Reproductive Health Services in Abortion-Providing Clinics: A Scoping Review of Provision and Policy Contexts

提供堕胎服务的诊所中的生殖健康服务:服务提供和政策背景的范围界定综述

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Abstract

OBJECTIVES: Abortion-providing clinics often offer preventive reproductive health services. We conducted a scoping review to characterize provision of contraceptive care, sexually transmitted infection (STI) testing and/or treatment, and cervical cancer prevention and/or screening at U.S. abortion-providing clinics and to highlight policy drivers of variation in access to and provision of these services at the time of abortion by abortion-providing clinics. DATA SOURCES: Researchers screened articles and extracted data from PubMed, Embase, Scopus, and CINAHL from inception through March 2023. METHODS OF STUDY SELECTION: Articles were eligible for review if they related contraceptive care, STI testing and/or treatment, or cervical cancer prevention and/or screening to abortion access, demand, or provision. Within these articles, we closely examined any discussion of health policy, conceptualized broadly based on existing literature describing policy associations with reproductive health care to identify policy drivers of reproductive health care provision in abortion care settings. TABULATION, INTEGRATION, AND RESULTS: A total of 5,359 articles were screened; 74 were included in the review. Sixty-five were about contraceptive care, seven on STI testing and/or treatment, and two on cervical cancer prevention and/or screening. Drivers of variation in provision of preventive reproductive health services included insurance and billing policies and regulatory requirements on abortion-providing facilities and clinicians. Existing data on the association between policies that restrict or protect abortion access and provision of preventive health services by abortion-providing clinics on a national scale are limited. CONCLUSION: Abortion-providing clinics are an access point for reproductive health services. Legislative trends to constrain abortion access may have spillover effects on provision of preventive reproductive health care such as contraceptive care, STI testing and/or treatment, and cervical cancer prevention and/or screening.

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