PICO: P = population; I = intervention; C = comparator (where applicable*); O = outcome(s)^[1] 

* Where a comparator is available, these data have been included, but very few studies that report on abortion-related policy interventions include a comparator of any kind.

Abortion regulation

Criminalization

PICO 1: The impact of criminalization (see Recommendation 1)

PICO question: For pregnant people seeking abortion and also for medical professionals providing abortion services, what is the impact of criminalization on delayed abortion, continuation of pregnancy, opportunity costs (including psychological opportunity costs), unlawful abortion, self-managed abortion, referral to another provider, workload implications (including reassignment, issues with organization of work, as well as increases or decreases in workload), system costs (includes direct system costs, and “diversions” from public health systems to paid-for services/private fees), perceived impact on provider–client relationship, stigmatization of health-care providers (considering the application of the intervention), criminal justice procedures, harassment, anti-abortion sting operations, availability of trained providers, reporting of suspected unlawful abortion?

P: Pregnant people seeking abortion; medical professionals providing abortion services
I: Criminalization
C: None (studies do not need to specify comparator)
O:^[2] 

• Delayed abortion
• Continuation of pregnancy
• Opportunity costs (includes psychological opportunity costs)
• Unlawful abortion
• Self-managed abortion
• Referral to another provider
• Workload implications (including reassignment issues with organization of work, as well as increases or decreases in workload)
• System costs (includes direct system costs, and “diversions” from public health systems to paid-for services/private fees)
• Perceived impact on provider–client relationship
• Stigmatization of health-care providers (considering the application of the intervention)
• Criminal justice procedures
• Harassment
• Anti-abortion sting operations
• Availability of trained providers
• Reporting of suspected unlawful abortion.

Grounds-based approaches

PICO 2: The impact of grounds-based approaches (see Recommendation 2)

PICO question: For pregnant people seeking abortion and also for medical professionals providing abortion services, what is the impact of grounds-based approaches (that limit access to and/or provision of abortion on “grounds” or that prohibit access to abortion) on delayed abortion, continuation of pregnancy, opportunity costs (including psychological opportunity costs), unlawful abortion, self-managed abortion, anticipated or experienced family disharmony, anticipated or experienced exposure to interpersonal violence or exploitation, anticipated or experienced reproductive coercion, disproportionate impact, referral to another provider, workload implications (including reassignment, issues with organization of work, as well as increases or decreases in workload), perceived imposition on personal conscience or ethics, perceived impact on provider–client relationship, system costs (includes direct system costs, and “diversions” from public health systems to paid-for services/private fees), stigmatization of health-care providers (considering the application of the intervention)?

P: Pregnant people seeking abortion; medical professionals providing abortion services
I: Grounds-based approaches (that limit access to and/or provision of abortion on “grounds” or that prohibit access to abortion)
C: None (studies do not need to specify comparator)
O:

• Delayed abortion
• Continuation of pregnancy
• Opportunity costs (includes psychological opportunity costs)
• Unlawful abortion
• Self-managed abortion
• Anticipated or experienced family disharmony
• Anticipated or experienced exposure to interpersonal violence or exploitation
• Anticipated or experienced reproductive coercion
• Disproportionate impact
• Referral to another provider
• Workload implications (including reassignment issues with organization of work, as well as increases or decreases in workload)
• Perceived imposition on personal conscience or ethics
• Perceived impact on provider–client relationship
• System costs (includes direct system costs, and “diversions” from public health systems to paid-for services/private fees)
• Stigmatization of health-care providers (considering the application of the intervention).

Gestational age limits

PICO 3: The impact of gestational age limits (see Recommendation 3)

PICO question: For pregnant people seeking abortion and also for medical professionals providing abortion services, what is the impact of gestational age limits on delayed abortion, continuation of pregnancy, opportunity costs (including psychological opportunity costs), unlawful abortion, self-managed abortion, disqualification from unlawful abortion, disproportionate impact, referral to another provider, workload implications (including reassignment, issues with organization of work, as well as increases or decreases in workload), system costs (includes direct system costs, and “diversions” from public health systems to paid-for services/private fees), perceived impact on provider–client relationship, stigmatization of health-care providers (considering the application of the intervention)?

