Abortion hotlines around the world: a mixed-methods systematic and descriptive review

Area of Science:

• Public Health
• Reproductive Health
• Healthcare Access

Background:

• Global barriers to abortion access necessitate alternative support methods.
• Abortion hotlines have emerged as a key resource for individuals seeking abortion care worldwide.
• Understanding the role and impact of these hotlines is crucial for improving reproductive health outcomes.

Purpose of the Study:

• To analyze how abortion hotlines facilitate access to abortion services.
• To explore the perceived impact of hotlines on abortion access from women's and stakeholders' perspectives.
• To identify the operational models and contextual factors influencing abortion hotline services.

Main Methods:

• Systematic review of published quantitative and qualitative studies and grey literature.
• Identification and description of publicly available abortion hotlines.
• Data extraction on hotline scope, operational models, and adherence to guidelines.

Main Results:

• Abortion hotlines are context-dependent, operating independently or within formal health systems.
• Hotlines in restrictive settings often adopt broader scopes and innovative strategies to reach underserved populations.
• While hotlines use evidence-based guidelines, challenges remain in accessing quality medications for medical abortion.

Conclusions:

• Abortion hotlines demonstrate significant potential to improve safe abortion access and reduce maternal mortality and morbidity.
• Further research is needed, particularly on user and provider experiences, to optimize hotline services.
• Context-specific adaptations are essential for maximizing the effectiveness of abortion hotlines globally.