Abortion metrics: a scoping review of abortion measures and indicators

Consensus is lacking on the most appropriate indicators to document progress in safe abortion at programmatic and country level. We conducted a scoping review to provide an extensive summary of abortion indicators used over 10 years (2008–2018) to inform the debate on how progress in the provision and access to abortion care can be best captured. Documents were identified in PubMed and Popline and supplemented by materials identified on major non-governmental organisation websites. We screened 1999 abstracts and seven additional relevant documents. Ultimately, we extracted information on 792 indicators from 142 documents. Using a conceptual framework developed inductively, we grouped indicators into seven domains (social and policy context, abortion access and availability, abortion prevalence and incidence, abortion care, abortion outcomes, abortion impact and characteristics of women) and 40 subdomains. Indicators of access and availability and of the provision of abortion care were the most common. Indicators of outcomes were fewer and focused on physical health, with few measures of psychological well-being and no measures of quality of life or functioning. Similarly, there were few indicators attempting to measure the context, including beliefs and social attitudes at the population level. Most indicators used special studies either in facilities or at population level. The list of indicators (in online supplemental appendix) is an extensive resource for the design of monitoring and evaluation plans of abortion programmes. The large number indicators, many specific to one source only and with similar concepts measured in a multitude of ways, suggest the need for standardisation.

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Economics of abortion: a scoping review protocol

BMJ Open ◽

10.1136/bmjopen-2019-029939 ◽

2019 ◽

Vol 9 (7) ◽

pp. e029939 ◽

Cited By ~ 1

Author(s):

Ernestina Coast ◽

Samantha R Lattof ◽

Yana van der Meulen Rodgers ◽

Brittany Moore

Keyword(s):

Scoping Review ◽

Economic Outcomes ◽

Primary Data ◽

Science Literature ◽

Safe Abortion ◽

Economic Implications ◽

Abortion Care ◽

Scoping Reviews ◽

The Impact ◽

Analytical Approaches

IntroductionAbortion is a common feature of people’s reproductive lives. However, the economic implications of abortion and policies affecting abortion provision are poorly understood. This scoping review aims to systematically review social science literature for studies that have investigated the impact of abortion care (ie, un/safe abortion, post-abortion care) or abortion policies on economic outcomes at the micro-levels (ie, abortion seekers and their households), meso-levels (ie, communities and health systems) and macro-levels (ie, societies and nation states). Informed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guideline for protocols, this protocol details the scoping review’s methodological and analytical approaches.Methods and analysisThis scoping review will utilise the PRISMA extension for Scoping Reviews (PRISMA-ScR) tool. Studies reporting on qualitative and/or quantitative data from any world region will be considered. For inclusion, studies must examine one of the following economic outcomes at the micro-levels, meso-levels and/or macro-levels: costs, benefits, impacts and/or value of abortion care or abortion policies. Searches will be conducted in eight electronic databases. We will conduct the searches and application of inclusion/exclusion criteria according to the PRISMA-ScR flow approach. No assessments of items’ quality will be made, as the purpose of this scoping review is to synthesise and describe the coverage of the evidence. After extracting all data, we will inductively develop an economic framework around the economics of abortion. The analysis will synthesise the evidence base and identify knowledge gaps on the costs and benefits of abortion to stakeholders at various levels.Ethics and disseminationFormal ethical approval is not required, as primary data will not be collected in this study. The findings of this study will be disseminated through peer-reviewed publications, conference presentations, and condensed summaries for key stakeholders and partners in the field.

