Abortion services during the COVID-19 pandemic: a systematic review.

Evidence suggests that COVID-19 may impair access to sexual and reproductive health services and safe abortion. The purpose of this systematic review was investigating the changes of abortion services in the COVID-19 pandemic era. We searched PubMed, Web of Science and Scopus for relevant studies published as of August 2021, using relevant keywords. RCT and non-original studies were excluded from the analysis and 17 studies of 151 included in our review. Requests to access medication abortion by telemedicine and demand for self-managed abortion were the main findings of identified studies. Women requested an abortion earlier in their pregnancy, and were satisfied with tele-abortion care due to its flexibility, and ongoing telephone support. Presenting telemedicine services without ultrasound has also been reported. Visits to clinics were reduced based on the severity of the restrictions, and abortion clinics had less revenue, more costs, and more changes in the work style of their healthcare providers. Telemedicine was reported safe, effective, acceptable, and empowering for women. Reasons for using tele-abortion were privacy, secrecy, comfort, using modern contraception, employing of women, distance from clinics, travel restrictions, lockdowns, fear of COVID-19, and political reasons (abortion prohibition). Complications of women using tele-abortion were pain, lack of psychological support, bleeding, and need to blood transfusions. The results of this study showed that using telemedicine and teleconsultations for medical abortion in the pandemic conditions may be extended after pandemic. Findings can be used by reproductive healthcare providers and policy makers to address the complications of abortion services.Trail registration This study is registered in PROSPERO with number CRD42021279042.

COVID-19 pandemic shocks the international community, especially health policymakers around the world. The most important consequence of this outbreak has been direct and indirect impacts on health service provisions in all parts of the health system, including sexual and reproductive health services. We reviewed numerous studies investigating healthcare related to abortion in the pandemic era that showed women had more requests to access medical abortion, more than surgical. They preferred self-managed abortion process by telemedicine. Presenting telemedicine services without ultrasound has also been reported. Visits to clinics were reduced, and this decrease was reported based on the severity of the restrictions. Abortion clinics had reduced revenue, increased costs, and changed work style of their healthcare providers. Reasons for using telemedicine were fear of COVID-19, travel restrictions, lockdowns, more privacy, secrecy, and comfort. Telemedicine was reported safe, effective, acceptable, satisfying, and empowering for women. Maternal complications using tele-abortion were pain, bleeding, and need to blood transfusions. These findings can be used by policy makers and reproductive healthcare providers to address the complications of abortion management.

Impact of COVID-19 on mental health of infertile couple: A rapid systematic review.

Infertile couples experience a lot of psychological stress due to the inability to achieve the desired social role. Couples who decide to continue assisted reproductive therapy (ART) during the epidemic also experience the psychological impact of the COVID-19 epidemic, which affects their daily lives due to social isolation, quarantine, travel restrictions, and cancellation of treatment. Therefore, the purpose of this study was to assess the mental health of infertile couple pausing or delaying their treatment due to the COVID-19 pandemic. PubMed, Scopus, Cochrane, Embase, Web of Science, ScienceDirect, Google Scholar, Research Gate, and the World Health Organization databases and websites were systematically searched for original studies concerning abortion in the era of COVID-19 pandemic published by August 15, 2021. We used the following keywords: "COVID-19 Corona virus, infertility, reproductive technique, fertilization, assisted reproduction, pregnant termination, psychological, in vitro mental status, depressive symptoms, and anxiety." In sum, after automatically and manually search and excluding duplicates, 269 articles were found. In final, after screening, 18 articles were selected. Most patients experienced negative emotions during the COVID-19 epidemic. When reproductive services were re-established, participants showed higher levels of anxiety and lower quality of life than before quarantine. Women who thought pregnancy was more important than getting COVID-19 had higher levels of anxiety than women who thought otherwise (P < 0.05). The COVID-19 pandemic has negative impacts on the mental health and quality of life of patients seeking fertility services and coping with it requires timely and appropriate psychological intervention, accurate information, and social and organizational support.

Trying to Control the Situation: A Theory of Iranian Midwives' Experiences of the Coping Process with their Professional Roles Following COVID-19.

Background: Midwives are at the frontlines of the fight against the Coronavirus Disease (COVID-19) pandemic. Working under these circumstances threatens their lives and that of their family members; midwives' adjustment to work increases their efficiency in providing care services to pregnant mothers, but midwives' coping process is ambiguous and complex. Thus, the aim of this study was to explore the coping process of midwives with their professional roles following COVID-19. Materials and Methods: This study was conducted using grounded theory during 2020 to 2021. For this purpose, 30 midwives were purposively and theoretically selected from two educational hospitals and health centers in Mashhad and Torbat Heydarieh cities, Iran. The data were collected using in-depth semi-structured interviews. The collected data were analyzed using the Strauss and Corbin method (2008) in MAXQDA software. Results: The main concern of the participants was "perception of the threats to their health" and the core category revealed from the data was "trying to control the situation." Midwives coped with the COVID-19 pandemic in four steps, namely early initial confrontation, reaction to the COVID-19 pandemic, management of challenges, and reconstructing. Support from family and the health system and religious belief were the interventional conditions in this theory. Conclusions: Results of this study can be used to provide health managers with a better understanding of the conditions affecting the coping strategies of midwives with their professional roles during COVID-19. Therefore, this study provides the required data for developing an effective intervention to help nurse midwives to cope with this issue.

Novel coronavirus disease 2019 and perinatal outcomes.

BACKGROUND AND AIM: Given the prevalence of novel coronavirus disease 2019 (COVID-19) and the lack of information on coronavirus and pregnancy, the purpose of this study was to evaluate the association of COVID-19 and perinatal outcomes in pregnant women. MATERIALS AND METHODS: In the present review article, the search process was conducted on English and Persian scientific databases of PubMed, Scopus, Google Scholar, Magiran, Irandoc, Iranmedx, and SID as well as the websites of international organizations of World Health Organization and Centers for Disease Control and Prevention using the main keywords of "Pregnancy," "Perinatal outcomes," "Coronavirus," "COVID-19," "MERS-CoV," "MERS," "SARS-CoV-2," and "SARS-CoV-1" and their Persian-equivalent keywords from inception until March 16 2020. RESULTS: The findings of studies on mothers with COVID-19 were limited, and insufficient information is available on the adverse pregnancy outcomes in pregnant women with COVID-19. In cases of infection with other coronaviruses such as Middle East respiratory syndrome and severe acute respiratory syndrome during pregnancy, there have been reports on adverse pregnancy outcomes such as miscarriage, stillbirth, preterm labor, low birth weight, and congenital malformations following high fever in the first trimester. CONCLUSION: Pregnant women may be more susceptible to viral respiratory infections, including COVID-19, due to immunological and physiological changes. Therefore, pregnant women should take routine preventive measures, such as washing their hands frequently and avoiding contact with infected people, to prevent infection.