P: Pregnant people seeking abortion; medical professionals providing abortion services
I: Gestational age limits
C: None (studies do not need to specify comparator)
O:

• Delayed abortion
• Continuation of pregnancy
• Opportunity costs (including psychological opportunity costs)
• Unlawful abortion
• Self-managed abortion
• Disqualification from unlawful abortion
• Disproportionate impact
• Referral to another provider
• Workload implications (including reassignment issues with organization of work, as well as increases or decreases in workload)
• System costs (includes direct system costs, and “diversions” from public health systems to paid-for services/private fees)
• Perceived impact on provider–client relationship
• Stigmatization of health-care providers (considering the application of the intervention).

Pre-abortion

Mandatory waiting periods

PICO 4: The impact of mandatory waiting periods (see Recommendation 6)

PICO question: For pregnant people seeking abortion and also medical professional providing abortion services, what is the impact of mandatory waiting periods on delayed abortion, continuation of pregnancy, opportunity costs (including psychological opportunity costs), disproportionate impact, unlawful abortion, self-managed abortion, disqualification from lawful abortion, referral to another provider, workload implications (including reassignment, issues with organization of work, as well as increases or decreases in workload), system costs (includes direct system costs, and “diversions” from public health systems to paid-for services/private fees), perceived impact on provider–client relationship, stigmatization of health-care providers (considering the application of the intervention)?

P: People seeking abortion services; medical professionals providing abortion services
I: Mandatory waiting periods
C: None (studies do not need to specify comparator)
O:

• Delayed abortion
• Continuation of pregnancy
• Opportunity costs (including abortion travel and psychological opportunity costs))
• Disproportionate impact
• Unlawful abortion
• Self-managed abortion
• Disqualification from lawful abortion
• Referral to another provider
• Workload implications (including reassignment, issues with organization of work, as well as increases or decreases in workload)
• System costs (includes direct system costs, and “diversions” from public health systems to paid-for services/private fees)
• Perceived impact on provider–client relationship
• Stigmatization of health-care providers (considering the application of the intervention).

Third-party authorization for abortion (see Recommendation 7)

PICO 5: Impact of judicial bypass

PICO question: For pregnant people seeking abortion, what is the impact of judicial bypass on delayed abortion, continuation of pregnancy, opportunity costs (including psychological opportunity costs), unlawful abortion, self-managed abortion, anticipated or experienced family disharmony, anticipated or experienced exposure to interpersonal violence or exploitation, anticipated or experienced reproductive coercion, system costs (includes direct system costs, and “diversions” from public health systems to paid-for services/private fees)?

P: Pregnant people seeking abortion
I: Judicial bypass
C: None (studies do not need to specify comparator)
O:

• Delayed abortion
• Continuation of pregnancy
• Opportunity costs (including abortion travel and psychological opportunity costs)
• Unlawful abortion
• Self-managed abortion
• Anticipated or experienced family disharmony
• Anticipated or experienced exposure to interpersonal violence or exploitation
• Anticipated or experienced reproductive coercion
• System costs (includes direct system costs, and “diversions” from public health systems to paid-for services/private fees).

PICO 6: Impact of judicial bypass versus parental consent

PICO question: For pregnant people seeking abortion, what is the impact of judicial bypass versus parental consent on delayed abortion, continuation of pregnancy, opportunity costs (including psychological opportunity costs), unlawful abortion, self-managed abortion, anticipated or experienced family disharmony, anticipated or experienced exposure to interpersonal violence or exploitation, anticipated or experienced reproductive coercion, system costs (includes direct system costs, and “diversions” from public health systems to paid-for services/private fees)?

[P-I-O same as PICO 5 but with a comparator (C) added: parental consent]

PICO 7: Impact of parental consent versus parental notification laws/requirements

PICO question: For pregnant people seeking abortion, what is the impact of parental consent versus parental notification laws/requirements on delayed abortion, continuation of pregnancy, opportunity costs (including psychological opportunity costs), unlawful abortion, self-managed abortion, anticipated or experienced family disharmony, anticipated or experienced exposure to interpersonal violence or exploitation, anticipated or experienced reproductive coercion, system costs (includes direct system costs, and “diversions” from public health systems to paid-for services/private fees)?

