Delivery of Abortion Services in the United Kingdom and Republic of Ireland, in Relation to the World Health Organization's Framework for Best Practices : A Literature Review

Abstract: Introduction: Accessible abortion services is a fundamental human right and in March 2022, the World Health Organization (WHO) updated their recommendations for best abortion services practice covering the components Abortion regulation, Services across the continuum of care, Pre abortion care, Abortion care, Post abortion care and Service-delivery options and Self-management approaches. England, Scotland and Wales, the Republic of Ireland, and Northern Ireland have different abortion laws, both currently and historically, but they have strong historical ties to each other, offering a good comparison on how regional difference can impact abortion services. Aim: The aim of this literature review is to investigate the three regions’ abortion service provision using the WHO guidelines as a framework. Methods: A literature review in which 20 articles describing abortion services in the three regions were thematically analyzed using a deductive approach. Results: Access to abortion in all regions is currently safe. However, non-legal barriers, such as lack of trained medical practitioners and conscientious objection, hinder accessibility of care, especially in the Irish regions. Moreover, the accessibility of abortions decreases with higher gestational ages in all regions and women describe a narrative of shame maintained by media and medical staff. The telemedical models introduced during the COVID-19 pandemic has been evaluated as safe, effective and accepted among care recipients Conclusion: Other factors than legal barriers impact the provision of abortion services. These barriers need to be considered when developing abortion service systems. The WHO guidelines serve as a useful tool to evaluate and improve abortion services.