Edwards Genevieve, Hooker Leesa, Edvardsson Kristina
La Trobe University Judith Lumley Centre, Melbourne, VIC, Australia.
School of Nursing, Midwifery & Paramedicine, Australian Catholic University, Ballarat, VIC, Australia.
Womens Health (Lond). 2025 Jan-Dec;21:17455057251348986. doi: 10.1177/17455057251348986. Epub 2025 Jun 24.
Almost half of all pregnancies worldwide and 34% of pregnancies in high-income countries are considered unintended. Several studies from high-income countries report that women from rural areas are more likely to continue their unintended pregnancy and give birth, while urban women are more likely to have an induced abortion. To explore how rurality influences women's decision making and pregnancy choices following unintended pregnancy by examining the global trends for women who reside in rural areas of high-income countries. This study is a systematic review of qualitative, cross-sectional and mixed-methods studies. A systematic review of peer-reviewed literature, published from January 2000 through to March 2024, retrieved from five databases: CINAHL, Embase, MEDLINE, PsycINFO and PubMed. Restrictions were applied to obtain original research that has been undertaken in high-income countries. The review included studies featuring participants that were either rural women who experience an unintended pregnancy or health care professionals providing direct care to rural women. Nineteen studies met the inclusion criteria and were included in this review. Several factors that influenced rural women's decision making following an unintended pregnancy were identified: access to abortion services; role of health care professionals; temporal factors; social norms and stigma; social factors and determinants; culture, ethnicity and religion; reproductive coercion and abortion legislation. The Social-Ecological Model highlighted the levels of interaction, the role health care professionals, family members and the wider community in supporting or obstructing rural women's decision making. Rural women's pregnancy decision making and reproductive autonomy can be compromised by intimate partners, family members, health professionals and rural culture. Health professionals have a pivotal role in supporting and respecting rural women's decision making when seeking an abortion and ensuring that rural women have timely access to abortion care. Registration number: PROSPERO CRD 42023409917.
全球近一半的怀孕以及高收入国家34%的怀孕被认为是意外怀孕。来自高收入国家的多项研究报告称，农村地区的女性更有可能继续她们的意外怀孕并分娩，而城市女性更有可能进行人工流产。通过研究高收入国家农村地区女性的全球趋势，探讨农村地区如何影响女性在意外怀孕后的决策和怀孕选择。本研究是对定性、横断面和混合方法研究的系统综述。对2000年1月至2024年3月发表的同行评审文献进行系统综述，从五个数据库检索：CINAHL、Embase、MEDLINE、PsycINFO和PubMed。施加限制以获取在高收入国家进行的原始研究。该综述纳入了以意外怀孕的农村女性或为农村女性提供直接护理的医疗保健专业人员为参与者的研究。19项研究符合纳入标准并被纳入本综述。确定了几个影响农村女性意外怀孕后决策的因素：堕胎服务的可及性；医疗保健专业人员的作用；时间因素；社会规范和耻辱感；社会因素和决定因素；文化、种族和宗教；生殖胁迫和堕胎立法。社会生态模型强调了互动水平、医疗保健专业人员、家庭成员和更广泛社区在支持或阻碍农村女性决策方面的作用。农村女性的怀孕决策和生殖自主权可能会受到亲密伴侣、家庭成员、健康专业人员和农村文化的损害。医疗保健专业人员在支持和尊重农村女性寻求堕胎的决策并确保农村女性及时获得堕胎护理方面具有关键作用。注册号：PROSPERO CRD 42023409917。
