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BRUSSELS -- When a 19-year-old woman from southern Poland decided to end her pregnancy at 18 weeks, she knew the only way to get an abortion was to rush to a neighboring European country.

Abortion is illegal in most circumstances in Poland, and so for years, many women have traveled within Europe to seek the procedure.

But it was April, and across the continent, borders were closing because of the coronavirus pandemic. So she and a friend loaded up their Renault with instant noodles and candy for a 14-hour race to Utrecht in the Netherlands. They made it just in time for her to have the procedure and return home, her friend said.

From the world's richest nations to some of its poorest, the pandemic has brought governments and health care systems to their knees. For many women in Europe seeking abortions, the virus added another obstacle in an already complicated and time-sensitive course.

Closing borders made it harder for women in countries with strict abortion regulations, like Poland, to seek the procedure elsewhere.

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And governments in Germany, Austria, Romania, Croatia and Slovakia, trying to tackle the health care demands of the pandemic, did not label abortions as essential, time-sensitive procedures.

Under normal circumstances, a woman in these countries can get an abortion during the first half of a pregnancy. But not including abortions on the essential procedures list meant that hospitals and clinics were free to turn women away. And some did, though they have now reopened or will this month.

But for a time, the continent had "a combination of factors coinciding: Hospital care is restricted, doctors are shutting down services, states are not classifying abortions as an essential service," said Leah Hoctor, the Europe director of the Center for Reproductive Rights, an advocacy group.

She added that governments failed to understand that a woman who needs an abortion needs to have it in a timely manner.

The pandemic also unexpectedly loosened restrictions in a small number of places in Europe.

France; Ireland; and England, Scotland and Wales in Britain all loosened restrictions and permitted at-home abortions with medication administered by prescription and the guidance of a medical professional over the phone or online.

Before the pandemic, medical abortions in these countries were permitted only after an in-person consultation with a doctor, and the medication had to be taken in a clinic, not at home.

Authorities in Britain said allowing at-home medical abortions with remote guidance was a temporary measure. But Hoctor said she hoped the countries that permitted the procedure would not go back to restricting it.

At-home abortions "represent women-centered, evidence-based policy changes," Hoctor said. "The fact that these laws and policies were changed quickly in order to respond to the pandemic demonstrates that it is possible to modernize European countries' abortion laws."

From the outset of the coronavirus outbreak, advocacy groups and the United Nations warned that women's access to reproductive services could be imperiled.

In April, the U.N.'s sexual and reproductive health agency estimated that there could be 7 million unintended pregnancies around the world -- potentially increasing the demand for abortions -- if lockdowns continued for six months and there were disruptions to reproductive services.

"As a corollary, unsafe abortions will increase," Natalia Kanem, executive director of the agency, said in April.

This month, the World Health Organization reiterated the need for governments to maintain access to safe reproductive services.

"Even a 10% reduction in these services could result in an estimated 15 million unintended pregnancies, 3.3 million unsafe abortions and 29,000 additional maternal deaths during the next 12 months," the organization said in a recent report.

Hoctor said that as the coronavirus swept through Europe, demand for abortions rose.

In many European Union countries, abortions are legal and relatively accessible. But there are restrictions in some parts of the region, so women have historically used the continent's open borders to choose providers and legal frameworks that suit them best, a largely unseen byproduct of mobility within Europe.

Advocacy groups and doctors say it's impossible to know how many women have been affected by closing borders, given that records of abortions and who has them are not public.


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