When a deadly virus spreads through a community, routine health care, including reproductive health care, may suffer. 

In North Carolina, the COVID-19 pandemic reshaped how and when residents got abortion care in unexpected ways, new research shows.

A team of University of North Carolina researchers tracked abortions in the state between March 2020, when the World Health Organization declared a global coronavirus pandemic, and December 2021. They specifically evaluated impacts on reproductive health care among Latina patients. 

The resulting peer-reviewed study, published in the Women’s Health Issues journal in December 2025, found that there was no spike in abortion care in the first month of COVID-19 being declared a global pandemic. But as the pandemic continued, the number of abortions began to climb.

“Despite all of the barriers that were in place during the pandemic, people in North Carolina were still able to obtain abortions,” said the paper’s lead author, Marissa Velarde, who is now a post-doctoral research fellow at San Diego State University. “And in fact, the number of abortions increased.”

That increase in abortions, which occurred between April 2020 and December 2021, was more pronounced among Latina-identifying women, who had 6.3 more abortions per month than they did in March 2020. The white women who served as a comparison group for the research saw 4.1 more abortions per month between April 2020 and December 2021. 

The study also found an increase in medication abortion care and a decrease in abortions after the first trimester.

Rewire News Group spoke with Velarde about what the COVID-19 pandemic revealed about abortion access—and how public health officials and policymakers can better prepare for the next public health emergency. 

The following conversation has been edited for length and clarity.

What does the study tell you about why or how patients accessed abortion during the COVID-19 pandemic?

The literature on family planning during the COVID-19 pandemic has indicated that people’s pregnancy intentions really changed due to the economic and social changes happening during COVID-19. And because of that, abortion increased—across the country, really—because people had more financial constraints and their systems of support just weren’t there anymore.

This is particularly true for people who are marginalized. In my study, I really focused on comparing Latina patients to white patients. And you can see that even though abortion was increasing for both white patients and Latina patients, Latina patients saw a much steeper incline. The rate of increase was much greater for Latina patients who received abortions in North Carolina.

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To what do you attribute that difference?

Prior research has indicated that women of color and people of color, in general, were impacted by the pandemic much greater than white, affluent patients. There are a number of reasons for that. One of them, for example, is that Latinas are more likely to work in service industry jobs. So they were more affected by the pandemic because they didn’t have work. 

So I think that’s one of the reasons for the steeper increase. …

At the beginning, we all thought we would be home for a couple of weeks. We didn’t think we’d be home for months, or for some people, even a year.

I think women started to realize that they had to deal with their impending [economic] situation. A lot of women didn’t have the economic or financial means to continue their pregnancies, so there was an increase in abortions. 

I also compared procedural and medication abortions. There was a huge jump in medication abortions(Editor’s note: Velarde’s research found that 64 percent of pandemic-era North Carolina abortions used medication, up from 43 percent pre-pandemic.) … That’s another reason for the increase. Health facilities were able to see a lot more patients [for medication abortion] than they normally were able to before the COVID-19 pandemic. 

You also saw a drop in abortions that occurred after the first trimester. What do you think explains that decrease?

There are a couple of factors at play here. 

Patients were able to make their decisions a lot faster during the pandemic. Before the pandemic, a patient might have taken their time trying to decide whether or not they wanted to have an abortion. But because of the precarity of COVID-19, it seems that patients were much more eager to make a decision because they felt [they were] in a place of instability. 

And on top of that, they were able to have their abortions earlier, as indicated by the huge increase in medication abortions.

The second piece to that is that there’s a specific demographic that is often associated with abortions in later pregnancy—and that’s adolescents. We saw that there was a decrease in adolescent abortions in general. … 

That is because their social lives surround school. And because of the pandemic stay-at-home order, [teens] weren’t having social lives. They weren’t convening with friends. And so they weren’t getting pregnant. And I think that was another driver of the decrease in the proportion of abortions after the first trimester. 

What can your research teach us about abortion care during pandemics?

We absolutely have to consider abortion an essential health service. … In North Carolina, you still cannot have medication abortion dispensed remotely. You have to come in person to do it. I do think that there is a need to eliminate that stipulation. 

There are states that [allow for telehealth abortion] and patients can keep themselves safe. And health-care providers don’t have to interact with more people, thereby keeping themselves and future patients safer from viral illnesses. 

Is there anything else important for RNG readers to know?

My study was before Dobbs v. Jackson Women’s Health Organization came down. And I do think if we were to have [another] pandemic, that intersection of pandemic with Dobbs could potentially have devastating effects on access to abortion.

[That] further amplifies the need for telehealth, for medication abortion, and … [for] shield laws for providers who continue to provide medication abortion for patients that are in ban states. 

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