Induced abortion and COVID-19: What changed with the pandemic in 2020

Objective. - The management measures to contain the SARS-CoV-2 pandemic in 2020 has upset the organization of society, particularly the organization of the health system. We aimed to analyze the evolution of induced abortions in the Paris region in 2020 and to highlight the impact of the first confinement. Method. - Data from the National Health Insurance plan was analyzed to study abortion during the pandemic period (2020) compared to the previous four years (2016-2019). In 2020 the indicators of induced abortion were studied monthly to highlight the impact of the confinement. The age of women, the method used to terminate the pregnancy, the gestational age at the time of the abortion and the area of residence of women were analyzed. Results. - After five consecutive years of increasing abortion rates, our result showed that the number of abortions declined from 53,601 in 2019 to 50,615 in 2020 (decline of 5.6%). The abortion rate was 17.3 per 1,000 women aged 15-49 in 2019 and 16.3%0 in 2020. This drop was observed within 4 weeks following the first confinement. It concerned particularly abortions carried out in the hospital context and abortions of young women (< 25 years old). In 2020 the rate of medical abortions increased compared to the 4 years preceding the pandemic. The use of local anesthesia for surgical abortions also increased in the Paris region during the first confinement. Our study showed a fewer proportion of late abortion (over 12 weeks of amenorrhea) in 2020. This analysis also showed a drop in the number of births in the eight to nine months that followed the first confinement in the Paris region. Discussion and Conclusion. - The COVID-19 pandemic has had health consequences not directly attributable to the virus. In terms of reproduction, the pandemic, particularly the first lockdown, has been associated to a decrease in conceptions resulting in a decrease in the number pregnancies including those ending in induced abortion or childbirth. The reduction of abortions is observed in the four weeks following the first confinement and the fall in the birth rate in the following 8 to 9 months. (C) 2022 The Author(s). Published by Elsevier Masson SAS.