What the COVID-19 pandemic has revealed about abortion access: Research

When a deadly virus spreads through a community, routine health care, including reproductive health care, can can suffer.

In North Carolina, the COVID-19 pandemic has reshaped how and when residents received abortion care in unexpected ways, new research shows.

A team of researchers from the University of North Carolina tracked abortions in the state between March 2020, when the World Health Organization declared a global coronavirus pandemic, and December 2021. They specifically evaluated the impact on reproductive health care among Latina patients.

The result peer-reviewed researchpublished in the Women’s health problems magazine in December 2025 found that there was no spike in abortion care in the first month of COVID-19 being declared a global pandemic. But as the pandemic continued, the number of abortions began to rise.

“Despite all the barriers that existed during the pandemic, people in North Carolina were still able to get abortions,” said the paper’s lead author, Marissa Velarde, who is now a postdoctoral researcher at San Diego State University. “And in fact the number of abortions has increased.”

That increase in abortions, which occurred between April 2020 and December 2021, was more pronounced among Latina-identifying women, who had 6.3 more abortions per month than in March 2020. The white women who served as the study’s comparison group saw 4.1 more abortions per month between April 2020 and December 2021.

The study also found an increase in medication abortion care and a decrease in the number of abortions after the first trimester.

Newsgroup rewiring spoke with Velarde about what the COVID-19 pandemic has revealed about abortion access – and how public health officials and policymakers can better prepare for the next public health emergency.

The following conversation has been edited for length and clarity.

What does the research tell you about why and how patients accessed abortion during the COVID-19 pandemic?

The literature on family planning during the COVID-19 pandemic has indicated that people’s pregnancy intentions actually changed due to the economic and social changes that occurred during COVID-19. And because of that abortion increased—throughout the countrybasically – because people were more financially constrained and their support systems just weren’t there anymore.

This is especially true for people who are marginalized. In my research, I really focused on comparing Latina patients to white patients. And you can see that while abortion increased in both white patients and Latina patients, Latina patients saw a much steeper slope. The rate of increase was much greater for Latina patients undergoing abortions in North Carolina.

To what do you attribute that difference?

Preliminary research has indicated that women of color and people of color in general were much more affected by the pandemic than white, affluent patients. There are a number of reasons for this. One of these, for example, is that Latinas are more likely to work in service sector jobs. So her were hit harder by the pandemic because they had no work.

So I think this is one of the reasons for the steeper increase. …

At first we all thought we would be home for a few weeks. We didn’t think we would be staying at home for months, and for some people even a year.

I think women started to realize that they had to deal with their upcoming problems [economic] situation. Many women did not have the economic or financial resources to continue their pregnancies, leading to an increase in the number of abortions.

I also compared procedural and medication abortions. There was a huge jump in the number of medication abortions(Editor’s note: Velarde’s research found that medication was used in 64 percent of pandemic-era abortions in North Carolina, up from 43 percent before the pandemic.) … That’s another reason for the increase. Healthcare institutions were able to see many more patients [for medication abortion] than they could normally do before the COVID-19 pandemic.

You also saw a decrease in the number of abortions after the first trimester. What do you think explains that decline?

There are a number of factors at play here.

Patients were able to make their decisions much faster during the pandemic. Before the pandemic, a patient might have taken their time deciding whether or not to have an abortion. But due to the precariousness of COVID-19, it seems that patients were much more eager to make a decision because they felt [they were] in a place of instability.

And what’s more, they were able to have their abortions earlier, as evidenced by the dramatic increase in medication abortions.

The second point is that there is a specific target group that is often associated with abortions during later pregnancies – and that is adolescents. We saw one decrease in the number of abortions among adolescents in general. …

That’s because their social life surrounds the school. And because of the pandemic to stay at home, [teens] had no social life. They weren’t together with friends. And so they didn’t get pregnant. And I think this was another driving force behind the decline in abortion rates after the first trimester.

What can your research teach us about abortion care during pandemics?

We absolutely must consider abortion an essential health care option. … In North Carolina you still cannot have a medication abortion provided remotely. You must come personally for this. I think it is necessary to delete this provision.

There are states that do that [allow for telehealth abortion] and patients can keep themselves safe. And healthcare providers don’t have to communicate with more people, making themselves and future patients safer from viral diseases.

Is there anything else important to it? RNG readers know?

My studies were earlier Dobbs v. Jackson Women’s Health Organization came down. And I think if we did that [another] pandemic, that intersection of pandemic with Dobbs could have potentially devastating consequences for access to abortion.

[That] reinforces the need for telecare, medication abortion and… [for] protect laws for providers who continue to provide medication abortion to patients located in prohibited states.