# Trends in Second‐Trimester Safe Abortion Service Utilization During the Two Phases of COVID‐19 Pandemic in an Ethiopian Setting: A Cross‐Sectional Study

## TL;DR

This study shows more second-trimester abortions were performed during the peak of the pandemic in Ethiopia compared to the early phase.

## Contribution

The study reveals a significant increase in second-trimester abortion service utilization during the peak of the pandemic.

## Key findings

- There was a 107% increase in second-trimester abortion service coverage during the peak pandemic compared to the early phase.
- Over 80% of abortions for maternal health problems used medical methods during the peak pandemic.
- Dilation and evacuation procedures increased from one in the early pandemic to 14 during the peak.

## Abstract

Providing abortion services during pandemics without interruption is essential. The objective of the study was to compare the utilization of second‐trimester safe abortion care services between early pandemic and peak pandemic months.

We conducted a retrospective comparative study of second‐trimester safe abortion service provision during the peak of COVID‐19 pandemic in Ethiopia (April 2021) versus during that of early pandemic (April 2020). Data were collected using data extraction form from MICHU clinic HMIS registry. Data were analyzed using SPSS version 23. Chi‐squared test and simple descriptive statistics were applied as appropriate. A p‐value of less than 0.05 was used to describe the significance of the results.

There were significantly more second‐trimester abortions performed during the peak pandemic month as compared to early pandemic month (32.6% vs. 67.4%, respectively). Nearly half of the abortions were done for maternal health problems (47.8%, 44/92), and of which over 80% of them used medical methods for abortion (83.7%, 77/92). There was only one case of dilation and evacuation (D&E) during the early pandemic, compared to 14 D&E procedures during the pandemic peak.

We found a significant increment in the second‐trimester abortion service coverage during the peak of COVID‐19 pandemic. The measures we took during the early pandemic: increasing public awareness about continuation of abortion care services during the pandemic, change in the attitude of care‐providers, and early sticking to national guidelines on essential care during COVID‐19 should be passed on as important lessons for future pandemics.

Providing abortion services during pandemics without interruption is essential. We conducted a retrospective comparative study, and we found a significant increment (an increase by 107%, p‐value = 0.019) in the second‐trimester abortion service coverage during the peak of COVID‐19 pandemic (April 2021) compared to during early COVID‐19 pandemic (April 2020).