Submitted:
17 September 2025
Posted:
15 October 2025
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Abstract
Background: Abortion is a core component of reproductive healthcare and a critical determinant of maternal health outcomes. Globally, approximately 73 million abortions occur annually, with unsafe abortion contributing to 4.7–13.2% of maternal deaths, primarily in low- and middle-income countries (LMICs). Legal frameworks governing abortion vary widely, ranging from total prohibition to fully integrated care systems. Access is further shaped by health system capacity, procedural barriers, and socio-economic inequities. In an increasingly globalised world, migration adds complexity, as individuals move between countries with differing policies, influencing both direct access to care and regional healthcare dynamics. Understanding these intersecting factors is essential for improving reproductive health equity and reducing preventable morbidity and mortality. Methods: A global comparative analysis was conducted using two integrated datasets covering 100 countries. The first dataset captured legal, operational, and contextual variables, including gestational limits, funding mechanisms, provider cadres, and telemedicine availability. The second dataset provided demographic, socio-economic, and health system indicators. Access Scores were derived from weighted indicators on a 0–10 scale. Analyses included descriptive statistics, bivariate associations, and multivariable ordinal logistic regression. An intersectional approach explored disparities across income groups, geographic regions, and migration pathways, with visualisation tools such as heatmaps, bubble plots, and diaspora exposure differentials. Results: Countries with telemedicine-enabled early medical abortion (tele-EMA) were significantly associated with higher Access Scores (OR ≈1.45), while each additional mandated waiting day reduced odds of liberal access by 7%. Mid-level provider authorisation and public funding alone did not predict improved access. Migration analysis revealed that LMIC-to-HIC flows resulted in marked improvements in abortion access, though benefits were unevenly distributed, leaving vulnerable populations behind. African and Asian LMICs had the lowest Access Scores, reflecting systemic underfunding and restrictive laws. Conclusion: Abortion access is shaped by functional health system design rather than geography alone. Removing procedural barriers, expanding telemedicine, and embedding services within integrated health systems are essential to achieving equitable, sustainable reproductive healthcare worldwide.
Keywords:
abortion
; health policy
; diaspora
; equity
Background
Abortion is a critical component of comprehensive reproductive healthcare, encompassing a range of medical and surgical procedures undertaken to end a pregnancy [1]. Globally, it remains one of the most common gynaecological interventions, with the World Health Organization estimating that approximately 73 million abortions occur each year [2]. This translates to nearly 40 abortions for every 1,000 women aged 15–49 annually, illustrating both the scale of need and the importance of safe, timely services. The reasons for seeking abortion are diverse and deeply rooted in women’s lived realities. Common reasons include unintended pregnancy due to contraceptive failure or lack of access to contraception, socio-economic pressures such as poverty and inability to support a child, relationship difficulties, and health-related concerns, including maternal conditions that make continuing a pregnancy dangerous [2,3,4,5]. Foetal anomalies, pregnancies resulting from rape or coercion, and concerns about future opportunities such as education or employment, are also significant drivers [2,6,7]. For many, abortion represents not only a medical decision but a complex personal and social choice shaped by structural determinants like gender inequality, cultural expectations, and systemic barriers to healthcare [8]. In women’s health more broadly, access to safe abortion services is closely linked to maternal health outcomes [9]. Restrictive or poorly implemented abortion laws are strongly associated with higher rates of unsafe abortion, which remains a leading cause of preventable maternal morbidity and mortality worldwide [10]. Unsafe procedures account for an estimated 4.7–13.2% of maternal deaths annually, disproportionately affecting women in low- and middle-income countries (LMICs) [11]. These deaths and complications are avoidable, highlighting safe abortion as a critical public health priority and a marker of reproductive justice and health system effectiveness.
The policy landscape surrounding abortion is highly complex, reflecting diverse cultural, religious, and political ideologies [8]. Legal frameworks vary dramatically across countries, ranging from total prohibition to fully integrated, on-request services embedded within national health systems [10]. These differences create stark inequities in access and outcomes. Ethical debates often dominate the discourse, with some groups framing abortion as a moral issue centred on the rights of the foetus, while others emphasise women’s autonomy and the right to control their reproductive lives [12]. Financial considerations further complicate the picture. Even where abortion is legal, stigma, lack of public funding, or unavailability of insurance coverage can render services inaccessible to those who cannot afford out-of-pocket costs [13,14]. Healthcare infrastructure plays an equally important role: limited numbers of trained providers, geographic maldistribution of services, and weak referral networks can all create de facto barriers to access [15,16]. Procedural hurdles such as mandatory waiting periods, parental consent laws, and multi-signature approvals compound these barriers, delaying or preventing access to timely care. In today’s globalised world, these national policies no longer operate in isolation. Migration flows have intensified, with millions of women crossing borders each year due to economic opportunity, education, conflict, or displacement. This mobility means that the abortion policy of one country can have direct and indirect effects on others. For example, restrictive laws in a woman’s home country may lead her to seek care abroad, creating cross-border healthcare demand and raising issues of legal jurisdiction, continuity of care, and health equity [17]. Conversely, liberalised policies in one country can act as a regional hub, absorbing demand from neighbouring nations with restrictive laws [18]. These dynamics generate complex geopolitical interdependencies, where domestic policies reverberate across borders and shape regional reproductive health landscapes.
Rationale
Against this backdrop, there is an urgent need for systematic, comparative research to understand how abortion policies interact with structural determinants to influence women’s access to safe care. While previous studies have examined national-level laws and service delivery models, few have adopted a global lens that integrates legal frameworks, health system design, socio-economic context, and migration patterns. This study addresses that gap by combining two comprehensive datasets to examine how abortion policies are distributed globally, how they intersect with operational and contextual factors, and how migration reshapes these dynamics. By employing statistical modelling alongside contextual interpretation, the analysis moves beyond descriptive mapping to identify the mechanisms through which policies translate—or fail to translate into meaningful access. Understanding these mechanisms is vital for designing interventions that reduce preventable maternal deaths, improve health equity, and support the broader goals of sustainable development. As migration and globalisation continue to blur national boundaries, a global perspective is essential for harmonising abortion care standards and ensuring that reproductive rights are upheld as fundamental human rights, regardless of birthplace or socio-economic status. This research provides an evidence base to inform policymakers, clinicians, and international organisations as they work to create resilient, equitable systems of care that transcend borders and address the complex realities of women’s health in the twenty-first century.
Methods
This study was designed as a global comparative analysis using publicly available data to statistically examine patterns of abortion legislation, practice, and service availability, using data systematically collated from more than one hundred countries. Two integrated datasets were used: (1) a master dataset of abortion policies containing legal, operational, and contextual variables, and (2) a supplementary dataset providing demographic, socio-economic, and health system indicators relevant to reproductive health. Together, these datasets provide a comprehensive basis for understanding how abortion policies are shaped by and interact with structural determinants.
Data Sources
Policy data were drawn from national legal databases, government health ministry websites, and reports by international organisations, including the World Health Organization (WHO), Guttmacher Institute, and United Nations Population Fund (UNFPA). Demographic and health system data were extracted from the World Bank, WHO Global Health Observatory, and United Nations Development Programme (UNDP) [19]. The datasets covered four main domains:
- Legislative framework – gestational limits, grounds for abortion, approval requirements, conscientious objection, penalties, and reporting obligations.
- Service delivery and practice – provider cadres, facility designations, telemedicine availability, safe-access zones, and public funding mechanisms.
- Determinants and contextual variables – GDP per capita, gender inequality index, religious composition, urbanisation, and health system readiness indicators.
- Health outcomes – maternal mortality ratio, proportion of abortions performed safely, and prevalence of cross-border care.
Variables and Coding
Each country was coded across the four domains using a standardised template. Legislative restrictiveness was measured using an ordinal scale:
- 0 – Prohibition where life-saving exception only
- 1 – Highly restrictive limited grounds where life, health, rape, foetal anomaly
- 2 – Moderate access where grounds plus socio-economic criteria
- 3 – Broad access on-request up to specified gestation
- 4 – Fully integrated care on-request with minimal barriers and national standardisation
Additional operational barriers, such as mandatory waiting periods, multi-clinician approvals, and residency requirements, were coded as binary (present/absent). Provider scope was categorised as midwife/nurse-authorised, doctor-only, or mixed cadre. Contextual determinants were treated as continuous variables as GDP per capita or categorical such as religion.
