Abstract

Background The refugee population increases around the world each year, and 25% of these individuals are capable of pregnancy. We sought to understand the potential impact to refugees’ lives, with regard to their ability to access abortion services, as they crossed international borders.

Methods We analyzed global refugee movement in 2022 and country-level abortion law data to identify patterns of forced migration. We conducted a scoping review to identify emerging topics and research gaps related to refugee fertility intentions and access to reproductive health services.

Results 6,860,398 female refugees aged 12-59 years moved between countries in 2022. 76% of these refugees went to host countries without abortion on request. 16% of these refugees sought asylum in countries with more restrictive abortion laws than their country of origin, 44% sought asylum in countries with similarly restrictive laws, and 40% sought asylum in countries with less restrictive laws. We identified fifty-two items in our scoping review with the following themes: unintended fertility; intended fertility; need to space, postpone and/or limit fertility; changing fertility intentions; and access to reproductive health services. These items revealed mixed fertility intentions among newly resettled adult refugees and clear evidence that adolescent refugees want to control their fertility despite significant barriers.

Discussion The results reveal the need for renewed commitment to ensuring that refugees capable of pregnancy have access to the full range of sexual and reproductive health services, so they can exercise their human right to decide if, when, and how many children to have.

Plain language summary The refugee population increases each year and approximately 25% of refugees are capable of pregnancy. The purpose of this study is to understand how refugee status affects refugees’ ability to access abortion. We analyzed refugee movement in 2022 and countries’ abortion law data to identify patterns of forced migration and associated changes in law. We conducted a scoping review to identify emerging or evolving topics and research gaps related to refugee fertility intentions and access to reproductive health services. 6,860,398 female refugees aged 12-59 years moved from 159 origin countries to 111 host countries in 2022. Around 76% of these refugees went to host countries that did not provide abortion on request: 16% of these refugees sought asylum in countries with more restrictive abortion laws than their country of origin, 44% sought asylum in countries with similarly restrictive abortion laws, and 40% sought asylum in countries with less restrictive abortion laws. Fifty-two items in our scoping review revealed mixed fertility intentions among newly resettled adult refugees and clear evidence that adolescent refugees want to control their fertility, despite significant barriers. The study results point to the need for a renewed commitment to ensuring that refugees capable of pregnancy have access to the full range of sexual and reproductive health services, so they can exercise their human right to decide if, when, and how many children to have.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

The author(s) received no specific funding for this work.

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Data Availability

All data generated or analyzed during this study are included in this published article or are publicly available online.

List of abbreviationsCATConvention against Torture and Other Cruel, Inhuman or Degrading Treatment or PunishmentCEDAWConvention on the Elimination of All Forms of Discrimination against WomenCRRCenter for Reproductive RightsSGBVSexual- and gender-based violenceUDHRUniversal Declaration of Human RightsUNHCRUnited Nations High Commissioner for RefugeesWRAWomen of reproductive age