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      The impact of mandatory waiting periods on abortion-related outcomes: a synthesis of legal and health evidence

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          Abstract

          This review follows an established methodology for integrating human rights to address knowledge gaps related to the health and non-health outcomes of mandatory waiting periods (MWPs) for access to abortion. MWP is a requirement imposed by law, policy, or practice, to wait a specified amount of time between requesting and receiving abortion care. Recognizing that MWPs “demean[] women as competent decision-makers”, the World Health Organization recommends against MWPs. International human rights bodies have similarly encouraged states to repeal and not to introduce MWPs, which they recognize as operating as barriers to accessing sexual and reproductive healthcare. This review of 34 studies published between 2010 and 2021, together with international human rights law, establishes the health and non-health harms of MWPs for people seeking abortion, including delayed abortion, opportunity costs, and disproportionate impact. Impacts on abortion providers include increased workloads and system costs.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s12889-022-13620-z.

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          GRADE Evidence to Decision (EtD) frameworks: a systematic and transparent approach to making well informed healthcare choices. 1: Introduction

          Pablo Alonso-Coello, Holger Schünemann, Jenny Moberg … (2016)
          Article 0 comments Cited 230 times – based on 0 reviews     Review now
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            Implications of a complexity perspective for systematic reviews and guideline development in health decision making

            Mark Petticrew, Cécile Knai, James Thomas … (2019)
            There is growing interest in the potential for complex systems perspectives in evaluation. This reflects a move away from interest in linear chains of cause-and-effect, towards considering health as an outcome of interlinked elements within a connected whole. Although systems-based approaches have a long history, their concrete implications for health decisions are still being assessed. Similarly, the implications of systems perspectives for the conduct of systematic reviews require further consideration. Such reviews underpin decisions about the implementation of effective interventions, and are a crucial part of the development of guidelines. Although they are tried and tested as a means of synthesising evidence on the effectiveness of interventions, their applicability to the synthesis of evidence about complex interventions and complex systems requires further investigation. This paper, one of a series of papers commissioned by the WHO, sets out the concrete methodological implications of a complexity perspective for the conduct of systematic reviews. It focuses on how review questions can be framed within a complexity perspective, and on the implications for the evidence that is reviewed. It proposes criteria which can be used to determine whether or not a complexity perspective will add value to a review or an evidence-based guideline, and describes how to operationalise key aspects of complexity as concrete research questions. Finally, it shows how these questions map onto specific types of evidence, with a focus on the role of qualitative and quantitative evidence, and other types of information.
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              Attitudes and Decision Making Among Women Seeking Abortions at One U.S. Clinic

              Diana Foster, Heather Gould, Jessica Taylor … (2012)
              Various restrictions on abortion have been imposed under the pretense that women may be uninformed, undecided or coerced in regard to their decision to terminate a pregnancy. Understanding whether certain women are at risk of low confidence in their abortion decision is useful for providing client-centered care and allocating counseling time to women with the greatest needs.
              Article 0 comments Cited 28 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Fiona de Londras: f.delondras@bham.ac.uk
                Journal
                Journal ID (nlm-ta): BMC Public Health
                Journal ID (iso-abbrev): BMC Public Health
                Title: BMC Public Health
                Publisher: BioMed Central (London )
                ISSN (Electronic): 1471-2458
                Publication date (Electronic): 21 June 2022
                Publication date PMC-release: 21 June 2022
                Publication date Collection: 2022
                Volume: 22
                Electronic Location Identifier: 1232
                Affiliations
                [1 ]GRID grid.6572.6, ISNI 0000 0004 1936 7486, Birmingham Law School, University of Birmingham (UK), ; B15 2TT, Birmingham, UK
                [2 ]GRID grid.4714.6, ISNI 0000 0004 1937 0626, Women’s and Children’s Health, Karolinska Institute, ; Stockholm, Sweden
                [3 ]GRID grid.3575.4, ISNI 0000000121633745, Department of Sexual and Reproductive Health and Research, , UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, ; Geneva, Switzerland
                [4 ]GRID grid.5288.7, ISNI 0000 0000 9758 5690, Department of Obstetrics and Gynecology, , Oregon Health and Science University, ; Portland, OR USA
                [5 ]GRID grid.5685.e, ISNI 0000 0004 1936 9668, York Law School, University of York (UK), ; York, UK
                Article
                Publisher ID: 13620
                DOI: 10.1186/s12889-022-13620-z
                PMC ID: 9210763
                PubMed ID: 35725439
                SO-VID: b2127ce9-8a3c-47ea-b291-d79bbd50ab6c
                Copyright © © The Author(s) 2022
                License:

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                Date received : 17 February 2022
                Date accepted : 9 June 2022
                Categories
                Subject: Research
                Custom metadata
                issue-copyright-statement © The Author(s) 2022

                ScienceOpen disciplines: Public health
                Keywords: abortion,mandatory waiting periods,cooling off periods,reflection periods,reproductive rights,sexual and reproductive health
                Data availability:
                ScienceOpen disciplines: Public health
                Keywords: abortion, mandatory waiting periods, cooling off periods, reflection periods, reproductive rights, sexual and reproductive health

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