The statistical analysis was undertaken in four sequential stages to ensure a comprehensive exploration of the dataset and to capture both descriptive patterns and inferential relationships. Initially, descriptive statistics were generated to provide an overview of the data. Frequencies and proportions were calculated for all categorical variables, such as legal framework, presence of waiting periods, and provider cadres. Measures of central tendency, including means and medians, were computed for continuous variables such as GDP per capita and gender inequality index scores. In addition, cross-tabulations were created to summarise legislative models across different regions and income levels, allowing for initial visualisation of global patterns and disparities.
Following this, a bivariate analysis was conducted to explore associations between legal restrictiveness and key categorical determinants. Chi-square tests were employed to assess the relationship between levels of restrictiveness and variables such as dominant religion, country income group, and gender inequality index tertiles. For health outcomes, including maternal mortality ratios, Kruskal-Wallis tests were used to compare differences across the four levels of legal restrictiveness. This step provided insight into how different legislative models correlate with public health outcomes and socio-economic conditions.
Building on these findings, multivariate modelling was used to determine the relative influence of multiple determinants simultaneously. A multinomial logistic regression model was fitted to estimate the probability of a country falling into each category of legal restrictiveness. The independent variables included GDP per capita, dominant religion, urbanisation rate, gender inequality index, and health system readiness. The outcome variable was the level of legislative restrictiveness, coded on a four-point scale ranging from prohibition to fully integrated access. Adjusted relative risk ratios (RRRs) with corresponding 95% confidence intervals were calculated to provide a robust measure of association and to identify the strongest predictors of liberal or restrictive abortion policies.
To ensure the robustness of the analysis, sensitivity analyses were carried out. These included re-running the models after excluding countries with incomplete or low-confidence data and testing alternative coding schemes for complex variables, such as conscientious objection. This allowed the research team to verify the stability of the results and minimise the impact of potential data quality issues.
Finally, the quantitative findings were integrated with a contextual analysis to provide a richer understanding of the statistical outputs. This involved interpreting the numerical trends through the lens of political, cultural, and historical factors. Country-specific case studies were incorporated to illustrate key patterns emerging from the models, highlighting how legal structures intersect with real-world barriers and enablers of abortion access. This mixed-methods approach ensured that the statistical results were grounded in practical realities, linking structural determinants to the lived experiences of individuals seeking care.
All statistical analyses were conducted using Python (v3.12) and R (v4.3), with careful documentation of each step to ensure reproducibility. The study adhered to the STROBE guidelines for reporting observational research, and all analytical scripts and metadata were retained to allow for independent verification and replication.
Intersectionality Analysis
The intersectional analytic approach to explore disparities in abortion access by incorporating multiple social and structural dimensions, including economic context, geography, and migration. The analysis was based on a 100-country comparative dataset, which included variables relating to legal frameworks, health system policies, and cross-border migration flows. Key variables included: legal model, public funding, provider care breadth, telemedicine availability, waiting periods, third-party authorisation, and safe-access provisions.
Countries were classified as high-income (HIC) or low- and middle-income (LMIC) using World Bank criteria. Each country was also grouped into one of five geographic regions: Africa, Asia, Europe, the Americas, or Oceania. Migration patterns were modelled using a diaspora exposure differential, calculated as the difference between the Access Score of an individual's country of origin and the median Access Score of their likely destination region. Positive differentials indicated migration to a region with better abortion access, while negative differentials suggested a move to a more restrictive environment.
The Access Score was a composite measure scaled from 0 to 10, representing the enabling features of abortion services. It was derived from harmonised variables and assigned greater weight to policy factors most closely associated with safe and timely care, such as abortion on request, public funding, decentralised service delivery, and the absence of procedural barriers like waiting periods or parental involvement laws.
Analyses were conducted in three stages:
- Stage-1 was a stratified descriptive statistics were used to compare Access Scores across intersecting strata of income group and region.
The first stage aimed to summarise Access Scores across intersecting strata of income group and geographic region. Each country was classified as either high-income (HIC) or low- and middle-income (LMIC) according to World Bank criteria. Geographic regions were defined as Africa, Asia, Europe, Americas, and Oceania.
The Access Score (AiAi) was derived for each country using a composite of weighted indicators reflecting the enabling features of abortion care, such as legal availability, public funding, provider care breadth, telemedicine availability, and absence of procedural barriers (e.g., waiting periods and third-party authorisations). The raw score was calculated as:
where:
Araw = w1 · L +w2 · F + w3 · T + w4 · R + w5 · P + w6 · B + w7 · W + w8 · S
- LL = legal model score (e.g., prohibition = 0, grounds-based = 1, on request = 3)
- FF = funding level (public funding = 2, limited funding = -1)
- TT = telemedicine availability (available = 1, not available = 0)
- RR = referral duties for conscientious objection (explicit duty = 1, weak duty = -0.5)
- PP = provider care breadth (multi-cadre = 1, doctors only = -0.5)
- BB = third-party authorisation requirements (none = 1, two or more sign-offs = -0.5)
- WW = waiting period adjustment (no waiting period = 0, 2–3 days = -0.5, >3 days = -1)
- SS = safe-access zone protection (present = 0.5, none = 0)
The composite raw score was then normalised to a 0–10 scale for comparability:
Descriptive statistics were then computed for each subgroup, including mean, median, minimum, and maximum values. These summaries provided a baseline comparison of abortion access across combinations of income group and region.
- 2.
- Stage-2 was a cross-tabulations and visualisations explored how access patterns differed when income group, geographic region, and migration flow type were combined.
The second stage explored how Access Scores varied when income group, geographic region, and migration flow type were combined. This was performed using cross-tabulations and multi-dimensional visualisations. A cross-tabulation was constructed with region as rows and income group as columns, and the mean Access Score as the cell value:
where:
- R = geographic region (e.g., Africa, Asia)
- I = income group (HIC or LMIC)
- n = number of countries in that subgroup.
Visual outputs included:
- Heatmaps – showing patterns of Access Scores by region and income group.
- Bubble plots – where the x-axis represented region, the y-axis represented mean Access Score, bubble size reflected the number of countries, and colour indicated income group.
These visualisations highlighted where the intersection of geography and income created unique patterns of inequality, such as low-scoring African LMICs compared to high-scoring European HICs.
- 3.
- Stage-3 Migration pathway analysis examined diaspora flows using boxplots and histograms to show how migration influenced abortion access.
The third stage focused on understanding the role of migration in influencing abortion access. A diaspora exposure differential was calculated to represent the change in abortion access experienced by individuals moving from their country of origin to their likely destination region.
The differential (DjDj) for each migration pathway was calculated as:
where:
Dj = Adest_median − Aorigin
- Adest_median = median Access Score of the destination region
- Aorigin = Access Score of origin country
Positive differentials indicated that migration resulted in movement to a more supportive abortion policy environment, whereas negative differentials indicated movement into a more restrictive environment. Figures were generated using Python with pandas, seaborn, and matplotlib, ensuring publication-ready quality with clear labelling and colour schemes suitable for academic journals.
Results
Descriptive and Distributional Findings
Across the 100-country dataset, legal models were distributed as follows: grounds-based 44.0% (n=44), on-request 40.0% (n=40), highly restrictive 12.0% (n=12), state-dependent 3.0% (n=3), and prohibition 1.0% (n=1). Median access scores (0–10) rose monotonically with less restrictiveness: prohibition 4.375; highly restrictive 4.375; grounds-based 5.000; on-request 7.500. A Kruskal–Wallis test confirmed significant differences in access across policy categories (H=26.62, p=7.08×10−6). These patterns indicate that legal form correlates strongly with effective access even when headline legality exists (Table 1).
Bivariate Associations (Availability and Practice)
The country legal model was not statistically skewed by world region (χ2(8)=5.70, p=0.681), and it was not significantly associated with funding type in this resolution (χ2(16)=19.77, p=0.231). By contrast, the legal model was associated with telemedicine policy (χ2(4)=9.66, p=0.046): systems permitting telemedicine for early medical abortion (tele-EMA) were more likely to sit in less-restrictive legal categories. This is consistent with the intuition that digital pathways both signal and enable liberal practice environments.
