Understanding barriers for refugees and migrants when accessing abortion care in Europe: a scoping review

Access to safe abortion care has been the subject of international policy deliberation for several decades and was included in the World Health Organization’s essential healthcare services in 2020. It differs across Europe, with legal barriers like gestational age limits and the conscientious objection persisting in most European countries. Refugees and migrants can encounter additional barriers when accessing healthcare services for various reasons, such as health system exclusion and language barriers. The aim of this study was to map existing evidence on refugees’ and migrants’ access to abortion care in Europe. Adopting a scoping review methodology, we conducted a systematic search in PubMed, complemented by web-based hand searches and citation tracking to identify the relevant literature. We included qualitative and quantitative studies as well as grey literature published in English between 2014 and 2025, addressing how refugees and migrants accessed abortion services across Europe. Data were charted according to Levesque et al.’s dimensions of healthcare access framework. Results were reported using a narrative synthesis approach. We identified 19 studies in eleven different European countries and one EU-wide report (n = 20), including twelve qualitative, five mixed, and three quantitative designs. While some studies focused specifically on migrant women seeking reproductive healthcare, others focused on abortion seekers in general while highlighting barriers unique to migrant populations. Prominent barriers were lack of information and insufficient availability of translation services. Availability of services was often restricted by regional disparities and restrictive laws. Affordability issues were amplified by variations in cost entitlements and the precarious status of undocumented migrants. Quality of care was compromised by discriminatory attitudes held by providers. Refugees and migrants in Europe face barriers in access to abortion tied to their migration context. Gaps in coverage for refugees and migrants constitute a violation of universal human rights. Ensuring access requires improved outreach efforts, free availability of translation services, decriminalization, and integration of abortion care into a Universal Health Coverage framework, while combating racism in health care and amplifying the voices of marginalized groups.