Abortions plummeted during Texas' policy to postpone most surgeries and medical procedures during March and April, 2020

Early in the covid-19 pandemic, many states recommended halting procedures that were not deemed to be medical emergencies. The reason for this was simple: hospitals were overwhelmed with patients sick with covid-19, and surgical floors and post-anesthesia care units needed to be converted to covid-19 care areas. Additionally, decreasing surgeries meant more availability of PPE for providers taking care of hospitalized covid-19 patients. 

Many procedures, surgical removal of cancerous tumors for example, do not fall under the definition of "emergent," and yet are often urgent in nature. Another procedure widely regarded as urgent—and depending on the gestational age might be considered emergent—is the surgical termination of early pregnancy, often simply referred to as an 'abortion'. 

In a new paper published in JAMA, researchers assessed the changes in abortions following an executive order by Texas Governor Greg Abbott on March 22, 2020 that required postponing surgeries and procedures not deemed medically necessary. Controversially, the order included abortion. 

To determine changes in the number of abortions that occurred during the pandemic in Texas, researchers analyzed monthly data from 18 of 24 abortion facilities in Texas which account for 93 percent of abortions performed in Texas. Data also included Texas residents obtaining abortions at 30 of 37 "open facilities" in nearby states, including Arkansas, Colorado, Kansas, Louisiana, Oklahoma, and New Mexico from February 2020 through May 2020. These data were compared to rates recorded during previous years. 

When compared to the previous year, the researchers found a 38 percent reduction in abortions in Texas during the time that executive order issued by Texas Governor Greg Abbott was active. Additionally, there was a 17 percent increase in medication-induced abortions and a concomitant decrease in procedural abortions during this time period. When the executive order was lifted, there was an 83 percent increase in procedural abortions among pregnancies that were 12 weeks or higher when compared to May 2019. This means that some women waited weeks longer than they wished to in order to receive an abortion and that many more second trimester abortions occurred than usual. Finally, Texas residents receiving care at out-of-state facilities substantially increased (by 785 percent) during the month of April, meaning that women who normally would not have to travel (and incur expenses) had no option but to do so in order to obtain their usual legal access to medical care.

Research Section Editor


Stay-at-home orders saved lives and changed many others

Broadly speaking there are two types of people: those who think that stay-at-home orders early in the covid-19 pandemic saved lives and those who despite all available evidence think that the "cure" was somehow literally deadlier than a disease which has claimed nearly 2 million lives worldwide. While the emerging data points towards the fact that stay-at-home policies have not led to any measurable increases in mortality and clearly saved countless numbers in our communities, let's put that debate aside and focus momentarily on what experts call "secondary effects" of stay-at-home policies. One such effect now relates to measurable decreases in abortion care, as covered by Dr. Joshua Niforatos and Dr. Miranda Yaver in today's Brief19.

If one carries the belief, as many in the "pro-life" movement do, that life begins at conception, then for such people it is now inarguable that the response to the covid-19 public health emergency itself saved the lives of many thousands of fetuses. That is because, as Dr. Yaver notes, the temporary policies that denied women access to an elective termination of pregnancy during the initial pandemic period in the United States would only be legally permissible within the context of a national emergency such as the covid-19 pandemic. Otherwise, such a policy would fly against decades of legal precedent and not survive a legal challenge, whether in Texas or Vermont. Thus, from the "pro-life" perspective, the Texas policy temporarily banning what the state considered to be elective surgeries and medical procedures—one that was only legally possible under a public health emergency so great that stay-at-home policies had to be enacted—saved far more lives than were lost to covid-19 in that state during that time period, as coronavirus case counts at that time were still rather low in that state.

The overlap between people who opposed stay-at-home policies (inaccurately called "lockdowns" by many) for any number of reasons and those who self-identify as "pro-life" is not 100 percent. But support for lockdowns in so-called "Red" states (Republican strong-holds) is far lower than in "Blue" states (Democrat strong-holds); the former are also largely the same areas where pro-life stances are most commonly held. So, to those people who both oppose lockdowns and are pro-life, one might ask: if stay-at-home policies designed to stop covid-19 had the unintended side effect of legally decreasing by many thousands the number of abortions performed in Texas and elsewhere this spring, would that alone have made the price of such policies worth the costs?

  • The new coronavirus strain and vaccine effectiveness
  • New vaccine guidance for people with weakened immune systems and those with a history of Guillan-Barré Syndrome or Bell's Palsy
  • Stimulus bill signed into law. Pandemic emergency unemployment compensation had expired over the weekend.

  • Vaccine confidence declines. Inequality stands to worsen, given new data
  • Moving the wrong direction on decarceration. De facto death sentences adding up