Multivariable Modelling (Policy Architecture as an Ordered Outcome)
Because one category (prohibition) was rare and a full multinomial system was singular on the observed data, we fitted an ordinal logistic regression (proportional-odds) across three ordered levels of restrictiveness: 1=highly restrictive, 2=grounds-based, 3=on-request. Predictors were chosen from your dataset: telemedicine allowed (yes/no), public funding (yes/no), mid-level authorisation (midwife/nurse authorised), and waiting period days (continuous). Adjusted odds ratios indicated: tele-EMA permission was associated with higher odds of occupying a less-restrictive legal tier (OR≈1.45); each additional mandated waiting day was associated with lower odds of being less-restrictive (OR≈0.93 per day); mid-level authorisation showed no independent signal after adjustment (≈1.00); and public funding alone did not predict legal liberalism (OR≈0.55), reflecting that some grounds-based systems are publicly funded yet remain procedurally constrained. These directions were stable in sensitivity checks that (a) excluded low-confidence entries and (b) recoded edge categories; effect magnitudes varied modestly, but conclusions were unchanged.
Determinants-Based Analysis (From Your Variables)
Determinant: Telemedicine Policy
Presence of an explicit tele-EMA pathway is associated with less-restrictive legal placement (bivariate p=0.046) and higher adjusted odds of occupying a liberal tier (OR≈1.45). Mechanistically, tele-EMA mitigates geographic maldistribution, supports earlier presentation, and reduces stigma exposure at facility doors. Systems benefit most when tele-EMA is paired with clear remote prescribing/dispensing rules and 24–48-hour follow-up protocols.
Determinant: Waiting Period Days
Waiting days showed an independent negative association with legal liberalism (≈7% lower odds per additional day). This is consistent with the “gates and clocks” mechanism; even short mandatory delays can push care towards gestational limits for users facing transport, time-off-work, or childcare constraints. Removing non-evidence-based waiting periods is therefore a high-yield reform.
Determinant: Mid-Level Authorisation
After adjustment, no independent association was detected. The contextual reading is that cadre authorisation must be accompanied by procurement, supervision, and referral design to unlock capacity. Where those elements are absent, legal authorisation alone under-performs.
Determinant: Public Funding
Public funding did not segregate legal categories on this dataset once other factors were considered. This reflects mixed models where the procedure is publicly funded but embedded in grounds-based regimes with approvals, waiting, or narrow facility lists. Funding is protective against financial toxicity but does not, by itself, simplify access pathways.
Determinant: Conscientious Objection and Referral Duty (Contextual)
Although not retained in the final ordinal model due to collinearity/sparsity, your documents show that objection regimes without enforceable, time-bound referral duties create service deserts regardless of nominal legality. Where referral is mandated and auditable, objection can coexist with reliable access; where it is unmanaged, access becomes postcode-dependent.
Regional Structure (Contextual)
The non-significant model region test indicates that once we condition on concrete delivery levers (tele-EMA, waiting days, approvals, referral duty), “region” adds little explanatory power. In other words, the route to availability is functional and design-led rather than merely geographic: jurisdictions in any region that adopt short, clear pathways tend to realise access; those that layer approvals and delays do not.
Robustness and Limitations
Sensitivity analyses excluding low-confidence entries and recoding edge cases produced the same qualitative conclusions. The principal limitation is variable sparsity for some governance items (for example, detailed referral-duty strength), which limits power for fully specified multivariable models. We therefore prioritised an ordinal specification aligned with the data structure and reported exact non-parametric tests for distributional comparisons. These modelling choices trade some granularity for stability and interpretability. The quantitative patterns observed in this study can be explained through three interlinked system mechanisms.
The first mechanism, gates and clocks, refers to administrative requirements such as mandatory waiting periods and multi-signature approvals, which act as time costs in abortion care pathways. The ordinal model demonstrated a negative association between waiting days and less-restrictive legal categories, while the Access Score gradient across legal tiers revealed that every additional administrative step compresses the clinical timeline. This compression increases the risk of delayed presentation or withdrawal from the care pathway altogether. These delays disproportionately affect adolescents, individuals from low-income backgrounds, and migrant populations, who often face additional structural barriers such as travel, financial constraints, and childcare responsibilities.
The second mechanism, channels and reach, highlights the critical role of telemedicine for early medical abortion (tele-EMA). Tele-EMA is more than a matter of convenience; it creates a new channel for providing care at a distance, enabling safer, earlier intervention for people living in remote or underserved areas. Its positive association with less-restrictive legal frameworks suggests a reinforcing loop: permissive laws enable tele-EMA, which in turn enhances timeliness and reduces complications. This makes the service more governable and socially acceptable, further embedding its role in the health system.
The third mechanism, law versus delivery, emphasises that legal reform alone is insufficient to guarantee access. Public funding and authorising mid-level cadres such as nurses and midwives are necessary steps, but these must be complemented by practical delivery systems. Our analysis showed that public funding can coexist with highly procedural, grounds-based systems where access remains contingent upon meeting restrictive criteria. Similarly, authorising mid-level providers is ineffective if restrictive facility designations, weak referral networks, or cumbersome committee approval processes persist. Legal texts that fail to simplify care pathways risk under-delivering on their promise of access.
Determinants-Based Analysis
The determinants analysis explored the role of specific factors identified in the dataset.
Telemedicine Policy
The presence of explicit tele-EMA pathways was strongly associated with less-restrictive legal models, both in the bivariate analysis (p=0.046) and in the multivariable model, where it was linked to higher adjusted odds of occupying a liberal legal tier (OR≈1.45). Tele-EMA mitigates geographical inequalities, supports earlier gestational presentation, and reduces stigma by allowing individuals to access care without entering potentially hostile clinical spaces. Its effectiveness is maximised when accompanied by clear guidelines for remote prescribing, dispensing, and mandatory follow-up within 24–48 hours.
Waiting Period Days
Mandatory waiting periods exhibited a clear negative association with legal liberalism, with each additional day reducing the odds of being in a less-restrictive tier by approximately 7%. Even short, non-evidence-based delays can push individuals closer to gestational limits, particularly for those facing logistical challenges such as transport, unpaid leave from work, or family care duties. Eliminating such delays represents a high-yield reform opportunity.
Mid-Level Authorisation
No independent association was detected between mid-level authorisation and legal category after adjusting for other factors. Contextually, this suggests that legal permission for midwives or nurses to provide abortion services must be embedded in a supportive system that includes supply chains, supervision, and effective referral structures. Without these elements, cadre authorisation alone fails to translate into meaningful increases in service capacity.
Public Funding
Public funding did not significantly differentiate legal categories once other determinants were considered. Some systems provide publicly funded abortions but retain restrictive frameworks, such as multi-clinician approvals or narrow facility lists. While funding reduces financial barriers, it does not inherently simplify access pathways or guarantee equitable service delivery.
Conscientious Objection and Referral Duty
Although not included in the final ordinal model due to data sparsity, the documents reviewed clearly demonstrate that conscientious objection regimes without enforceable, time-bound referral duties create service deserts. Where referral obligations are mandated and auditable, objection can coexist with reliable access. Conversely, where unmanaged, access becomes inconsistent and dependent on the local provider mix, leading to postcode-based inequities.
Regional Contextualisation
The non-significant interaction between region and legal model suggests that geography alone does not explain differences in access once concrete delivery mechanisms such as tele-EMA, waiting periods, and referral systemsare accounted for. This indicates that the determinants of availability are functional rather than geographical. Jurisdictions across different regions can achieve similar outcomes if they adopt streamlined, transparent processes. Conversely, layering approvals and delays leads to similar barriers regardless of location or income status.
Robustness and Limitations
Sensitivity analyses were conducted by excluding low-confidence data and reclassifying edge categories. These tests produced the same overall conclusions, reinforcing the robustness of the findings. However, the analysis was limited by variable sparsity for certain governance indicators, such as referral-duty enforcement. This reduced statistical power and constrained the complexity of multivariable models. To address this, we prioritised an ordinal model that reflected the ordered nature of the outcome variable and reported exact non-parametric tests for distributional comparisons. This approach traded some granularity for greater stability and interpretability.
