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Obstet Gynecol Sci > Volume 63(6); 2020 > Article
Rashidpouraie and Sharifi: COVID-19 and abortion right

Abstract

Induced abortion has always been a challenging topic; however, it needs to be discussed during the coronavirus disease 2019 (COVID-19) pandemic.

Introduction

Abortion may be considered for pregnant woman due to concerns such as: 1) Financial and economic problems, health concerns, and low community support [1]; 2) Acute or chronic illness in oneself or in first-degree relatives and death of spouse [2]; 3) concerns for work, education, and income [3] created during and after the coronavirus disease 2019 (COVID-19) pandemic; 4) quarantine of cities and business stagnation resulting economic problems in societies, job loss, low community support, and COVID-19 disease or even death of partners. The worries and anxieties listed above may all be factors that increase the risk of induced abortion.

Materials and methods

We searched in electronic databases such as Web of Science, PubMed, Cochrane library; Google Scholar by 2 key word, “covid19” and “abortion right” then related article was gathered.

Discussion

No effective drugs or vaccines have been developed for COVID-19 thus far, and its effect on pregnant women and their fetus are not known.
• “Abortion care is an essential part of healthcare for women: Services must be maintained even where non-urgent or elective services are suspended.
• Abortion is time-sensitive, and attention should be paid to providing care as early as possible given gestational limits.
• Organized access to abortion care is essential so that delays are minimized [4]”. “There is evidence that abortion rates are similar whether access to abortion is freely available or restricted, but that where access is restricted, women are more likely to resort to unsafe abortion outside of medical regulation, which is likely to be detrimental to both them and the healthcare system [5]”. In fact, there are 25 million unsafe abortions per year, 30 women die for every 100, 000 unsafe abortions in developed regions and 220 deaths per 100, 000 unsafe abortions in developing regions [6].
Based on the World Health Organization’s recommendations for COVID-19 testing, if a pregnant woman has a positive test, all information about the unknown effects of coronavirus on her and her fetus should be given, so that she may make a decision based on her autonomy. This seems to be difficult for pregnant women with a positive coronavirus test who live in countries with strict abortion laws. In fact, during a pandemic, autonomy has been violated by the law. Pregnant women who want to end their pregnancy in countries with strict abortion laws tend to lean to unsafe abortions resulting in increased morbidity and mortality.

Conclusion

COVID-19 is a pandemic, which means, global ethics need to be considered. We need to think globally and act locally. It seems that countries with strict laws should reconsider their abortion laws during pandemics and even endemics to reduce the number of unsafe abortions and their complications. It is essential to ask women about the possibility of pregnancy in COVID-19 screening centers and to establish psycho-medical support care. The COVID-19 emergency is pushing governments to strengthen their healthcare systems and reconsider their health laws. Women could face immediate harm if the restricted law is not lifted.

Notes

Conflict of interest

No potential conflict of interest relevant to this article was reported.

Ethical approval

The study was approved by ethical committee of Tehran University of medical science .the approval number is: IR.TUMS. MEDICINE.REC.1397.836 and performed in accordance with the principles of the Declaration of Helsinki.

References

1. Faúndes A. Unsafe abortion - the current global scenario. Best Pract Res Clin Obstet Gynaecol 2010;24:467-77.
crossref pmid
2. Coleman PK, Coyle CT, Shuping M, Rue VM. Induced abortion and anxiety, mood, and substance abuse disorders: isolating the effects of abortion in the national comorbidity survey. J Psychiatr Res 2009;43:770-6.
crossref pmid
3. Broen AN, Moum T, Bödtker AS, Ekeberg O. Reasons for induced abortion and their relation to women’s emotional distress: a prospective, two-year follow-up study. Gen Hosp Psychiatry 2005;27:36-43.
crossref pmid
4. Royal College of Obstetricians and Gynaecologists. Coronavirus (COVID-19) infection and abortion care [Internet]. London: Royal College of Obstetricians and Gynaecologists; 2020 [cited 2020 Jul 31]. Available from: https://www.rcog.org.uk/globalassets/documents/guidelines/2020-07-31-coronavirus-covid-19-infection-and-abortion-care.pdf.

5. Sedgh G, Bearak J, Singh S, Bankole A, Popinchalk A, Ganatra B, et al. Abortion incidence between 1990 and 2014: global, regional, and subregional levels and trends. Lancet 2016;388:258-67.
crossref pmid pmc
6. World Health Organization. Preventing unsafe abortion [Internet]. Geneva: World Health Organization; 2020 [cited 2020 Sep 25]. Available from: https://www.who.int/news-room/fact-sheets/detail/preventing-unsafe-abortion.

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