Abstract
Background: Immigrants, as a group, are especially vulnerable to unfair and unjust differences in health, often referred to as «health inequity». An important part of the overall health of immigrants is reproductive health, including access to contraception and safe abortion. The purpose of this systematic review is to compare the use of contraception and induced abortion among female immigrants and non-immigrants in the Nordic countries. Methods: Four databases (MEDLINE, Embase, CINAHL and Maternity & Infant Care) were systematically searched for quantitative literature on contraception and/or induced abortion among immigrants. The articles were transferred to Covidence for blinded screening and full text review. Relevant articles were identified using the set inclusion and exclusion criteria. Results: 23 articles, published between 1993 and 2022, were included. Compared to non- immigrants, immigrant women were found to have lower use of contraception and higher use of induced abortion. Contraception use prior to requesting an abortion was also found to be lower among immigrants. Contraception pills, condoms and copper IUD seemed to be preferred methods of contraception among immigrant women. On average, immigrants had an increased risk of repeated abortions with a higher number of induced abortions per woman. The immigrant women were found to be of greater age and parity, which was associated with an increased risk of having an induced abortion. Conclusion: Our findings largely correlate with international research. Cultural beliefs, lower socioeconomic status and lack of knowledge or access to contraception could partially explain the results. However, we believe that more research on particularly why their abortion rate is higher could identify new ways of reducing it. Increased focus among healthcare workers on individualized contraceptive counseling and culturally appropriate communication could be important measures to improve the reproductive health of immigrants.