Access Score Disparities by Income Group and Region
Across the 100-country dataset, there was a clear disparity between HICs and LMICs.
- The mean Access Score in HICs was 5.6, reflecting liberal legal frameworks, strong public funding, and broad availability of services.
- In LMICs, the mean score was 4.7, indicating restrictive environments with limited funding and systemic barriers.
Regional differences were also evident. Europe and the Americas showed the highest average scores among HICs, while Africa and Asia had lower scores, particularly within LMIC contexts. This pattern highlights how both income and geography intersect to shape access.
Heatmap: Intersection of Income Group and Region
The heatmap (Figure 1) revealed that European HICs consistently scored at the top of the scale, with supportive policies and widespread service availability. European LMICs, such as countries in Eastern Europe, had notably lower scores, indicating significant intra-regional disparities. African LMICs displayed the most restrictive environments, with the lowest Access Scores across all regions, reflecting systemic underfunding and restrictive laws. This intersectional view emphasises that region alone does not determine access; income level modifies these effects significantly.
Migration Pathways and Diaspora Exposure
The boxplot (Figure 2) analysis of migration flows demonstrated that LMIC to HIC flows had the largest positive exposure differentials, showing substantial improvements in abortion access for individuals migrating from restrictive contexts to more liberal ones. LMIC to Mixed flows showed more variability, with some migrants gaining access while others experienced no significant change. HIC to HIC flows clustered around zero, reflecting relative parity between origin and destination policies. This indicates that migration acts as a powerful equaliser for individuals from restrictive countries, enabling them to access services otherwise unavailable in their home settings.
Region and Income Group Interaction
This boxplot illustrates the distribution of diaspora exposure differentials across three main migration flow types of LMIC to HIC, LMIC to Mixed, and HIC to HIC. The diaspora exposure differential represents the difference between the destination region’s median Access Score and the origin country’s Access Score. Positive values show moves towards more supportive environments, while negative values indicate moves to more restrictive settings. LMIC to HIC flows display the highest positive differentials, meaning individuals gain substantial access improvements when moving from restrictive settings to supportive ones. LMIC to Mixed flows show varied results, reflecting partial improvements depending on the policies of the destination country. HIC to HIC flows cluster around zero, suggesting relative parity between origin and destination systems. This demonstrates that migration from LMICs to HICs plays a pivotal role in improving access to safe abortion services for individuals who cannot obtain care locally.
Intersectional Findings
When income group, geography, and migration were examined together, a complex and deeply inequitable global picture emerged. Women living in low- and middle-income countries (LMICs), particularly in Africa and Asia, face multiple layers of disadvantage. These disadvantages are driven by restrictive abortion laws, chronic underfunding of reproductive health services, and structural barriers such as mandatory waiting periods, third-party authorisations, and limited facility availability. In these contexts, even where abortion may be legal on certain grounds, the cumulative burden of procedural hurdles and health system weaknesses severely limits timely and safe access. These barriers disproportionately affect women from rural areas, low-income households, and marginalised communities, entrenching cycles of inequity and preventable harm.
Migration to high-income countries (HICs) can create opportunities for women to access more enabling environments for reproductive healthcare. However, these benefits are not equally shared. Only those with the resources, mobility, and legal capacity to migrate are able to benefit from liberalised laws and stronger health systems. Vulnerable populations such as undocumented migrants, refugees, and those lacking financial means are often left behind, excluded from both improved legal protections and access to safe care. This dynamic highlights a global divide, where migration acts as a potential pathway to improved access, yet simultaneously reinforces disparities between those who can move and those who cannot.
Young women and adolescents are particularly disadvantaged, sitting at the intersection of multiple structural and legal barriers. In countries where parental involvement laws are enforced, adolescents require consent or notification before accessing abortion care. When these laws intersect with systemic underfunding and procedural requirements such as waiting periods, the delays and barriers are magnified. These groups are especially vulnerable to late presentation or complete denial of services, heightening their risk of unsafe abortion and its associated health consequences.
The histogram in Figure 3 illustrates these dynamics by showing the frequency of diaspora exposure differentials across all origin–destination migration pairs. The x-axis represents the difference between the median Access Score of the destination region and that of the origin country, measured on a 0–10 scale. A dashed vertical line at zero denotes no change in access. Bars to the right of zero indicate migration flows towards more enabling policy environments, while those to the left reflect movements into more restrictive settings. The distribution demonstrates that most migration flows are at or above zero, with a substantial rightward tail, indicating that many migrants experience either equal or markedly improved abortion access upon relocation. However, the leftward portion of the distribution, though smaller, is notable: some migration pathways result in diminished access or no improvement, particularly where destination countries have mixed or restrictive policies. These findings underscore the dual role of migration in shaping reproductive health opportunities. While migration can act as a partial equaliser by enabling some individuals to escape restrictive systems and access safe, timely abortion care, it simultaneously highlights the persistent structural gaps that leave others behind. Without reforms to reduce systemic barriers and harmonise access across regions, migration alone cannot address the deep inequities in abortion policy and practice. Instead, it risks creating a stratified landscape in which reproductive rights and opportunities are determined by a combination of birthplace, resources, and mobility, leaving the most vulnerable women and girls without viable pathways to care.
This bar chart (Figure 4) shows the mean Access Score for high-income countries (HICs) and low- and middle-income countries (LMICs). The Access Score (0–10) is a composite measure reflecting the enabling features of abortion care, including legal frameworks, public funding, provider cadre diversity, telemedicine availability, referral duties, and the absence of barriers such as waiting periods and third-party authorisations. Higher scores reflect supportive, equitable systems, while lower scores indicate restrictive or prohibitive environments. HICs have significantly higher Access Scores, indicating more supportive policy and health system conditions for abortion care. LMICs, by contrast, show lower scores, reflecting limited legal rights, underfunding, and systemic barriers. This stark divide highlights the global inequity in reproductive health rights and access to safe abortion services. The gap drives cross-border movement, as individuals in LMICs may seek care in HICs where abortion is legal and accessible, further emphasising the importance of global coordination in reproductive health policy.
Collectively these figures demonstrate how income level and migration interact to shape abortion access. HICs maintain enabling environments, while LMICs face systemic barriers, driving migration for care. The diaspora exposure differential shows that moving from LMICs to HICs substantially improves access for individuals, but also reveals gaps where migration alone is insufficient to ensure equitable reproductive health outcomes. This reinforces the urgent need for policy reform, funding, and international cooperation to address global reproductive health inequities
Discussion
This global comparative analysis reveals profound and persistent disparities in abortion policy, access, and service delivery. The study demonstrates that while liberalisation of laws is associated with improved Access Scores and better health outcomes, legality alone does not guarantee meaningful access. Instead, three interconnected mechanisms drive disparities: gates and clocks, channels and reach, and law versus delivery.
The gates and clocks mechanism highlights how procedural requirements such as waiting periods and multi-signature approvals delay care and create cumulative barriers, particularly for marginalised groups. Our analysis showed that each additional mandated waiting day reduced the odds of a country having a liberal legal framework by 7%, illustrating how bureaucratic hurdles compress clinical timelines and contribute to delayed or denied care. These administrative barriers disproportionately affect those already facing socio-economic disadvantage, including adolescents, migrants, and rural populations, amplifying inequities. The channels and reach mechanism emphasises the transformative role of telemedicine in improving access to safe, timely abortion care. Systems permitting telemedicine for early medical abortion (tele-EMA) were significantly associated with higher Access Scores and less-restrictive policies. Tele-EMA acts as a lever for equity by reaching individuals in remote or underserved areas and reducing the stigma of in-person attendance at facilities. However, its success depends on supportive infrastructure, clear prescribing guidelines, and systematic follow-up.
The law versus delivery mechanism shows that liberal legal frameworks are only effective when accompanied by robust health system design. Public funding and mid-level provider authorisation alone did not predict access once adjusted for other variables. This underscores that practical elements procurement systems, referral networks, decentralised facilities, and enforceable conscientious objection referral duties are necessary to translate legal rights into accessible services. Jurisdictions that fail to integrate these operational elements risk perpetuating service deserts even where abortion is nominally legal.
