What would another pandemic do to abortion care?

A mystery illness in Africa recently spiked fears of another pandemic. How would reproductive care adapt to a second medical scourge?

Recently, national journalists reported on two significant health risks that may have implications for abortion workers and patients throughout the world.

First, in the Democratic Republic of the Congo, a mystery illness took the lives of more than 50 people, with 453 falling ill. The other news that made waves was that Chinese researchers had found another viral strand in bats that could spread like COVID-19.

Telehealth abortions became commonplace during the coronavirus pandemic. According to the Society of Family Planning, one of every five abortions is arranged through telehealth consultation now. That development brought with it some legal questions because sometimes it was hard for doctors to determine safely how far along in the pregnancy a woman was when she met with them. Much of it relied on self-reporting.

As we saw in England, women could request and take medication abortion much later in pregnancy than they had thought they were. It led to some investigations and prosecutions in that country. Similar things happened in America and elsewhere.

Finding ways to protect these women is paramount to preserving their liberties. It may not be possible to legally protect a doctor unless a medical document or letter was sent to them by another healthcare provider indicating how far along the woman was in the pregnancy.

Many doctors I’ve spoken to who work in reproductive healthcare want patients to come into a clinic even if they have opted for medication abortion. Of course, this isn’t an option in abortion-banning or restrictive states. So that complicates matters enormously.

If telehealth abortions were eliminated because of this liability, then vast swaths of the country wouldn’t have either a digital option or a physical one to end an unwanted pregnancy. Likely, there would be international organizations that would wilfully violate the laws and send mifepristone into those areas anyway. If that becomes a reality, postal inspectors may examine envelopes and packages to see if they violate the once-dormant Comstock Act, which forbids the mailing of abortifacients.

There are other considerations as well. There may be limits on air travel if a contagion were to spread. So, it would be harder for women to travel to places like New York or California, where abortion is accessible. People who chose to drive the distance would be imperiling themselves by being in such proximity to another person.

Even things like activism could be affected. Demonstrations, which play a key part in rallying support for ballot initiatives, wouldn’t be recommended by disease control experts. Knocking on doors would be seen as unnecessary. So we’d be left with social media content, most of which wouldn’t be compelling pictures of people holding placards and marching down the streets. The blend of activism and journalistic narrative that I’ve done at these events wouldn’t be something we could do.

There needs to be some contingency planning for the likely event of another pandemic. Most disease control experts have warned that more of them are possible. Similar mitigation efforts may affect abortion care and politics.