How armed conflict shapes women's family planning and abortion uptake and decision-making: a scoping review

Armed conflict profoundly affects women's sexual and reproductive health and rights, yet the pathways through which conflict shapes family planning and abortion uptake and decision-making remain insufficiently understood. This scoping review aimed to identify and map the available evidence on how armed conflict influences women's use of, access to, and decisions about family planning and abortion in conflict-affected settings. Following JBI guidance and -ScR reporting standards, searches were conducted in Web of Science, Scopus, PubMed and Embase for peer-reviewed articles published in English between 2014 and 2024. Studies were eligible if they included primary data on women living in conflict-affected settings or internally displaced populations, treated conflict as an exposure or shaping condition, and addressed family planning, contraception, sterilisation, abortion or post-abortion care. Thirty studies were included, and the data were synthesised using a thematic synthesis approach. Relevant findings from each article were organised into subcategories based on their commonalities under two main themes: a) Factors shaping the uptake of and decision-making about family planning, including contraception and sterilisation, and b) Factors shaping the uptake of and decision-making about abortion. The results highlight that armed conflict does not automatically affect reproductive health in a single direction; rather, its effects depend on how violence, service availability, gendered power relations, social norms and social conditions interact. This study calls for further research to better understand the effects of conflict on women's reproductive health and autonomy, and inform tailored humanitarian interventions to address these needs.