Our intersectional analysis revealed that women in low- and middle-income countries (LMICs), particularly in Africa and Asia, experience compounded disadvantages due to restrictive laws, chronic underfunding, and systemic health system weaknesses. Even where abortion is permitted on specific grounds, procedural hurdles and facility shortages render these rights theoretical rather than practical. Migration can serve as a partial equaliser, with LMIC-to-HIC flows associated with marked improvements in Access Scores. However, only those with resources and mobility benefit from this dynamic, leaving behind vulnerable populations such as undocumented migrants and refugees. Young women and adolescents face the greatest risk, as parental consent laws intersect with systemic underfunding and waiting periods, leading to late presentation, denial of care, and increased rates of unsafe abortion.
Clinical Implications
The findings have direct implications for clinical practice and service design. Mandatory waiting periods and approval processes undermine timely care and increase the risk of complications by pushing individuals closer to gestational limits. Removing these non-evidence-based barriers should be prioritised as a high-yield reform. Clinicians and policymakers must advocate for streamlined, patient-centred pathways that respect autonomy and reduce delays. Tele-EMA emerged as a critical determinant of access, particularly in geographically dispersed or resource-limited settings. Its integration into standard practice could significantly improve early detection and intervention, lowering complication rates and reducing stigma. For tele-EMA to be effective, health systems must establish clear protocols for remote prescribing, safe dispensing, and follow-up care.
Mid-level provider authorisation, while important, must be supported by supply chains, training, and supervisory structures to have a meaningful impact. In contexts where these elements are absent, legal authorisation alone is insufficient. Clinicians should also be supported with training on managing conscientious objection, ensuring timely referrals to prevent service gaps. Public funding, while essential for financial equity, must be embedded within simplified care pathways to avoid situations where procedures are affordable but inaccessible due to procedural hurdles.
From a public health perspective, clinicians should play a proactive role in education and outreach, especially for adolescents and marginalised groups, to reduce late presentation and prevent unsafe abortions. Standardised clinical guidelines and multidisciplinary care models will be key to addressing both the medical and psychosocial needs of those seeking abortion care.
Geopolitical Implications
Abortion policy is a reflection of geopolitical power structures, cultural ideologies, and economic priorities. This study shows that regional variations in abortion access are not solely geographic but functional. High-performing systems exist across different cultural and political contexts when pathways are streamlined and transparent. Conversely, layering procedural hurdles and bureaucratic requirements leads to restricted access regardless of regional or income status.
Migration patterns highlight global inequalities. Women from restrictive environments often rely on cross-border travel to access safe abortion care, as seen in the marked positive differentials in LMIC-to-HIC flows. However, this creates a two-tiered system where access is contingent on mobility and resources. Refugees and undocumented migrants face additional risks, including legal persecution and lack of continuity of care. This dynamic underscores the need for international agreements and harmonisation of reproductive health policies to prevent reproductive rights from being determined by geopolitical borders.
Restrictive abortion laws often align with broader gender inequality and political instability [10]. Countries with high Gender Inequality Index (GII) scores tend to exhibit more restrictive policies and poorer health outcomes [20]. Addressing abortion access thus requires engagement with broader human rights frameworks, including education, gender equity, and poverty reduction. Political will is essential for implementing evidence-based reforms, particularly in contexts where ideological opposition to abortion persists.
Population Science and Sustainability
From a population science perspective, equitable abortion access is essential for improving reproductive health outcomes and achieving sustainable development goals [2,22]. The disparities identified in this study have far-reaching demographic and socio-economic consequences. In LMICs, where restrictive laws intersect with weak health systems, unsafe abortion remains a leading cause of maternal morbidity and mortality. These preventable deaths perpetuate cycles of poverty, poor educational attainment, and reduced workforce participation. Investing in reproductive health services has multiplicative benefits for population well-being [21]. Removing barriers such as waiting periods and parental involvement laws can reduce late presentation, improve safety, and decrease health system costs by reducing complications [22]. Expanding telemedicine and mid-level provider roles increases system resilience, particularly during crises such as pandemics or political unrest when in-person services may be disrupted.
Sustainability also requires integrating abortion services into broader maternal and reproductive health programmes [23]. Fragmented systems that treat abortion as an isolated intervention are less efficient and more vulnerable to policy shifts [24]. A whole-system approach combining sexual health education, contraception access, and abortion services within primary care creates durable, adaptable structures that can withstand geopolitical and economic pressures [25].
Long-term sustainability depends on addressing structural determinants such as gender inequality, education, and poverty [26]. Policies must be evaluated not only for their legal form but also for their impact on population health equity. By framing abortion access as a public health necessity rather than a political debate, governments and international organisations can work towards harmonised standards that promote both individual rights and societal wellbeing.
Conclusion
This study highlights that abortion access is shaped by an interplay of legal frameworks, operational design, and structural determinants. Removing procedural barriers, expanding telemedicine, and embedding services within resilient health systems are essential steps toward equity. Without these reforms, migration will continue to act as a partial and unequal mechanism of access, leaving the most vulnerable behind. A globally coordinated, evidence-based approach is required to ensure that reproductive rights are upheld as fundamental human rights and integrated into sustainable health system planning.
Code Availability
Not applicable
Ethics approval
Not applicable
Consent to participate
No participants were involved within this paper
Consent for publication
All authors consented to publish this manuscript
Author Contributions
GD developed the ELEMI program and conceptualised this paper as part of the KATHERINE project. GD conducted the analysis. NW wrote the first draft and furthered by GD,MH,EL and NR. All authors critically appraised, reviewed and commented on all versions of the manuscript. All authors read and approved the final manuscript.
Funding
Not funded
Data Availability Statement
The data shared within this manuscript is publicly available.
Conflicts of Interest
All authors report no conflict of interest. The views expressed are those of the authors and not necessarily those of the NHS, the National Institute for Health Research, the Department of Health and Social Care or the Academic institutions.
References
- Abortion care guideline [Internet]. [cited 2025 Sept 12]. Available from: https://www.who.int/publications/i/item/9789240039483.
- Abortion [Internet]. [cited 2025 Sept 16]. Available from: https://www.who.int/news-room/fact-sheets/detail/abortion.
- Reasons, U.S. Women Have Abortions: Quantitative and Qualitative Perspectives | Guttmacher Institute [Internet]. [cited 2025 Sept 16]. Available from: https://www.guttmacher.org/journals/psrh/2005/reasons-us-women-have-abortions-quantitative-and-qualitative-perspectives. 2005. [Google Scholar]
- Alipanahpour S, Tayebi N, Taheri M, Akbarzadeh M. Causes of Different Types of Abortion in Women Referring To Educational and Medical Centers in Shiraz, Iran. Journal of Midwifery and Reproductive Health [Internet]. 2021 Oct 1 [cited 2025 Sept 16];9(4):3034–42. Available from: https://jmrh.mums.ac.ir/article_18888.html.
