Addressing the urgent global need for later abortion care during COVID-19 and beyond.

Abortions beyond 12 weeks’ gestation comprise the minority of cases globally, namely 10%–40% of all services, depending on country.1 2 Later abortions are critical to facilitate as their safe provision can mitigate significant abortion-related mortality and morbidity.1 People seeking later abortions often face financial and logistical barriers, are more likely to have experienced violence, and be young.1 2 In March 2020, the World Health Organization (WHO) declared COVID-19 a pandemic. Since then, we have witnessed strains on health services, travel restrictions, stay-at-home orders and physical distancing measures to curtail disease spread.3 The resulting disruptions in supply chains, economic instability, interruptions in health services, and fear of seeking treatment have impacted both the need for and access to abortion care, which is considered an essential service by WHO.3 4 While all abortion services are essential, ensuring access to later care is crucial given the numerous barriers and delays women face which may be exacerbated by the pandemic, particularly among the most vulnerable and underserved.3 In many settings, particularly low-resource and legally restricted countries, accessing facility-based later abortion care was challenging prior to the pandemic.1 It has become even more difficult during lockdowns, public transportation stoppages and travel restrictions.3 Strategies to mitigate the COVID-19 impact and maintain or expand access to later abortion care must draw on key innovations, including task-sharing (both provider cadre and facility level), expansion of …