{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T02:55:11Z","timestamp":1791428111413,"version":"4.3.3"},"reference-count":15,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2020,10,22]],"date-time":"2020-10-22T00:00:00Z","timestamp":1603324800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Sex Reprod Health"],"accepted":{"date-parts":[[2020,9,3]]},"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Unprecedented public health actions restricting movement and non-COVID related health services are likely to have affected abortion care during the pandemic in Europe. In the absence of a common approach to ensure access to this essential health service, we sought to describe the variability of abortion policies during the outbreak in Europe in order to identify strategies that improve availability and access to abortion in times of public health crises.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We collected information from 46 countries\/regions: 31 for which country-experts completed a survey and 15 for which we conducted a desk review. We describe abortion regulations and changes to regulations and practice during the pandemic.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>During COVID-19, abortions were banned in six countries and suspended in one. Surgical abortion was less available due to COVID-19 in 12 countries\/regions and services were not available or delayed for women with COVID-19 symptoms in eleven. No country expanded its gestational limit for abortion. Changes during COVID-19, mostly designed to reduce in-person consultations, occurred in 13 countries\/regions. Altogether eight countries\/regions provided home medical abortion with mifepristone and misoprostol beyond 9\u2009weeks (from 9 weeks+6 days to 11 weeks+6 days) and 13 countries\/regions up to 9\u2009weeks (in some instances only misoprostol could be taken at home). Only six countries\/regions offered abortion by telemedicine.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The lack of a unified policy response to COVID-19 restrictions has widened inequities in abortion access in Europe, but some innovations including telemedicine deployed during the outbreak could serve as a catalyst to ensure continuity and equity of abortion care.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjsrh-2020-200724","type":"journal-article","created":{"date-parts":[[2020,10,22]],"date-time":"2020-10-22T17:21:14Z","timestamp":1603387274000},"page":"e14-e14","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":55,"title":["Abortion regulation in Europe in the era of COVID-19: a spectrum of policy responses"],"prefix":"10.1136","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8637-6249","authenticated-orcid":false,"given":"Caroline","family":"Moreau","sequence":"first","affiliation":[{"name":"Population Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA"},{"name":"Soins et Sant\u00e9 Primaire, Centre for Research in Epidemiology and Population Health (CESP) INSERM 1018, INSERM, Villejuif, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mridula","family":"Shankar","sequence":"additional","affiliation":[{"name":"Population Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Glasier","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, University of Edinburgh, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1168-2276","authenticated-orcid":false,"given":"Sharon","family":"Cameron","sequence":"additional","affiliation":[{"name":"Sexual and Reproductive Health Services, NHS Lothian, Edinburgh, Scotland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina","family":"Gemzell-Danielsson","sequence":"additional","affiliation":[{"name":"Department of Women\u2019s and Children\u2019s Health, Karolinska Institute, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,10,22]]},"reference":[{"key":"2025090221253636000_47.4.e14.1","doi-asserted-by":"crossref","first-page":"1160","DOI":"10.1093\/humrep\/dex071","article-title":"Induced abortion","volume":"32","year":"2017","journal-title":"Hum Reprod"},{"key":"2025090221253636000_47.4.e14.2","doi-asserted-by":"crossref","first-page":"e323","DOI":"10.1016\/S2214-109X(14)70227-X","article-title":"Global causes of maternal death: a WHO systematic analysis","volume":"2","author":"Say","year":"2014","journal-title":"Lancet Glob Health"},{"key":"2025090221253636000_47.4.e14.3","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.13552"},{"key":"2025090221253636000_47.4.e14.4","unstructured":"Federal Statistical Office of Switzerland . Pregnancy terminations in Switzerland in 2018. Available: https:\/\/www.bfs.admin.ch\/bfs\/fr\/home\/statistiques\/sante\/etat-sante\/reproductive\/interruptions-grossesses.html [Accessed 18 May 2020]."},{"key":"2025090221253636000_47.4.e14.5","unstructured":"National Board of Health and Welfare . Swedish Ministry of Health. Statistics on abortion in 2018. Available: https:\/\/www.socialstyrelsen.se\/globalassets\/sharepoint-dokument\/artikelkatalog\/statistik\/2019-5-18.pdf [Accessed 18 May 2020]."},{"key":"2025090221253636000_47.4.e14.6","unstructured":"Direction de la recherche, des \u00e9tudes, de l\u2019\u00e9valuation et des statistiques . French Ministry of Health. Induced abortion statistics 2018, France. Available: https:\/\/drees.solidarites-sante.gouv.fr\/IMG\/pdf\/er1125.pdf [Accessed 18 May 2020]."},{"key":"2025090221253636000_47.4.e14.7","unstructured":"Department of Health & Social Care . Abortion statistics, England and Wales, 2018. Available: https:\/\/assets.publishing.service.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/808556\/Abortion_Statistics__England_and_Wales_2018__1_.pdf [Accessed 18 May 2020]."},{"key":"2025090221253636000_47.4.e14.8","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m1712"},{"key":"2025090221253636000_47.4.e14.9","doi-asserted-by":"crossref","first-page":"1746065","DOI":"10.1080\/26410397.2020.1746065","article-title":"COVID-19: what implications for sexual and reproductive health and rights globally?","volume":"28","author":"Hussein","year":"2020","journal-title":"Sex Reprod Health Matters"},{"key":"2025090221253636000_47.4.e14.10","doi-asserted-by":"crossref","first-page":"1758394","DOI":"10.1080\/26410397.2020.1758394","article-title":"Abortion in the context of COVID-19: a human rights imperative","volume":"28","author":"Todd-Gher","year":"2020","journal-title":"Sex Reprod Health Matters"},{"key":"2025090221253636000_47.4.e14.11","unstructured":"House of Commons . Abortion in Northern Ireland: recent changes to the legal framework. Number CBP 8909. Available: https:\/\/commonslibrary.parliament.uk\/research-briefings\/cbp-8909\/ [Accessed 26 Jun 2020]."},{"key":"2025090221253636000_47.4.e14.12","doi-asserted-by":"crossref","unstructured":"Mahase E . Covid-19: EU states report 60% rise in emergency calls about domestic violence. BMJ 2020:m1872.","DOI":"10.1136\/bmj.m1872"},{"key":"2025090221253636000_47.4.e14.13","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.15684"},{"key":"2025090221253636000_47.4.e14.14","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1016\/j.contraception.2016.06.019","article-title":"Public funding for abortion where broadly legal","volume":"94","author":"Grossman","year":"2016","journal-title":"Contraception"},{"key":"2025090221253636000_47.4.e14.15","unstructured":"UK Government . A new legal framework for abortion services in Northern Ireland. Available: https:\/\/assets.publishing.service.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/875380\/FINAL_Government_response_-_Northern_Ireland_abortion_framework.pdf"}],"container-title":["BMJ Sexual &amp; Reproductive Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjsrh-2020-200724","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T04:25:46Z","timestamp":1756873546000},"score":1,"resource":{"primary":{"URL":"https:\/\/jfprhc.bmj.com\/lookup\/doi\/10.1136\/bmjsrh-2020-200724"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,22]]},"references-count":15,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2021,10,12]]},"published-print":{"date-parts":[[2021,10]]}},"alternative-id":["10.1136\/bmjsrh-2020-200724"],"URL":"https:\/\/doi.org\/10.1136\/bmjsrh-2020-200724","relation":{},"ISSN":["2515-1991","2515-2009"],"issn-type":[{"value":"2515-1991","type":"print"},{"value":"2515-2009","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10,22]]}}}