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History and scientific background on the economics of abortion

PLoS ONE ◽

10.1371/journal.pone.0257360 ◽

2021 ◽

Vol 16 (9) ◽

pp. e0257360

Author(s):

Brittany Moore ◽

Yana van der Meulen Rodgers ◽

Ernestina Coast ◽

Samantha R. Lattof ◽

Cheri Poss

Keyword(s):

Scoping Review ◽

Evidence Base ◽

Economic Outcomes ◽

Secondary Outcome ◽

Care Seeking ◽

Safe Abortion ◽

World Region ◽

Abortion Care ◽

Scientific Background ◽

Scoping Reviews

Background Approximately one quarter of all pregnancies globally end in abortion, making it one of the most common gynecological practices worldwide. Despite the high incidence of abortion around the globe, the synthesis of known economic outcomes of abortion care and policies is lacking. Using data from a systematic scoping review, we synthesized the literature on the economics of abortion at the microeconomic, mesoeconomic, and mesoeconomic levels and presented the results in a collection of studies. This article describes the history and scientific background for collection, presents the scoping review framework, and discusses the value of this knowledge base. Methods and findings We conducted a scoping review using the PRISMA extension for Scoping Reviews. Studies reporting on qualitative and/or quantitative data from any world region were considered. For inclusion, studies must have examined one of the following outcomes: costs, impacts, benefits, and/or value of abortion-related care or policies. Our searches yielded 19,653 unique items, of which 365 items were included in our final inventory. Studies most often reported costs (n = 262), followed by impacts (n = 140), benefits (n = 58), and values (n = 40). Approximately one quarter (89/365) of studies contained information on the secondary outcome on stigma. Economic factors can lead to a delay in abortion care-seeking and can restrict health systems from adequately meeting the demand for abortion services. Provision of post-abortion care (PAC) services requires more resources then safe abortion services. Lack of insurance or public funding for abortion services can increase the cost of services and the overall economic impact on individuals both seeking and providing care. Conclusions Consistent economic themes emerge from research on abortion, though evidence gaps remain that need to be addressed through more standardized methods and consideration to framing of abortion issues in economics terms. Given the highly charged political nature of abortion around the world, it is imperative that researchers continue to build the evidence base on economic outcomes of abortion services and regulations.

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The Stratified Legitimacy of Abortions

Journal of Health and Social Behavior ◽

10.1177/0022146516669970 ◽

2016 ◽

Vol 57 (4) ◽

pp. 503-516 ◽

Cited By ~ 13

Author(s):

Katrina Kimport ◽

Tracy A. Weitz ◽

Lori Freedman

Keyword(s):

United States ◽

The United States ◽

Safe Abortion ◽

Private Practices ◽

Abortion Care ◽

Unequal Access ◽

Abortion Access ◽

Roe V Wade

Roe v. Wade was heralded as an end to unequal access to abortion care in the United States. However, today, despite being common and safe, abortion is performed only selectively in hospitals and private practices. Drawing on 61 interviews with obstetrician-gynecologists in these settings, we examine how they determine which abortions to perform. We find that they distinguish between more and less legitimate abortions, producing a narrative of stratified legitimacy that privileges abortions for intended pregnancies, when the fetus is unhealthy, and when women perform normative gendered sexuality, including distress about the abortion, guilt about failure to contracept, and desire for motherhood. This stratified legitimacy can perpetuate socially-inflected inequality of access and normative gendered sexuality. Additionally, we argue that the practice by physicians of distinguishing among abortions can legitimate legislative practices that regulate and restrict some kinds of abortion, further constraining abortion access.

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Trends of Abortion Care Utilization in a Medical College of Western Region of Nepal

Journal of Gandaki Medical College-Nepal ◽

10.3126/jgmcn.v11i1.20788 ◽

2018 ◽

Vol 11 (1) ◽

pp. 14-16 ◽

Cited By ~ 2

Author(s):

R Shrestha ◽

P Adhikari

Keyword(s):

