The number of abortions performed in Louisiana plummeted 31 percent between March and May compared with the previous two years, according to new research published in the American Journal of Public Health.
The drop was not offset by patients traveling out of state, the study found, suggesting that the drop represents people who would have obtained abortions, if not for the impacts of the pandemic.
“This 31 percent reduction really does represent a decrease in abortions among Louisiana residents,” said lead researcher Dr. Sarah Roberts, a professor in the Department of Obstetrics Gynecology and Reproductive Sciences at the University of California, San Francisco. “It’s striking in terms of what a dramatic impact there was.”
Researchers collected monthly data on abortions performed in Louisiana clinics and clinics in neighboring states and compared those numbers to the same time period in 2019 and 2018. They also called clinics in the region through July to find out what clinics were open and the average length of wait times.
The number of second-trimester abortions performed nearly doubled, from 10 percent to 17 percent, according to the study, suggesting that many people’s abortions were delayed until far later in pregnancy.
Only one or two of the state’s three clinics were open in early May, researchers found, and the median wait time for an appointment was more than two weeks — a significant delay for a time-sensitive procedure, Roberts said.
Researchers followed up with abortion clinics through early July and did not find a rebound in services.
“This really is an indication of the fact that more people were unable to obtain abortions during the first few months of the pandemic,” Roberts said.
The study’s timeframe from March through May shows that abortion did not decline for other reasons — such as fewer pregnancies, Roberts added.
“It was too early for the reduction to be due primarily to people successfully avoiding pregnancy, or to more people not being able to obtain contraception and therefore more pregnancies,” she said.
The research supports anecdotal evidence of a drop in abortions during the spring of last year, as Louisiana entered a shutdown that banned elective health services and sparked a political battle over whether abortion clinics would be forced to close.
Two of the state’s three abortion clinics briefly stopped performing abortions as they tried to determine whether they’d be allowed to operate under a health notice banning elective procedures issued by the Louisiana Department of Health in late March, which did not define whether abortion was considered elective.
Hope Medical Group for Women, a clinic in Shreveport, sued the health department and Attorney General Jeff Landry after Landry’s office sent staff to inspect two of the state’s three abortion clinics as part of a task force Landry created to enforce the health department’s orders. According to documents released by the health department, Landry’s task force inspected the state’s three abortion clinics and one endoscopy center.
Meanwhile, abortion clinics in Texas bounced between government shut down orders and federal court rulings allowing them to reopen, causing Texas patients to travel to Louisiana.
Elizabeth Gelvin, the client and community coordinator with the New Orleans Abortion Fund, remembers a state of “extreme fear and confusion.”
“We had everyone in a state of really frantic flux,” Gelvin said. “Folks from Texas coming into Louisiana, folks in Louisiana not knowing if they could access care, folks who are forced to prolong their care.”
The fund helps people pay for abortions, and during the pandemic, it launched a program to help coordinate and pay for patients’ hotels, travel and childcare.
Staff called “hotel after hotel to see if they would allow someone to book who wasn't like an essential worker,” Gelvin said. She said it felt like “an expedited version” of what would happen if the United States Supreme Court had upheld a Louisiana law that summer that was expected to lead two or all three of the state’s abortion clinics to close. Instead, the court struck down the law.
Merritt Rebouche, who coordinates support for clients beyond helping pay for abortions, said clients faced layers of challenges: children at home studying remotely rather than in schools, flooding from summer storms and lost jobs. More than half of the New Orleans Abortion Fund’s clients are on Medicaid or uninsured, and 70 percent are Black.
From March through June 2020, 73 percent of its clients were already parents, a 135 percent increase from before the pandemic.
Roberts said the research showed that ambiguity and political battles over abortion clinics can have a similar effect as simply shutting clinics down.
“I would say given all everything going on related to abortion and abortion politics more broadly and messages around abortion, lack of clarity can also contribute to some similar patterns and findings,” she said.
The drop in abortions shows that public health leaders need to think about how to provide abortions in emergency situations, she said.
“This is a service that cannot be disrupted. It is a time-sensitive service. And when people are unable to obtain that service, it can have long-term implications for their health, and for the health and well-being of their children,” Roberts said.
Other research into the impacts of the pandemic on pregnancy and abortion has found that COVID-19 caused many to reconsider whether to have children. A survey by the reproductive health and rights group the Guttmacher Institute from June of 2020 found that one-third of women wanted to delay pregnancy or have fewer children because of the pandemic, a figure that jumped to 44 percent for Black women and 48 percent for Hispanic women.