Women’s Awareness and Knowledge of Abortion Laws: A Systematic Review

Abstract

BackgroundIncorrect knowledge of laws may affect how women enter the health system or seek services, and it likely contributes to the disconnect between official laws and practical applications of the laws that influence women’s access to safe, legal abortion services.ObjectiveTo provide a synthesis of evidence of women’s awareness and knowledge of the legal status of abortion in their country, and the accuracy of women’s knowledge on specific legal grounds and restrictions outlined in a country’s abortion law.MethodsA systematic search was carried for articles published between 1980–2015. Quantitative, mixed-method data collection, and objectives related to women’s awareness or knowledge of the abortion law was included. Full texts were assessed, and data extraction done by a single reviewer. Final inclusion for analysis was assessed by two reviewers. The results were synthesised into tables, using narrative synthesis.ResultsOf the original 3,126 articles, and 16 hand searched citations, 24 studies were included for analysis. Women’s correct general awareness and knowledge of the legal status was less than 50% in nine studies. In six studies, knowledge of legalization/liberalisation ranged between 32.3% - 68.2%. Correct knowledge of abortion on the grounds of rape ranged from 12.8% – 98%, while in the case of incest, ranged from 9.8% - 64.5%. Abortion on the grounds of fetal impairment and gestational limits, varied widely from 7% - 94% and 0% - 89.5% respectively.ConclusionThis systematic review synthesizes literature on women’s awareness and knowledge of the abortion law in their own context. The findings show that correct general awareness and knowledge of the abortion law and legal grounds and restrictions amongst women was limited, even in countries where the laws were liberal. Thus, interventions to disseminate accurate information on the legal context are necessary.

Access to knowledge and the Global Abortion Policies Database

“…This knowledge gap influences how women enter the health system and whether they can successfully navigate its bureaucratic measures, including in countries with permissive laws. Findings from a systematic review confirm women's general low knowledge, but also show important inequalities in knowledge based on geography, wealth, and education. In the USA, low‐income first‐generation immigrants and Spanish speakers are significantly less likely to have correct knowledge of gestational age limits and parental or partner consent laws .…”

Is abortion justified to save the life or health of a woman? Evidence of public opinion from Accra, Ghana

“…Previous research suggests that many Ghanaians are unaware of the abortion laws in Ghana and are not clear on whether abortion is legal or illegal . In fact, in one assessment, Ghanaian women had the lowest correct level of general awareness and knowledge of abortion laws when compared across countries .…”

Setting the research agenda for induced abortion in Africa and Asia

“…Many research gaps were identified in factors that affect women's induced‐abortion care‐seeking behaviors. For example, even in less‐restrictive contexts, knowledge of the legal grounds under which an induced abortion can be obtained and where induced abortion services (including medical abortion) can be safely obtained can be very incomplete . Family members' lack of support can limit women's choices, and gender inequality—in addition to cultural stigma—may restrict access to available abortion services .…”