College Teaching ◽

Well Being ◽

Care Utilization ◽

Western Region ◽

Age Group ◽

Safe Abortion ◽

Medical College ◽

Abortion Care ◽

Vacuum Aspiration ◽

Health And Well Being

Introduction: Unsafe abortion is one of the important issues in reproductive and women’s health in developing countries. Social values and stigmas have much role and have been obstacle in countries like Nepal for the utilization of safe abortion services.Objectives: This study helps to provide brief overview of the pattern of abortion and its associated factors in a centre providing safe abortion services.Methods: This is a retrospective study carried out in Gandaki Medical College Teaching Hospital after reviewing the records of all the women who underwent Manual Vacuum Aspiration (MVA). Age, gravida, week of gestation and type of abortion were noted and analysed.Results: Maximum number of women belonged to age group of 25-29 and is primigravida. Most of them presented at fifth to ninth weeks of gestation and had incomplete abortion.Conclusions: Awareness and education regarding the availability of safe abortion services and its practice would improve the women’s reproductive health and well being. J-GMC-N | Volume 11 | Issue 01 | January-June 2018, Page: 14-16

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Maternal Health in Crisis: A Scoping Review of Barriers and Facilitators to Safe Abortion Care in Humanitarian Crises

Frontiers in Global Women's Health ◽

10.3389/fgwh.2021.699121 ◽

2021 ◽

Vol 2 ◽

Author(s):

Bianca Dias Amaral ◽

Dikaios Sakellariou

Keyword(s):

Scoping Review ◽

Unwanted Pregnancy ◽

Barriers And Facilitators ◽

Unsafe Abortion ◽

Humanitarian Law ◽

Humanitarian Crisis ◽

Safe Abortion ◽

Abortion Care ◽

Humanitarian Crises ◽

Published Research

During humanitarian crises, women are particularly vulnerable to unwanted pregnancy. Unsafe abortion is among the five leading causes of maternal mortality and it is the only one which is entirely preventable. This study aimed to identify the barriers and facilitators to the provision of safe abortion care by humanitarian organisations. We performed a scoping review of the literature in July 2020, covering the years 2010–2020, on the following databases: Medline, Global Health, CINAHL Plus and ReliefWeb. We critically appraised all included articles and we conducted a narrative synthesis of the findings. We retrieved 881 articles. After removing duplicates and excluding articles that did not meet the inclusion criteria, twenty-four articles published between 2015 and 2020 were included in the review. Nine of the included papers were non-research practise items. The findings revealed five main themes: legal environment; context; stigma; economic factors; and service delivery. Restrictive laws, stigma, and lack of funding were reported as the main barriers to safe abortion, while the main facilitators were the fact that abortion is permitted under some circumstances in most countries, humanitarian actors' ability to inform healthcare policies at the onset of a humanitarian crisis, and community engagement. This scoping review revealed a dearth of published research. Increased dissemination of studies on Termination of Pregnancy (ToP) could increase the visibility of unsafe abortion and the need to provide ToP in humanitarian settings. Moreover, humanitarian organisations need to have a clear protocol on safe abortion and an in-depth understanding of relevant legislation, including the International Humanitarian Law, in order to provide this service to the full extent of the law.

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Guidelines and best practice recommendations on contraception and safe abortion care service provision amid COVID-19 pandemic: Scoping review.

10.21203/rs.3.rs-25326/v1 ◽

2020 ◽

Author(s):

Lemi Belay Tolu ◽

Garumma Tolu Feyissa

Keyword(s):

