Table 2.

Overall conclusions from Table A, PICO 1 + Summary B-table + Conclusion from C-table

Outcome	Overall conclusion of evidence (A)	Application of HR standards (B)	Conclusion evidence + HR (C)
Delayed abortion	Overall, evidence from 8 studies suggest that MWPs contribute to abortion delays by increasing the time from counselling to the abortion appointment, and by contributing to logistical difficulties in obtaining care. This effect is magnified when two visits are required.	MWPs engage states’ obligation to respect, protect and fulfil the rights to life and health (by taking steps to reduce maternal mortality and morbidity including addressing unsafe abortion, and protecting people seeking abortion).	MWPs can result in delayed access to abortion care. Where such delays increase risks of maternal mortality or morbidity, they have negative implications for rights.
Continuation of pregnancy	Overall, evidence from 6 studies suggest that MWPs may contribute to the continuation of pregnancy, especially among adolescents, Black, and Hispanic women, women who have to travel far for an abortion, and poor women. The effect is greater where two visits are required rather than one. Evidence from 7 studies suggest that MWPs do not contribute to any changes to abortion rates, unintended pregnancy or birth rates in general, but MWPs may decrease births among unmarried women.	MWPs engage states’ obligation to respect, protect and fulfil the rights to life and health (by ensuring abortion regulation is evidence-based and proportionate), the right to equality and non-discrimination, and the right to decide on the number and spacing of one’s children.	Where MWPs are associated with undesired continuation of pregnancy they may interfere disproportionately with the rights of abortion seekers. This may disproportionately be the case for adolescents, Black, and Hispanic women, women who have to travel far for an abortion and poor women.
Opportunity costs	Overall, evidence from 18 studies suggest that MWPs contribute to opportunity costs including financial and emotional impacts such as: logistical burdens, emotional stress, financial costs, increased prices for abortions, increased travel time, and out of state travel. Online or phone-based counselling may mitigate some opportunity costs related with two-visits. The negative impacts of MWPs are exacerbated for women who need to travel far for an abortion. Evidence from 2 studies suggest that MWPs are not associated with incidence of postpartum depression and for most women, MWPs do not impact women’s certainty in the abortion decision.	MWPs engage states’ obligation to respect, protect and fulfil the rights to life and health (by ensuring abortion regulation is evidence-based and proportionate, and that where it is lawful abortion is safe and accessible), and the right to equality and non-discrimination.	MPWs are associate with opportunity costs. These costs (including travel costs, unnecessary multiple visits.) make abortion less accessible in practice, and are exacerbated for women who need to travel for abortion.
Unlawful abortion	No evidence identified.	MWPs engage states’ obligation to respect, protect and fulfil the rights to life and health (by taking steps to reduce maternal mortality and morbidity including addressing unsafe abortion, and protecting people seeking abortion).	The operation of MWPs may lead persons to avail of abortions outside of the formal medical system, including unlawful abortions. Such abortions may be unsafe. States must take steps to reduce maternal mortality and morbidity, including addressing unsafe abortion. Disqualification from lawful abortion as a result of the application of a MWP (often in conjunction with gestational limits) can result in criminal liability when a pregnant person seeks abortion outside the formal system, including availing of unlawful self-managed abortion. Criminalisation of abortion may constitute a human rights violation.
SMA	No evidence identified.	MWPs engage states’ obligation to respect, protect and fulfil the rights to life and health (by taking steps to reduce maternal mortality and morbidity including addressing unsafe abortion, and protecting people seeking abortion).	The operation of MWPs may lead persons to avail of abortions outside of the formal medical system, including self-managed abortions. Such abortions may be unsafe. States must take steps to reduce maternal mortality and morbidity, including addressing unsafe abortion. Disqualification from lawful abortion as a result of the application of a MWP (often in conjunction with gestational limits) can result in criminal liability where a pregnant person seeks abortion outside the formal system including availing of unlawful self-managed abortion. Criminalisation of abortion may constitute a human rights violation.
Disqualification from lawful abortion	No evidence identified.	MWPs engage states’ obligation to respect, protect and fulfil the rights to life and health (by taking steps to reduce maternal mortality and morbidity including addressing unsafe abortion, and protecting people seeking abortion). They may also result in the violation of the state’s obligation to ensure abortion is available where the life and health of the pregnant person is at risk, or where carrying a pregnancy to term would cause her substantial pain or suffering, including where the pregnancy is the result of rape or incest or where the pregnancy is not viable.	MWPs may result in women exceeding gestational limits, which may result in disqualification from lawful abortion including in cases of sexual violence or therapeutic abortion, with implications for the rights to health, life, security of person, and privacy. Disqualification from lawful abortion as a result of the application of a MWP (often in conjunction with gestational limits) can result in criminal liability where a person avails of abortion without satisfaction of the MWP. Criminalisation of abortion may result in a violation of the right to equality and non-discrimination, right to security of person, or right to be free from torture, and cruel, inhuman and degrading treatment.
Disproportionate impact	Overall, evidence from 6 studies suggest that MWPs have a disproportionate negative impact on women who need to travel farther for an abortion, women of colour, and women with fewer resources.	MWPs engage states’ obligation to respect, protect and fulfil the right to equality and non-discrimination.	MWPs have a disproportionate impact on women of colour, women with fewer resources, and women who need to travel for an abortion, with negative implications for the right to equality and non-discrimination in the provision of sexual and reproductive healthcare.
Referral to another provider	No evidence identified.	MWPs engage states’ obligation to respect, protect and fulfil the rights to life and health (by taking steps to reduce maternal mortality and morbidity including addressing unsafe abortion, and protecting people seeking abortion).	MWPs may operate to delay referral and thus delay access to abortion care.