{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T23:21:50Z","timestamp":1781565710914,"version":"3.54.5"},"reference-count":31,"publisher":"Wiley","issue":"S1","license":[{"start":{"date-parts":[[2024,2,15]],"date-time":"2024-02-15T00:00:00Z","timestamp":1707955200000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Forty\u2010seven of the 203 countries with abortion laws detailed by the Center for Reproductive Rights have a health exception (HE) clause, inconsistent in both wording and implementation, even within countries. This narrative review sought to determine the understanding and implementation of the legally permissible HE in different countries, or states, to provide clarification and guidance for strategies that will maximize permitted access to safe abortion within the law and avoid undue delays that harm the lives and health of women and their families. A multimethod approach was used. The literature search for countries with HE laws, including physical, mental, and social health, and exceptions for threat to life, rape, incest, and fetal anomaly, returned sparse results. The review of emblematic cases that had reached regional courts on the grounds of human rights violation for failure to obtain legal abortion under the country's HE clause included some examples qualifying on multiple grounds. We interviewed 15 physician advocates from 14 countries about use of the HE in their countries. Informants from Latin America interpreted the HE to refer to physical, psychological, and social health. HE laws are common but confusing, with significant opportunities to improve access through clarification and implementation. Where multiple grounds permit ending a pregnancy, the least onerous exception for the patient is the most ethical. Examples of progress in Colombia and Ghana demonstrate successful approaches to broader HE implementation.<\/jats:p>","DOI":"10.1002\/ijgo.15337","type":"journal-article","created":{"date-parts":[[2024,2,16]],"date-time":"2024-02-16T01:59:30Z","timestamp":1708048770000},"page":"67-80","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Perils and possibilities of health exception laws: A narrative review"],"prefix":"10.1002","volume":"164","author":[{"given":"Dorothy","family":"Shaw","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology University of British Columbia  Vancouver British Columbia Canada"},{"name":"Health Exception Committee Global Doctors for Choice  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koku","family":"Awoonor\u2010Williams","sequence":"additional","affiliation":[{"name":"Health Exception Committee Global Doctors for Choice  New York New York USA"},{"name":"Ghana College of Physicians and Surgeons  Accra Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annika","family":"Brauer","sequence":"additional","affiliation":[{"name":"Health Exception Committee Global Doctors for Choice  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Gil","sequence":"additional","affiliation":[{"name":"Health Exception Committee Global Doctors for Choice  New York New York USA"},{"name":"Grupo M\u00e9dico por el Derecho a Decidir\/Global Doctors for Choice  Bogota Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juana P\u00e9rez","family":"Morales","sequence":"additional","affiliation":[{"name":"Health Exception Committee Global Doctors for Choice  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy","family":"Chavkin","sequence":"additional","affiliation":[{"name":"Health Exception Committee Global Doctors for Choice  New York New York USA"},{"name":"Public Health and Obstetrics\u2010Gynecology Columbia University  New\u00a0York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,2,15]]},"reference":[{"key":"e_1_2_11_2_1","volume-title":"Constitution of the World Health Organization","author":"World Health Organization","year":"2006"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12914-018-0183-1"},{"key":"e_1_2_11_4_1","unstructured":"Center for Reproductive Rights.The world's abortion laws. 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