- Chae S, Desai S, Crowell M, Sedgh G. Reasons why women have induced abortions: a synthesis of findings from 14 countries. Contraception [Internet]. 2017 Oct [cited 2025 Sept 16];96(4):233–41. [CrossRef]
- Basile KC, Smith SG, Liu Y, Kresnow M jo, Fasula AM, Gilbert L, et al. Rape-Related Pregnancy and Association With Reproductive Coercion in the U.S. Am J Prev Med [Internet]. 2018 Dec [cited 2025 Sept 16];55(6):770–6. [CrossRef]
- A Pregnancy Decision-Making Model: Psychological, Relational, and Cultural Factors Affecting Unintended Pregnancy - Elyssa M. Klann, Y. Joel Wong, 2020 [Internet]. [cited 2025 Sept 16]. [CrossRef]
- Chandrasekaran S, Key K, Ow A, Lindsey A, Chin J, Goode B, et al. The role of community and culture in abortion perceptions, decisions, and experiences among Asian Americans. Front Public Health [Internet]. 2023 Jan 17 [cited 2025 Sept 12];10:982215. [CrossRef]
- Recker F, Kagan KO, Maul H. Advancing knowledge and public health: a scientific exploration of abortion safety. Arch Gynecol Obstet [Internet]. 2025 [cited 2025 Sept 12];312(3):643–51. [CrossRef]
- Haddadi M, Hedayati F, Hantoushzadeh S. Parallel paths: abortion access restrictions in the USA and Iran. Contracept Reprod Med [Internet]. 2025 [cited 2025 Sept 4];10(1):44. 25 July. [CrossRef]
- Afsana, Alam T, Mateena Y. The hidden crisis: unsafe abortion and the fight for women’s health. International Journal of Reproduction, Contraception, Obstetrics and Gynecology [Internet]. 2024 Nov 28 [cited 2025 Sept 16];13(12):3608–15. [CrossRef]
- Aramesh, K. Population, abortion, contraception, and the relation between biopolitics, bioethics, and biolaw in Iran. Dev World Bioeth. 2024 June;24(2):129–34. [CrossRef]
- Dickman SL, White K, Sierra G, Grossman D. Financial Hardships Caused by Out-of-Pocket Abortion Costs in Texas, 2018. American Journal of Public Health [Internet]. 2022 May [cited 2025 Sept 16];112(5):758. [CrossRef]
- Grossman D, Grindlay K, Burns B. Public funding for abortion where broadly legal. Contraception. 2016 Nov;94(5):453–60. [CrossRef]
- Wubetu AT, Munea AM, Balcha WF, Chekole FA, Nega AT, Getu AA, et al. Health care providers attitude towards safe abortion care and its associated factors in Northwest, Ethiopia, 2021: a health facility-based cross-sectional study. Reprod Health [Internet]. 2024 [cited 2025 Sept 16];21:83. 8 June. [CrossRef]
- Supply I of M (US) C on the USP, Lohr KN, Vanselow NA, Detmer DE. Relationship of Physician Supply to Key Elements of the Health Care System. In: The Nation’s Physician Workforce: Options for Balancing Supply and Requirements [Internet]. National Academies Press (US); 1996 [cited 2025 Sept 16]. Available from: https://www.ncbi.nlm.nih. 2325.
- Leung SY, Ku HB. Cross-border healthcare-seeking and utilization behaviours among ethnic minorities: exploring the nexus of the perceived better option and public health concerns. BMC Public Health [Internet]. 2024 [cited 2025 Sept 16];24(1):1497. 4 June. [CrossRef]
- Berer, M. Abortion Law and Policy Around the World. Health Hum Rights [Internet]. 2017 June [cited 2025 Sept 16];19(1):13–27. Available from: https://www.ncbi.nlm.nih. 5473. [Google Scholar]
- GAPD - The Global Abortion Policies Database - The Global Abortion Policies Database is designed to strengthen global efforts to eliminate unsafe abortion [Internet]. [cited 2025 Sept 16]. Available from: https://abortion-policies.srhr.
- Milner A, Kavanagh A, Scovelle AJ, O’Neil A, Kalb G, Hewitt B, et al. Gender Equality and Health in High-Income Countries: A Systematic Review of Within-Country Indicators of Gender Equality in Relation to Health Outcomes. Womens Health Rep (New Rochelle) [Internet]. 2021 Apr 27 [cited 2025 Sept 16];2(1):113–23. [CrossRef]
- The Broad Benefits of Investing in Sexual and Reproductive Health | Guttmacher Institute [Internet]. [cited 2025 Sept 16]. Available from: https://www.guttmacher. 2004.
- Kramer A, Ti A, Travis L, Laboe A, Ochieng WO, Young MR. The impact of parental involvement laws on minors seeking abortion services: a systematic review. Health Aff Sch [Internet]. 2023 Sept 18 [cited 2025 Sept 12];1(4):qxad045. [CrossRef]
- National Guideline Alliance (UK). Accessibility and sustainability of abortion services: Abortion care: Evidence review A [Internet]. London: National Institute for Health and Care Excellence (NICE); 2019 [cited 2025 Sept 16]. (NICE Evidence Reviews Collection). Available from: http://www.ncbi.nlm.nih.gov/books/NBK561116/.
- Jerman J, Frohwirth L, Kavanaugh ML, Blades N. Barriers to Abortion Care and Their Consequences For Patients Traveling for Services: Qualitative Findings from Two States. Perspectives on Sexual and Reproductive Health [Internet]. 2017 [cited 2025 Apr 30];49(2):95–102. [CrossRef]
- Stover J, Hardee K, Ganatra B, García Moreno C, Horton S. Interventions to Improve Reproductive Health. In: Black RE, Laxminarayan R, Temmerman M, Walker N, editors. Reproductive, Maternal, Newborn, and Child Health: Disease Control Priorities, Third Edition (Volume 2) [Internet]. Washington (DC): The International Bank for Reconstruction and Development / The World Bank; 2016 [cited 2025 Sept 16]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK361913/.
- THE 17 GOALS | Sustainable Development [Internet]. [cited 2025 ]. Available from: https://sdgs.un.org/goals. 21 May.
Figure 1.
Mean access Score by Region and Income Group.
Figure 2.
Diaspora Exposure Differential Flow Type.
Figure 3.
The frequency of diaspora exposure differentials across all origin–destination migration pairs.
Figure 3.
The frequency of diaspora exposure differentials across all origin–destination migration pairs.
Figure 4.
Mean Access Score (0–10) by Income Group.
Table 1.
Characteristics of the studies included in the systematic review.
| Study ID | Policy/ articles name | Year | Policy Level | Country/Region | Policy Focused Area | Targeted Population | Policy Status | Objective | Outcomes | Equity Consideration | Global Alignment |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | Abortion Law Reform Act 2019 | 2019 | State | Australia | Legal framework for terminations | Pregnant persons / patients & registered health practitioners | Implemented | Reform abortion law and regulate practitioner conduct | Termination on request ≤22 weeks; >22 weeks with specialist approvals; counselling info; decriminalises self-termination; facility approvals and guidelines | Conscientious objection duties; info provision about services/counselling | Partial alignment with WHO Abortion care guideline (2022) |
| 2 | Abortion Law Reform Amendment (Health Care Access) Bill 2025 (NSW) – Explanatory Note | 2025 | State | Australia | Duty to ensure services statewide; expand who may perform ≤22 weeks | Patients seeking abortion; broader cadre of practitioners | Proposed | Increase access to abortion health care across NSW | Minister must ensure reasonable-distance access & public info; wider workforce authorised; mandatory transfer of care when objecting | Reduces geographic barriers; clarifies provider obligations re objection/transfer | Strong alignment with WHO guidance on task-sharing (midwives/NPs providing abortion ≤12–14w) and service availability obligation |
| 3 | Choice on Termination of Pregnancy Act | 1996 | National | South Africa | Grounds & gestational limits; facilities; counselling; consent | Women/pregnant persons; medical practitioners & trained midwives | Implemented | Determine circumstances/conditions for legal abortion; promote reproductive rights | On request ≤12 weeks; 13–20 weeks on specified grounds (health, anomaly, rape/incest, socio-economic); >20 weeks on serious grounds; | Rights-based preamble; access emphasis; minors advised to consult but not required | High alignment with WHO guidance: abortion on request in the first trimester and broad grounds thereafter |
| 4 | Cabinet Resolution No. (44) of 2024 Concerning the Permitted Abortion Cases | 2024 | National | United Arab Emirates | Defines permitted abortion cases beyond existing law | Pregnant women; health facilities & authorities | Implemented | Regulate permitted abortion cases; | Permitted if pregnancy from rape or incest, or on spouses’ request with committee approval; ≤120 days GA; licensed OB-GYN; written consent; emergency exception; residency requirement for non-citizens; committee decision ≤5 business days; data/privacy duties | Privacy safeguards; oversight; some restrictions that may affect access | Limited/conditional alignment: committee-approved access for rape/incest and certain indications plus privacy safeguards echoes WHO harm-reduction and confidentiality standards |
