Medical Examiner

Abortion Care Is Essential Health Care

If anything, it’s even more essential during a pandemic.

Greg Abbott, in a navy suit, holds up a clear plastic case containing several vials with green lids. Two men stand in the background.
Texas Gov. Greg Abbott displays a set of COVID-19 test vials at a press conference on Wednesday. Tom Pennington/Getty Images

Over the weekend, two states made moves to ban certain abortions under the guise of preparing for the expected surge in coronavirus cases. In Ohio, Attorney General Dave Yost sent letters to three abortion clinics ordering them to stop performing “nonessential” surgical abortions that “can be delayed without undue risk to the current or future health of a patient.” In Texas, Gov. Greg Abbott ordered a halt to all procedures performed on patients not facing an immediate risk of “serious adverse medical consequences or death.” The Texas attorney general confirmed on Monday that most abortions would fall under the order.

Both officials have said the bans are necessary to reduce coronavirus-induced strain on health care systems and reserve personal protective equipment, including masks and gloves, for more urgent uses during a time of nationwide medical supply shortages. Their misclassification of abortion as nonessential health care betrays a deep-seated indifference for the health and welfare of pregnant women. Abortion care isn’t a delayable luxury, even during a pandemic. It’s essential preventive care—and if anything, it might be more essential than usual.

Abortion providers in Texas and Ohio have said they consider themselves exempt from the orders and will continue seeing patients, since the care they provide is necessary and time-sensitive. Though abortion care is extremely safe, it gets riskier, more expensive, and more difficult—or impossible—to access as a pregnancy progresses.

Let’s be clear about what patients will endure if states begin to enforce their state-of-emergency bans on surgical abortions. Women who cannot obtain surgical abortions won’t be freeing up space in an over-capacity, under-supplied health care system, as Yost and Abbott’s orders imply. The further along a pregnancy gets, the more likely a pregnant person is to develop life-threatening complications that require urgent medical care. Forced to carry unwanted pregnancies to term, women will also need prenatal care, which will compel them to risk exposure to COVID-19—and risk exposing others—to make several visits to doctor’s offices staffed by overworked practitioners. If they miscarry or develop certain pregnancy complications, they may have to take up valuable surgical supplies and hospital space during what will long be a dangerous time to inhabit a hospital bed. When they go into labor, in some hospitals, they’ll have to endure childbirth alone, without a partner, doula, or family member by their side. Their infants’ first days of life may be spent in a virus-rich environment without proper supplies, staffing, or standards of care.

The coronavirus pandemic is already placing pregnant people under terrible stress, as they must still leave their homes during shelter-in-place orders to attend doctor’s appointments and prepare to give birth under drastically different circumstances than they’d imagined when they conceived. For people with desired pregnancies, it’s a catastrophic situation that carries the possibility of long-term mental and physical harm. For people with undesired pregnancies, being forced to give birth against one’s will during a time of extraordinary social isolation, economic collapse, and health care deficiencies is nothing short of abuse.

In recent days, there have been multiple reports of abortion providers and abortion funds receiving unusually high volumes of clients and calls. People are losing their jobs, their health care, their child care, and their savings. They’re worried about their own existing health conditions and their vulnerable loved ones, and about a future of self-isolation that could last for several months more, or even longer. For many people right now, the financial and emotional strain of an unplanned pregnancy, much less an unplanned child, is too much to bear. The ability to obtain an abortion is an essential component of any sustainable strategy for weathering a crisis like this one. It’s an option we can’t afford to lose.

If public officials were more concerned with conserving health care resources than with punishing women by withholding abortion care, they’d work to make medication-based abortion more affordable and accessible. Abortion-inducing pills don’t use up surgical resources, they’re approved for use up to 10 weeks’ gestation, and they can be safely prescribed and administered from afar, all of which would be ideal right now. But in 18 states, including Texas, the law prohibits clinicians from prescribing abortion medication via telemedicine; in 33 states, that clinician must be a physician, not a nurse practitioner or physician’s assistant. To reduce the risk of coronavirus transmission and to ease current burdens on physicians, legislators should consider suspending these laws, which make it more difficult for women to get abortions in the early weeks of pregnancy, increasing the likelihood that they’ll need riskier and more resource-intensive surgical abortions. Instead, the Food and Drug Administration has confirmed that it will still require people to go to clinics to get abortion pills during the pandemic, rather than allowing them to be disbursed at pharmacies or through the mail.

By all accounts, we are still in the early stages of a coronavirus pandemic that has already imperiled our gravely inadequate health care system and the fast-growing number of patients whose lives depend on it. Increasing the number of women carrying pregnancies against their will won’t relieve the current drain on doctors and hospital resources—it’ll exacerbate it. In ordinary times, anti-abortion politicians tend to flaunt how little they understand about the science of human reproduction, even as they write aggressive legislation that regulates it. That cavernous gap between political and medical views of pregnancy always reveals an underlying contempt for women, a refusal to see them as subjects with inherent dignity. But it has rarely seemed more dangerous and shortsighted than in this attempt to ban certain abortions during a public health crisis. Anti-abortion policies that consign nonconsenting women to the physical pain, discomfort, and medical risks of childbirth are always cruel. At this moment, they’re a grave threat to public health.