Reproductive Health ◽

Scoping Review ◽

Service Provision ◽

Care Service ◽

Data Extraction ◽

Assessment Tools ◽

Safe Abortion ◽

Practice Recommendations ◽

Abortion Care ◽

Consensus Statements

Abstract Introduction: During pandemics there is uncertainty and information overload. Policy makers and health professionals prefer to use summarized evidence of practice recommendations. The aim of this scoping review is therefore to identify available best guidelines, consensus statements, standard of practice and practice recommendations on contraception and safe abortion care service provision during the COVID-19 pandemics.Methods: We searched guideline databases and websites of professional associations and international organizations working on sexual and reproductive health to locate guidelines, protocols, consensus statements and practice recommendations on sexual reproductive health services (SRH) during COVID-19 pandemics. Additionally, we searched: MEDLINE, EMBASE and Google Scholar. We included English records labelled guideline, or recommendation, or consensus, or practice parameter, or position papers on contraception and safe abortion care service practice during the COVID-19 pandemics. Data extraction was done by two independent reviewers using a customized tool that was developed to record the key information of the source that’s relevant to the review question. The difference between the two authors on data extraction was resolved by discussion.Results: Eleven records on safe abortion care and nine records on contraception service were identified. Identified recommendations were categorized into thematic areas. The records addressed approaches to the safe medication and surgical abortion, self-serving family planning and long term and reversible contraception. We haven’t employed any of the quality assessment tools as the pandemic is new clinical entity and evidences are based on expert opinion and limited clinical evidence.Conclusions: Consensus statements and recommendations consistently stated that there should be access to contraception service and safe abortion care during the COVID-19 pandemics with the concerted effort of service re-organization. The practice recommendations focus on innovative ways of service provision to minimize patient and staff exposure to COVID-19 as well as alleviate the burden on the health care system. These include utilizing telemedicine or digital health and community/home-based care or self-care.

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Supporting the Mental Health and Well-Being of First Responders from Career to Retirement: A Scoping Review

Prehospital and Disaster Medicine ◽

10.1017/s1049023x21000431 ◽

2021 ◽

pp. 1-6

Author(s):

Erin Smith ◽

Greg Dean ◽

Lisa Holmes

Keyword(s):

Mental Health ◽

Scoping Review ◽

Help Seeking ◽

First Responders ◽

Well Being ◽

First Responder ◽

Help Seeking Behaviors ◽

Holistic Approaches ◽

Pubmed Database ◽

Health And Well Being

Abstract Introduction: First responders are at greater risk of mental ill health and compromised well-being compared to the general population. It is important to identify strategies that will be effective in supporting mental health, both during and after the first responder’s career. Methods: A scoping review was conducted using the PubMed database (1966 to October 1, 2020) and the Google Scholar database (October 1, 2020) using relevant search terms, truncation symbols, and Boolean combination functions. The reference lists of all relevant publications were also reviewed to identify further publications. Results: A total of 172 publications were retrieved by the combined search strategies. Of these, 56 met the inclusion criteria and informed the results of this overview paper. These publications identified that strategies supporting first responder mental health and well-being need to break down stigma and build resilience. Normalizing conversations around mental health is integral for increasing help-seeking behaviors, both during a first responder’s career and in retirement. Organizations should consider the implementation of both pre-retirement and post-retirement support strategies to improve mental health and well-being. Conclusion: Strategies for supporting mental health and well-being need to be implemented early in the first responder career and reinforced throughout and into retirement. They should utilize holistic approaches which encourage “reaching in” rather than placing an onus on first responders to “reach out” when they are in crisis.

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Out of tune: Perceptions of, engagement with, and responses to mental health interventions by professional popular musicians—A scoping review

Psychology of Music ◽

10.1177/03057356211019477 ◽

2021 ◽

pp. 030573562110194

Author(s):

Amy Visser ◽

Megan Lee ◽

Timothy Barringham ◽

Nasim Salehi

Keyword(s):

Mental Health ◽

Scoping Review ◽

Distinct Group ◽

Well Being ◽

Health Interventions ◽

Therapeutic Approaches ◽

Increased Risk ◽

Mental Health Interventions ◽

Industry Peers

Professional popular musicians are at increased risk of psychological distress, substance use problems, and suicide, yet little evidence is available on effective psychotherapeutic practices to address these issues. This scoping review aims to understand how professional popular musicians perceive, engage with, and respond to mental health interventions. Four databases were searched, garnering a total of 310 articles. Of these, six met inclusion criteria. Four thematic categories were explored: (1) amenability of professional popular musicians to particular therapeutic approaches; (2) attribution of treatment outcomes to tailored approaches; (3) professional popular musicians’ perceived barriers to treatment; and (4) recommendations for treatment approaches. The scoping review supports the importance of considering the characteristics of professional popular musicians as a distinct group with unique well-being needs, challenges, and strengths. There is a clear preference for tailored, affordable, and accessible approaches that consider the uniquities of musicianship and the need to explore the role of nonclinical support, such as friends, family, and industry peers.