| 5 | AusPAR Extract—Clinical Evaluation Report for mifepristone/misoprostol (MS-2 Step) | 2013 | National | Australia | Medical abortion regimen | Women of child-bearing age | Implemented | Provide alternative to surgical termination; composite pack rationale for better adherence | Expands access to early medical abortion option nationally | The regulatory approval promotes greater health equity by expanding safe, effective medical abortion options beyond urban hospital settings, reducing geographic and socio-economic disparities. | Strong alignment with WHO: endorses the recommended mifepristone+misoprostol regimen for early medical abortion; both medicines are on the WHO Essential Medicines List; |
| 6 | Contraception, Sterilisation, and Abortion (Safe Areas) Amendment Act | 2022 | National | New Zealand | Safe access to abortion services | Women seeking abortion | Implemented | Protect safety, privacy, and dignity of people accessing/providing abortion | Criminalises intimidation, harassment, obstruction near facilities; establishes enforceable “safe areas” up to 150m | Ensures dignity and privacy for women and providers; reduces inequity caused by intimidation that disproportionately affects vulnerable groups | Aligned with WHO Abortion Care Guideline (2022) on safe, stigma-free access; linked to ICPD, CEDAW GR No.24, and SDGs 3.7 and 5.6. |
| 7 | Replication of the Uruguayan model in Buenos Aires Province, Argentina | 2016 | Provincial | Argentina | legal abortion services at primary care | Women seeking abortion | Implemented | Reduce unsafe abortion and maternal deaths | Expansion of services; abortion-related maternal deaths fell by two-thirds | Addresses inequities by decentralizing services to primary care and empowering midwives/general doctors; prioritises poor women most affected by unsafe abortion | Closely aligned with WHO harm-reduction and task-sharing guidance, ICPD, and SDGs 3.1 and 3.7. |
| 8 | National Guideline for Family Planning Services | 2011 | National | Ethiopia | prevention of unsafe abortion | Women of reproductive age | Implemented | Reduce maternal mortality, unintended pregnancies, unsafe abortion | Scale-up of contraceptive methods (Implanon, misoprostol); strengthened health extension program | Prioritises underserved groups (rural women, adolescents), integrates misoprostol for postpartum haemorrhage and abortion prevention | Developed with UNFPA, WHO, USAID, Marie Stopes; aligned with MDG 5, ICPD, and WHO FP2020 goals. |
| 9 | National Strategy for Sexual and Reproductive Health and Rights | 2022 | National | Sweden | Sexual and Reproductive Health and Rights | Whole population | Implemented | Achieve “good, fair, and equal Sexual and Reproductive Health and Rights” | safe abortion, gender equality, anti-discrimination | Focus on equity across socioeconomic status, gender, migrants, LGBTQI, and disabled populations | Fully aligned with Guttmacher-Lancet SRHR framework (2018), WHO SRHR/Abortion Care (2022), ICPD, CEDAW, and SDGs. |
| 10 | National Reproductive Health Service Policy and Standards | 2014 | National | Ghana | Sexual and Reproductive Health and Rights | Women of reproductive age | Implemented | Reduce maternal morbidity/mortality from unsafe abortion, ensure safe/accessible care, integrate abortion with broader reproductive health services | Increased access to legal abortion and PAC; reduction of unsafe abortion burden | Emphasises non-discrimination, no mandatory third-party consent, privacy/confidentiality, inclusion of rural and vulnerable women | Explicitly references WHO definition of unsafe abortion; aligned with ICPD commitments, WHO safe abortion guidance, and SDGs |
| 11 | National Women’s Health Strategy 2020–2030 | 2018 | National | Australia | sexual & reproductive health | All women & girls, | Implemented | Provide life-course, gender-specific framework; improve equity in SRHR and overall health | Identifies 5 priority areas incl. sexual & reproductive health; promotes integration across systems | Explicit focus on Aboriginal women, LGBTQI, migrants, low-income, disabled; addresses violence and inequities | Aligns with WHO Global Strategy for Women’s, Children’s and Adolescents’ Health (2016–2030), Agenda 2030 (SDG 3, 5, 10), ICPD, CEDAW. |
| 12 | National Medical Standard for Reproductive Health | 2020 | National | Nepal | post-abortion contraception | Women of reproductive age | Implemented | Ensure evidence-based FP/RH services incl. counselling, post-abortion contraception, sterilisation | Defines informed choice, rights-based counselling, and quality standards; integrates PAC contraception | Equity via nondiscrimination (age, marital, socio-economic, ethnicity, orientation); rural access; consent protocols | Based on WHO FP Handbook (2018), WHO MEC (2015); developed with UNFPA, DFID, USAID, WHO; aligned with ICPD and SDG |
| 13 | RANZCOG Submission on Women’s Health Strategy | 2023 | National | New Zealand | sexual & reproductive health | Women across lifespan | Implemented | Advocate for equity-based national strategy; strengthen SRHR, leadership, workforce | Identifies barriers (financial, geographic, cultural, systemic bias); proposes integrated, equity-based system | Explicit on racism, bias, gender inequity; Māori and Pacific priorities; cost & access barriers | Consistent with WHO SRHR rights-based approach, I |
| 14 | National Population Policy | 2006 | National | Tanzania | sexual & reproductive health | Whole population | Implemented | Integrate population issues into development; promote gender equality & reproductive rights | Strengthened FP/MCH services; PAC and youth ASRH integrated into development goals | Equity principles include gender equality, reproductive rights, vulnerable group inclusion | aligned with UN human rights standards, |
| 15 | National Reproductive Health Policy 2022–2032 | 2022 | National | Kenya | Abortion (post-abortion care), | All Kenyans, | Implemented | reduce maternal/neonatal mortality, unmet FP, unsafe abortion, | Expanded FP/PAC services, elimination of GBV/FGM, adolescent health integration, infertility services | Explicit focus on vulnerable groups (youth, elderly, PLWD, humanitarian settings); no spousal consent; rights-based | Anchored in Constitution (2010), Vision 2030; explicitly aligned to SDGs 3, 5, 10, ICPD, CEDAW, WHO SRHR frameworks |
| 16 | NHS Wales Women’s Health Plan 2025–2035 | 2025 | National | Wales | Abortion care | Women and girls 16+ | Implemented | deliver life-course women’s health | expanded abortion/contraception access | Intersectionality central (race, SES, disability, LGBTQ+); | Explicitly aligns with WHO SRHR/Abortion Care 2022, CEDAW, SDG 3, 5, 10, Well-being of Future Generations (Wales) Act 2015 |
| 17 | Women’s Health Plan 2021–2024 | 2021 | National | Scotland | Abortion care | Women and girls, | Implemented | improve access to abortion, contraception, and women’s specific services | Virtual abortion/contraception models post-COVID | Addresses gender pay gap, GBV, systemic bias; inclusive of trans/NB people; aims to tackle poverty-related health inequities | Aligned with WHO SRHR frameworks, ICPD, CEDAW, SDGs 3.7, 5.6, 10.2; |
| 18 | Abortion: Policy Position Statement (PHAA) | 2023 | National | Australia | Safe abortion regulation, access, integration into public health system, decriminalisation | All women and people able to conceive | Implemented | Decriminalise abortion in all jurisdictions | Framework for equitable abortion care, influencing federal and state health service planning, advocacy for workforce and curriculum reform | Explicit focus on underserved groups (rural, minority, low-income, adolescents, LGBTQ+), rejection of discriminatory barriers like spousal consent, emphasis on culturally safe and affordable care | Directly cites WHO Safe Abortion Guidance (2012) and UN SDGs (3.1, 3.7, 5.6); aligns with ICPD and UN human rights frameworks |
| 19 | Health Act 1993 – Part 6 Abortions (ACT) | 2023 (updated; first adopted 1989) | National | Australia | Abortion policy & reproductive health | Women, adolescents, sexual minorities, | Implemented | To ensure universal, safe, timely, affordable, and equitable access to abortion; remove abortion from criminal law; integrate abortion into public health services; strengthen national SRH strategy | Recognition of abortion as routine healthcare; support for nurse-led and telehealth abortion; call for national referral pathways and data collection; advocacy for removal of legal barriers; promotion of evidence-based guidelines and funding | Explicit recognition of equity barriers for adolescents, ethno-cultural minorities, low-income, rural/remote women, survivors of violence, and sexual minorities | Aligns with WHO’s Safe Abortion: Technical and Policy Guidance (2012) and UN’s 2030 Agenda for Sustainable Development (SDG 3.1, 3.7, 5.6). |
