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To analyze changes in national abortion clinic practices and telehealth utilization during the COVID-19 pandemic.
We conducted descriptive analyses of nationwide abortion service trends utilizing a longitudinal survey distributed by the Society of Family Planning. The dataset comprised three surveys: T1 (February–March 2020), T2 (May–July 2020), and T3 (August–October 2020). Demographic characteristics including region (Northeast, Midwest, South, Midwest, and West) and type of clinic site (academic/hospital-affiliated, Planned Parenthood, and independent) were provided in the survey data. Wilcoxon rank sum and Kruskal-Wallis tests were utilized for statistical analysis.
There was no difference in the volume of abortion services provided nationwide over T1–T3. However, there was a significant increase in the proportion of medical abortions compared to procedural abortions from T1 to T3 (26.7% to 40.0%, p<0.05). Planned Parenthood/independent sites performed a significantly greater proportion of medication abortions than academic/hospital-affiliated clinic sites (p<0.05) across all three time periods. There was no difference in utilization of telehealth across the time periods, even when controlling for type of site and region. Sites offering telehealth services did not experience changes in volume of abortions or in distribution of abortion services provided (medication vs. procedural).
An increase in the proportion of medication abortions compared with procedural abortions may suggest increasing access to medication abortion as clinics adapted to limitations of the COVID-19 pandemic. Utilization of telehealth did not appear to decrease the availability of operative procedures or volume of services, suggesting that telemedicine is a favorable care delivery option for clinics hoping to limit face-to-face interaction as the pandemic continues.