In the 2022 Abortion Care Guideline, the World Health Organization (WHO) undertook systematic evidence reviews of seven law and policy interventions to assess their health and social impacts. Distinct recommendations were formulated for each. The present article highlights how the Guideline reconceptualizes abortion regulation as a complex structural intervention that shapes clinical care and service delivery and distributes risks and resources within these systems and in the care relations that define them. It then presents the Guideline recommendations and summarizes their evidence base, drawing on recent legal and policy developments to emphasize their real-world significance. The article concludes by anticipating the future of abortion law and policy, focusing on service delivery innovations and diverse care models, drug regulation and the supply of abortion pills, and protective interventions crafted in the context of political crisis and immediate need that serve policy objectives and take regulatory forms different from the past.

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Overwhelming evidence from 168 studies over fifty years points to a clear dose-response relationship between surgical abortion and subsequent preterm birth. The 2018 National Academy of Sciences report considered only five of these 168 studies and represents a biased sample that underreports a significant association between surgical abortion and subsequent preterm birth. The purpose of this document is to review the quality of the data on this effect, review the size of this effect, and portray an accurate assessment of the data to improve informed consent prior to surgical abortion.

Evidence in peer-reviewed literature from 168 studies over fifty years points to a causal, dose-response relationship between surgical abortion and subsequent preterm birth. This document provides an overview of this literature, discusses mechanisms for this effect, demonstrates the strength of evidence for causality, and offers guidance for informed consent prior to surgical abortion. This document does not provide detailed statistical analysis or a high-resolution assessment of the quality of studies on surgical abortion and preterm birth (covered in Practice Guideline 11).

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In October 2020, the Polish Constitutional Court held unconstitutional an exception in the Family Planning Act of 1993 that provided for legal abortion in cases of fetal abnormalities. This retrogressive step has led to an almost total ban on abortion in Poland. Drawing on existing Strasbourg case law and other relevant legal material, this paper attempts to anticipate a possible outcome of applications recently filed before the European Court of Human Rights by more than 1,000 Polish women who were denied abortions or who postponed their reproductive decisions out of fear. I focus on two factors that play a determining role in the adjudication of cases related to reproductive rights. The first one is a public interest in restricting abortion-namely, the \"protection of morals.\" The second is the margin of appreciation doctrine, which determines the degree of freedom that states enjoy in regulating certain issues, such as abortion, and which is highly dependent on the concept of a European consensus. I argue that this consensus-revealed through the domestic laws and practice of 47 Council of Europe member states-shows considerable unity and should thus restrict individual states\' discretion in limiting human rights and freedoms. The European Court of Human Rights, by acknowledging the relevance of a European consensus in abortion regulation, as well as evolving universal standards concerning reproductive rights, would avoid two pitfalls: one connected with analyzing the doubtful public interest in protecting morals, and another with a potential criticism of judicial activism and the court\'s imposition of its own moral evaluation of an abortion ban.

Public health professionals, particularly those in state and local health departments, do not always have clear understandings of their roles related to politically controversial public health topics. A process of consensus development among public health professionals that considers the best available evidence may be able to guide decision making and lay out an appropriate course of action.
In May 2020, a group of maternal and child health and family planning professionals working in health departments, representatives of schools of public health, and members of affiliated organizations convened to explore values and principles relevant to health departments\' engagement in abortion and delineate activities related to abortion that are appropriate for health departments. The convening followed a structured consensus process that included multiple rounds of input and opportunities for feedback and revisions.
Convening participants came to consensus on principles to guide engagement in activities related to abortion, a set of activities related to abortion that are appropriate for health departments, and next steps to support implementation of such activities.
The experience of the convening indicates that consensus processes can be feasible for politically controversial public health topics such as abortion.

Intrauterine pregnancies of uncertain viability are common, and guidelines for diagnosing early pregnancy loss must balance the risk of interrupting a viable pregnancy with the anxiety and medical complications resulting from delayed diagnosis. Two cases of likely early pregnancy loss presenting as intrauterine pregnancies of uncertain viability are described, with stark differences in care availability related to state reproductive health care regulations. Onerous abortion restrictions, medical and societal stigma, and inherent pronatalism in diagnostic criteria interfere with the exercise of clinical judgment and can damage patients\' physical or mental health.

To develop a minimum data set, known as a core outcome set, for future abortion randomized controlled trials.
We extracted outcomes from quantitative and qualitative systematic reviews of abortion studies to assess using a modified Delphi method. Via email, we invited researchers, clinicians, patients, and healthcare organization representatives with expertise in abortion to rate the importance of the outcomes on a 9-point Likert scale. After 2 rounds, we used descriptive analyses to determine which outcomes met the predefined consensus criteria. We finalized the core outcome set during a series of consensus development meetings.
We entered 42 outcomes, organized in 15 domains, into the Delphi survey. Two-hundred eighteen of 251 invitees (87%) provided responses (203 complete responses) for round 1 and 118 of 218 (42%) completed round2. Sixteen experts participated in the development meetings. The final outcome set includes 15 outcomes: 10 outcomes apply to all abortion trials (successful abortion, ongoing pregnancy, death, hemorrhage, uterine infection, hospitalization, surgical intervention, pain, gastrointestinal symptoms, and patients\' experience of abortion); 2 outcomes apply to only surgical abortion trials (uterine perforation and cervical injury), one applies only to medical abortion trials (uterine rupture); and 2 apply to trials evaluating abortions with anesthesia (over-sedation/respiratory depression and local anesthetic systemic toxicity).
Using robust consensus science methods we have developed a core outcome set for future abortion research.
Standardized outcomes in abortion research could decrease heterogeneity among trials and improve the quality of systematic reviews and clinical guidelines. Researchers should select, collect, and report these core outcomes in future abortion trials. Journal editors should advocate for core outcome set reporting.