[P and O same as PICO 5; I = parental consent and C = parental notification laws/requirements]

PICO 8: Impact of authorization by parent through consent or notification

PICO question: For pregnant people seeking abortion, what is the impact of authorization by parent through consent or notification on delayed abortion, continuation of pregnancy, opportunity costs (including psychological opportunity costs), unlawful abortion, self-managed abortion, anticipated or experienced family disharmony, anticipated or experienced exposure to interpersonal violence or exploitation, anticipated or experienced reproductive coercion, system costs (includes direct system costs, and “diversions” from public health systems to paid-for services/private fees)?

[P-C-O same as PICO 5 but I = authorization by parent through consent or notification]

PICO 9: Impact of authorization by spousal consent

PICO question: For pregnant people seeking abortion, what is the impact of authorization by spousal consent on delayed abortion, continuation of pregnancy, opportunity costs (including psychological opportunity costs), unlawful abortion, self-managed abortion, anticipated or experienced family disharmony, anticipated or experienced exposure to interpersonal violence or exploitation, anticipated or experienced reproductive coercion, system costs (includes direct system costs, and “diversions” from public health systems to paid-for services/private fees)?

[P-C-O same as PICO 5 but I = authorization by spousal consent]

Abortion provider restrictions

PICO 10: Impact of provider restrictions (see Recommendation 21)

PICO question: For pregnant people seeking abortion and also for medical professionals providing abortion services, what is the impact of provider restrictions on delayed abortion, continuation of pregnancy, opportunity costs (including psychological opportunity costs), disproportionate impact, unlawful abortion, self-managed abortion, referral to another provider, workload implications (including reassignment, issues with organization of work, as well as increases or decreases in workload), system costs (including direct system costs, and “diversions” from public health systems to paid-for services/private fees), perceived imposition on personal conscience or ethics, perceived impact on provider–client relationship, stigmatization of health-care providers (considering the application of the intervention)?

P: Pregnant people seeking abortion; medical professionals providing abortion services
I: Provider restrictions
C: None (studies do not need to specify comparator)
O:

• Delayed abortion
• Continuation of pregnancy
• Opportunity costs (including abortion travel and stigmatization, and psychological opportunity costs)
• Disproportionate impact
• Unlawful abortion
• Self-managed abortion
• Referral to another provider
• Workload implications (including reassignment, issues with organization of work, as well as increases or decreases in workload)
• System costs (including direct system costs, and “diversions” from public health systems to paid-for services/private fees)
• Perceived imposition on personal conscience or ethics
• Perceived impact on provider–client relationship
• Stigmatization of health-care providers (considering the application of the intervention).

Conscientious objection

PICO 11: Impact of conscientious objection (see Recommendation 22)

PICO question: For pregnant people seeking abortion and also medical professionals providing abortion services, what is the impact of conscientious objection on delayed abortion, continuation of pregnancy, opportunity costs (including psychological opportunity costs), unlawful abortion, self-managed abortion, referral to another provider, workload implications (including reassignment, issues with organization of work, as well as increases or decreases in workload), system costs (includes direct system costs, and “diversions” from public health systems to paid-for services/private fees), perceived imposition on personal conscience or ethics, perceived impact on provider–client relationship, stigmatization of health-care providers (considering the application of the intervention)?

P: Pregnant people seeking abortion; medical professionals providing abortion services
I: Conscientious objection/refusal
C: None (studies do not need to specify comparator)
O:

• Delayed abortion
• Continuation of pregnancy
• Opportunity costs (including abortion travel and stigmatization, and psychological opportunity costs)
• Unlawful abortion
• Self-managed abortion)
• Referral to another provider
• Workload implications (including reassignment, issues with organization of work, as well as increases or decreases in workload)
• System costs (includes direct system costs, and “diversions” from public health systems to paid-for services/private fees)
• Perceived imposition on personal conscience or ethics
• Perceived impact on provider–client relationship
• Stigmatization of health-care providers (considering the application of the intervention).