Healthcare professionals and students’ knowledge on termination of pregnancy legislation and clinical practice: A systematic review

Background: Legal and safe termination of pregnancy (TOP) has long been recognised as an important public health issue internationally. Healthcare professionals (HCPs) and students have a key role within TOP services, and it is crucial that they have sufficient understanding of laws, guidelines and clinical practice to facilitate safe and effective care. The current systematic review aims to study the level of knowledge of both HCPs and students on TOP legislation, methods and procedures and potential associated complications. Methods: PubMed, Embase, Scopus and EBSCOhost were searched for peer-reviewed studies published until July 2020. After initial selection, 239 articles were screened in full and 31 studies (qualitative and quantitative) were included. A narrative review and synthesis of the findings was completed. Main findings: Poor knowledge on TOP legislation and clinical practice was reported for HCPs and students. The main issues identified included limited awareness of specific circumstances for legal TOP and poor understanding of methods and medical regimens recommended. Overall, education/training, experience in provision of TOP and receiving reminders of legislation were the main factors associated with increased levels of knowledge. Conclusion: HCPs must be fully aware of the clinical practice and circumstances in which TOP is legal in their country/region so adequate provision of this service is ensured. This study highlighted the importance of involving and promoting participation of HCPs and students in the provision of TOP services. A clear need and desire for staff education and training on TOP was shown. Adequate training allows preparation of current and future HCPs to provide respectful and compassionate care.