Influences on Where, when, and How Women Terminate a Pregnancy in Sub-Saharan African and Latin American Countries Where Abortion Is Highly Legally Restricted: A Systematic Review

Mara Steinhaus, International Center for Research on Women
Laura Hinson, International Center for Research on Women
Suzanne Bell, Johns Hopkins Bloomberg School of Public Health
Claire Twose, Welch Medical Library, Johns Hopkins School of Medicine, Baltimore, MD
Meroji Sebany, International Center for Research on Women
Chimaraoke Izugbara, International Center for Research on Women

With increasing availability of medication abortion drugs throughout the world, a safer option exists for many women to terminate a pregnancy. However, more than 22,000 women still die each year from complications of unsafe abortion, most often in developing countries where abortion is highly legally restricted. Evidence regarding factors influencing women’s decision making around abortion and what barriers restrict some women’s use of safer termination methods is lacking. This systematic review will provide important insight regarding the factors that influence women’s termination processes in countries where abortion is highly legally restricted in Latin America and the Caribbean and sub-Saharan Africa. Understanding what aspects of available abortion options women prioritize in determining where, when, and how to terminate can enable stakeholders to better meet women’s abortion needs to the full limit of the law and ensure access to safer options within a harm reduction framework for abortions obtained outside legal indications.