be forced to carry unwanted pregnancies or risk unsafe backstreet abortions as a result of new restrictions to reproductive healthcare services being introduced during the Covid-19 pandemic. Marie Stopes International reported that 9.5 million vulnerable women and girls risk losing access to contraception and safe abortion services, with Covid-19 related disruptions leading to an estimated 2.7 million unsafe abortions being performed and 11,000 pregnancy-related deaths.
Government imposed lock-downs have forced the closure of clinics, with medical staff being redeployed to fight the virus. Simultaneously China, the second largest exporter of pharmaceutical products in the world, has undertaken major closures of pharmaceutical factories, causing delays in shipping and a shortage of supplies.
Marie Stopes International were right to report that it is low-income and marginalised people who will be hit the hardest by these restrictions. Economic barriers already exist for millions of working-class women seeking abortions under normal circumstances. These will only be further exacerbated by this pandemic.
People increasingly feel wary using public transport, which in many countries is running on a reduced timetable, an obstacle to access healthcare services for those without a car. School closures across the board mean that those who cannot afford or attain childcare are deterred from attending clinics with their children or risk themselves, their children and healthcare workers further spreading or catching the virus.
Travel restrictions and lock-downs are being implemented globally and are certain to impede access to collection of contraceptives and to safe and legal abortions. This is especially pertinent in states where women are forced to travel in order to access abortion services.
In Poland, where abortions are barred in almost all circumstances, the closure of Polish boarders has meant women are unable to travel for surgical abortions.
The search for access to abortion clinics in Italy has been described as an “odyssey”, with women being turned away in high-risk areas due to the emergency, and in low-risk areas with fewer infections clinics are turning away women coming from these higher-risk zones.
The US has seen conservative politicians move to restrict access to abortion during the pandemic, with several Republican-run states deeming abortion clinics “non-essential” care. A state-wide ban in Texas means those seeking abortions must already make lengthy journeys for access to reproductive services.
In Northern Ireland, abortion services have been provided for the first time without restriction up to the 12th week of pregnancy. Pro-choice campaigners have called for the urgent approval of 'telemedicine' services to be put in place, as they have been in England and Wales as temporary emergency legislation, after days of back-peddling and confusion from the Department of Health.
Despite the recent changes to the law, the reality is in Northern Ireland that most women seeking abortions are currently still forced to travel to England. On 30 March, Mara Clarke from the Abortion Support Network (ASN) tweeted that someone from Northern Ireland seeking to travel for an abortion in England had had their appointment cancelled due to the Covid-19 lockdown. After being refused treatment by a local hospital, they were subsequently admitted the following day following an overdose, in attempt to take their own life.
Access to safe and legal abortion is essential healthcare at all times. These services are vital for the prevention of unnecessary pregnancy-related deaths as the Coronavirus pandemic progresses.
The Independent reported on 24 March that “over the next few weeks, the expected infection peak, it is expected that 44,000 women across England and Wales will need access to an early medical abortion”.
Netherlands-based Women on Web, which offers abortion medication, reported a doubling of calls to the services since the start of the outbreak.
In Nepal, the national lock-down imposed on 24 March included the closure of all Marie Stopes clinics across the country, with clinics only beginning to reopen under very reduced instructions from the government, despite Marie Stopes Nepal reporting an increased number of calls from those seeking abortion services since the start of the lock-down.
In Sierra Leone, Marie Stopes International representative Felix Ikenna pointed to the Ebola outbreak of 2014 as evidence of the importance of providing reproductive healthcare services during crisis, “people will always need services, irrespective of an epidemic”. Researchers found that the closure of clinics and reduced reproductive healthcare services in Sierra Leone led to between 3,600 and 4,900 additional maternal, neonatal and stillbirth deaths between 2014 and 2015, compared with 4,000 deaths from the Ebola virus itself during the entire epidemic.
Socialist Alternative recognises access to reproductive healthcare as an essential service. We fight for all women to have access to abortion, free of charge, when they need one - without the need for the 'permission' of two doctors as is currently required.
Telemedicine and home abortions are urgently needed in the current context of the Coronavirus pandemic and should be implemented immediately. Over-the-phone consultation and delivery of abortion pills for early at-home termination can bypass the need for face-to-face assessments from doctors and attending clinics in person - helping women to reduce their risk of contracting the virus when accessing these services.
Ruth Coppinger of Socialist Party Ireland stated that the emergency legislation should change in Ireland to include telemedicine consultations as well as prescriptions and abortion pills to be sent through the postal system, “extensive research has shown no difference in complications on this and it’s vital in this emergency to allow timely and safe abortions”.
Easy-to-access, home delivery of free contraceptive pills should also be rolled out immediately across Britain and Nothern Ireland.
Free and unfettered access to abortion requires not only the legal right to one - but the provision of high-quality healthcare which is fully accessible to working-class women. The huge strain that has been placed on our NHS, caused not only by Covid-19, but by ten years of austerity and privatisation, means this is not always the case. We need to fight for a fully-funded, publicly-owned, democratically run health service, and for the emergency resources needed to not only treat those affected by coronavirus, but all those who require access to healthcare in the midst of this crisis.
And the fight for such services does not stop there. We are part of International Socialist Alternative - which is organising to fight capitalism and against all forms of oppression in over 30 countries worldwide. We stand for free and unfettered access to safe and legal reproductive services, including abortion, and for fully publicly funded and democratically run free national health services in every country.