The UK government caused confusion this week when it first announced that women would temporarily be allowed to access early medical abortion at home, rather than attending a clinic — and then, hours later, reversed its decision.

Abortions are still allowed in Texas during this time if they are “medically necessary to preserve the life or health of the mother,” a press release from the state’s attorney general said.

In Ohio, the deputy attorney general sent letters last Friday and Saturday to three abortion providers, directing them to comply with the state health director’s executive order to stop performing non-essential procedures to preserve protective supplies.

The governor of Mississippi said he would take action if the state’s single clinic was providing elective abortions after the state health department required that non-essential surgery be postponed.

More than 5,000 miles away, in Italy’s worst-affected region, Lombardy, some struggling hospitals have closed their abortion services and are sending women to other hospitals for care, the head of a gynecologists’ association that supports abortion rights told CNN.

The move has greatly complicated abortion access for women in those areas, said Dr. Silvana Agatone, president of LAIGA.

Although abortions are considered urgent medical interventions, under Italian law each region is allowed to handle the provision as it sees fit, Agatone said. Her group had not yet been able to speak with the health minister about a national response, she added.

The Italian health ministry has not yet responded to CNN’s request for comment.

Meanwhile, two abortion rights advocate groups in Germany have warned that women’s health and lives are being put at risk as restrictions on movement and counseling center closures limit their access to abortion services.

UK reversal

Abortion providers pressed the UK government Wednesday to rethink its position.

The UK Department of Health and Social Care had told abortion providers Monday that women seeking an abortion in the first trimester of pregnancy could take both pills needed for a termination at home rather than having to go to a clinic to take the first one.

The British Pregnancy Advisory Service (BPAS), a charity which helps nearly 100,000 women a year with pregnancy counseling and abortion care, welcomed the step at a time when UK citizens have been largely banned from leaving their homes to help prevent the virus’ spread.

But within hours, the government rolled back the change outlined in the letter sent to abortion providers, BPAS said, and the new guidance was removed from the government’s website.

Asked about the issue Tuesday in the House of Commons, Health Secretary Matt Hancock said: “We have no proposals to change any abortion rules as part of the Covid-19 response.”

BPAS’ chief executive, Ann Furedi, tweeted her consternation at what she labeled a U-turn, saying the new measures were needed to keep legal abortion available as Britain responds to the coronavirus threat.

“Dozens of clinic staff are sick or self-isolating. This is no time to play politics with abortion. Let us provide safe care,” she said. Her tweet included an image of the letter sent to abortion providers Monday.

BPAS said Wednesday that nearly a quarter of its clinics were now closed due to staff sickness and isolation measures.

“In the next 13 weeks as the pandemic reaches its peak, at least 44,000 women will have to leave their homes needlessly to access care,” it said in a statement. “Women with severe health issues who have been told to self-isolate say they are being forced to choose between risking their health by leaving their house and being compelled to continue an unwanted pregnancy that also threatens their health.”

Marie Stopes International, another abortion provider in the UK and elsewhere, also condemned the government’s reversal of its decision to allow women to access early medical abortion from home, saying it was “cruel, irresponsible, and puts lives in danger.”

Opposition Labour MPs Stella Creasy and Diana Johnson backed the organizations’ call for the government to think again.

The Department of Health and Social Care did not immediately respond to CNN’s request for comment. UK media reports quoted the department as saying the announcement of the policy change had been published in error.

‘Acute risk’

Meanwhile, abortions are still happening in Germany, according to CNN’s German affiliate RTL, but women face delays in accessing counseling centers — a requirement there before terminating a pregnancy.

Groups including abortion rights advocate organizations Pro Familia and Doctors for Choice wrote an open letter Sunday to doctors performing abortions in which they warned that “access to abortions is now at acute risk” because of the restrictions imposed to help contain the pandemic.

Closures or reduced opening hours for counseling centers have led to serious delays for women seeking the required in-person counseling appointment before any abortion takes place, the letter warns. They may also struggle to get to clinics providing abortions because of travel restrictions.

These issues mean that women may no longer meet the legal deadline by which a legal termination is permitted, the letter states, and increases the risk that women will resort to “unsafe abortion methods.”

The abortion rights advocate organizations urge federal and state governments and health insurers to make it possible for all women to seek advice by video or telephone, rather than having to attend counseling appointments in person.

CNN has reached out to the German government for comment.

France commits to access

Officials in France and Spain have sought to reassure women that their reproductive healthcare rights will be protected.

The head of France’s national health agency, Jérôme Salomon, last week insisted that the country’s abortion centers would remain open during the crisis despite tight restrictions on people’s movements.

Salomon again stressed France’s commitment to ensuring women retain access to vital services during the country’s lockdown in a news conference on Tuesday.

“We want to uphold women’s sexual and reproductive rights. Access to the contraceptive pill will be maintained. Medical monitoring for pregnancies must continue to be ensured, including the three necessary ultrasound scans. We are exploring the possibilities of doing this through video calls,” he said.

In Spain, the Association of Clinics Accredited for the Voluntary Interruption of Pregnancy tweeted that its clinics remained open because abortion is part of the country’s national health provision. “It’s an urgent resource which cannot be postponed and should be attended to promptly,” the association said.

Other abortion clinics in Spain also tweeted that they were continuing their work.

CNN’s Benjamin Berteau, Ingrid Formanek and Caroline Kelly contributed to this report.

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