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Understanding the Abortion Experiences of Young People to Inform Quality Care in Argentina, Bangladesh, Ethiopia, and Nigeria

Youth & Society ◽

10.1177/0044118x211011015 ◽

2021 ◽

pp. 0044118X2110110

Author(s):

Laura E. Jacobson ◽

Ana Maria Ramirez ◽

Chiara Bercu ◽

Anna Katz ◽

Caitlin Gerdts ◽

...

Keyword(s):

Young People ◽

Quality Care ◽

First Trimester ◽

Structural Barriers ◽

Structured Interviews ◽

Safe Abortion ◽

Medication Abortion ◽

Abortion Care ◽

The Mean ◽

Reproductive Healthcare

Young people face social and structural barriers when accessing abortions. High-quality, sexual and reproductive healthcare is needed; however, literature on youth-informed abortion services is limited. This study assesses accounts of youth who obtained an abortion in Argentina, Bangladesh, Ethiopia, and Nigeria and provides recommendations to improve person-centered aspects of abortion quality. We analyzed 48 semi-structured interviews with clients recruited from clinics, safe abortion hotlines, and patent and proprietary medicine vendors. We coded transcripts and conducted a thematic analysis. The mean age was 21 years (range 16–24), and the majority had a first trimester, medication abortion. Prominent themes included access to information; privacy; stigma associated with age or marital status; the decision-making process; and comfort and rapport with providers. Youth-centered abortion care should anticipate the distinct needs of younger clients. Supportive providers have an important role in offering a non-judgmental service that makes young clients feel comfortable and prepared.

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Effectiveness of Tai Chi for Health Promotion of Older Adults: A Scoping Review of Meta-Analyses

American Journal of Lifestyle Medicine ◽

10.1177/15598276211001291 ◽

2021 ◽

pp. 155982762110012

Author(s):

Fei-Chi Yang ◽

Aishwarya B. Desai ◽

Pelareh Esfahani ◽

Tatiana V. Sokolovskaya ◽

Doreen J. Bartlett

Keyword(s):

Older Adults ◽

Health Promotion ◽

Health Outcomes ◽

Scoping Review ◽

General Health ◽

Tai Chi ◽

Well Being ◽

Cochrane Library ◽

Care Providers ◽

Meta Analyses

Background. Tai Chi is a form of exercise that is accessible to people from different socioeconomic backgrounds, making it a potentially valuable activity for health promotion of older adults. Purpose. The objective of this scoping review was to summarize the current knowledge about the effectiveness of Tai Chi for older adults across a range of general health outcomes from published, peer reviewed, unique meta-analyses. Methods. Meta-analyses were retrieved from Medline, Embase, AMED, CINAHL, SPORTDiscus, PsychINFO, Web of Science, PubMed Health, and the Cochrane Library from database inception to late August 2019. Multistage deduplication and screening processes identified eligible full-length meta-analyses. Two people independently appraised 27 meta-analyses based on the GRADE system and organized results into 3 appendices subsequently collated into heterogeneous, statistically significant, and statistically insignificant tables. Results. “High” and “moderate” quality evidence extracted from these meta-analyses demonstrated that practicing Tai Chi can significantly improve balance, cardiorespiratory fitness, cognition, mobility, proprioception, sleep, and strength; reduce the incidence of falls and nonfatal stroke; and decrease stroke risk factors. Conclusions. Health care providers can now recommend Tai Chi with high level of certainty for health promotion of older adults across a range of general health outcomes for improvement of overall well-being.

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