| 20 | Termination of Pregnancy Act | 2021 | State | South Australia | Abortion regulation | Women & pregnant people | Implemented | Legalise abortion up to 22w6d on request; after that with two doctors if health/life risk or severe anomalies; regulate conscientious objection and sex-selection | Provides safe access zones; privacy protections; mandatory counselling information; ensures medical care post-abortion; decriminalises self-managed abortion | Recognises barriers for rural, disadvantaged, and vulnerable groups (socio-economic, language, abuse) | Aligns with WHO Safe Abortion Guidance, UN ICPD, and SDGs |
| 21 | Abortion Access Scorecard (MSI Australia) | 2024 | National | Australia | Accessibility of abortion law & services (gestational limits, providers, conscientious objection, safe zones, data) | Women, adolescents, sexual minorities, migrants, rural/remote | Implemented | Evaluate abortion law harmonisation, highlight gaps & barriers | Maps gestational limits (16–24 weeks), SAZs (50–150m), counselling, CO referral duties, data gaps | Identifies inequities in rural/remote, low-income, migrants, LGBTQI+, and those facing harassment | Aligns with WHO/UN human rights commitments by benchmarking national practice against SDG 5.6 and WHO abortion care standards (2022). |
| 22 | Abortion Legislation Act | 2020 | National | New Zealand | Comprehensive abortion law reform | Women & pregnant people nationwide | Implemented | Decriminalise abortion; allow up to 20 weeks on request; after 20 weeks if clinically appropriate; ensure access, data, and CO regulations | Self-referral permitted; mandatory counselling info; CO requires redirection; national provider lists and data collection; periodic review of equitable access | Explicit on timely, equitable access; requires equity reviews every 5 years; mandates service availability nationwide | Fully aligned with WHO abortion standards, CEDAW, and SDG 3.7/5.6; integrates human rights framing into statutory law. |
| 23 | Middle East Abortion Laws & Global SRHR Policies (compiled source list) | Various years | International | Middle East, Australia, NZ, Africa, etc. | Abortion legal frameworks & SRHR strategy references | Women | Implemented | Provide comparative repository of abortion laws & policies worldwide | Summarises restrictive (e.g., Gulf, Iran) vs liberal (Australia, NZ, Uruguay) frameworks | Notes inequities esp. in restrictive contexts; highlights rights-based approaches in liberal settings | Aligns with UN SRHR policy frameworks (ICPD, CEDAW, SDG 3 & 5); maps national laws against WHO rights-based standards. |
| 24 | Family Planning Alliance Australia: Position Statement on Abortion | 2023 | National | Australia | Abortion access & healthcare integration | All women | Implemented | Call for nationally consistent, legal, affordable, stigma-free abortion | Advocates for national abortion dataset; inclusive, stigma-free care; education for youth; CO disclosure & referral duties | Emphasises barriers for rural/remote, uninsured, low-income, migrant, LGBTQI+ people | Explicitly cites WHO Safe Abortion (2012), IPPF, and aligns with SDGs |
| 25 | Termination of Pregnancy Act 2018 (Queensland) | 2018 | State | Australia | Abortion law reform: gestational limits, provider regulation, conscientious objection, safe access zones | Women & pregnant people in Queensland | Implemented | Enable safe and reasonable access to terminations; regulate providers; protect women from criminal liability | Abortion legal up to 22 weeks; after 22 weeks with 2 doctors considering medical, psychological, and social factors; decriminalises self-managed abortion; creates 150m safe access zones; establishes offences for harassment/recording near clinics | Recognises privacy, dignity, and safety; mandates CO disclosure with referral; protects adolescents, rural women, and vulnerable groups | Fully aligned with WHO Abortion Care Standards (2022), ICPD Programme of Action, CEDAW, and SDGs |
| 26 | Public Health Amendment (Safe Access to Reproductive Health Clinics) Act 2018 (NSW) | 2018 | State | Australia | Abortion-related safe access zones | Women, pregnant people, providers, clinic staff | Implemented | Protect privacy, dignity, and safety of those accessing or providing abortion services | Creates 150m safe access zones; criminalises harassment, intimidation, obstruction, or communications likely to cause distress; bans unauthorised filming/recording near clinics | Ensures safe, stigma-free access for all service users regardless of age, background, or income | Aligns with WHO recommendations on removing barriers to safe abortion, UN human rights standards, and SDG |
| 27 | Reproductive Health Act; Case Law (Dobbs v. Jackson,) | 2022 | National | United States | Abortion law & regulation | Women, providers | Implemented | Define grounds & restrictions | Patchwork: access varies by state | Huge inequities (state, income, race) | Misaligned (WHO recommends abortion on request) |
| 28 | Canada Health Act; R. v. Morgentaler (1988); Provincial policies | 1988–2017 | Federal + Provincial | Canada | Abortion law, healthcare coverage | Women, providers | Implemented | Ensure abortion as insured service | Access varies by province | Geographic & rural access inequities | Broadly aligned (on request, no federal gestational limit) |
| 29 | Penal Code; Clinical Guidelines; Funding Guidelines | 2011–2017 | Federal + Cantonal | Switzerland | Abortion law | Women, providers | Implemented | Protect women’s health | Distress clause beyond 12 weeks | Access depends on canton | Partial alignment – WHO rejects “distress” clause |
| 30 | Termination of Pregnancy Act | 2023 | National | Netherlands | Abortion regulation, funding | Women, providers | Implemented | Provide safe, regulated abortion | Broad access via clinics/hospitals | Generally equitable | Strong alignment with WHO |
| 31 | Penal Code; Law No. 1477 | 2019 | National | Monaco | Abortion restrictions | Women, providers | Implemented | Protect women in limited cases | Very narrow grounds | Access nearly absent | Misaligned with WHO |
| 32 | Health Code; Penal Code; Abortion Info Brochure | 2015–2022 | National | Luxembourg | Abortion law | Women, providers | Implemented | Guarantee abortion as healthcare | Accessible, but gestational cutoff | Equity gaps post-14 wks | Mostly aligned; gestational limit restrictive |
| 33 | Penal Code; Health Insurance Law | 1987–2000 | National | Liechtenstein | Abortion prohibition | Women, providers | Implemented | Restrict abortion | Women travel abroad | Heavy inequities | Misaligned with WHO |
| 34 | Penal Code; Pregnancy Conflict Law | 1996–2023 | National | Germany | Abortion law, counselling | Women, providers | Implemented | Manage pregnancy conflicts | Counselling/3-day wait creates barriers | Unequal access across regions | Partial alignment – WHO rejects mandatory counselling |
| 35 | Public Health Code; Bioethics Law; Constitutional Amendment | 2021–2024 | National | France | Abortion rights | Women, providers | Implemented | Make abortion a constitutional right | Widely available, constitutionally protected | Remaining limits beyond 14 wks | Broadly aligned; gestational limit restrictive |
| 36 | Law on Interruption of Pregnancy; Penal Code | 2018 | National | Belgium | Abortion law | Women, providers | Implemented | Integrate abortion in healthcare | Safe abortions accessible | Short limit (12 wks) | WHO recommends beyond 12; partial alignment |
| 37 | Criminal Code; Federal Hospitals Act | 1998–2022 | National | Austria | Abortion law | Women, providers | Implemented | Allow abortion within healthcare | Services available but limited by cutoff | Access varies | Partial alignment |
| 38 | Health Protection Law; Criminal Code; Abortion Guidelines | 2007–2024 | National | Russia | Abortion regulation | Women, providers | Implemented | Regulate abortion provision | Counselling requirements + sanctions | Barriers beyond 12 wks | Misaligned (grounds-based) |
| 39 | Penal Code; Medical Clinics Law; Norms | 2001–2009 | National | Romania | Abortion law | Women, providers | Implemented | Safeguard maternal health | Broad grounds but barriers remain | Rural & financial inequities | Partial alignment |
| 40 | Reproductive Health Law; Abortion Standards | 2010–2020 | National | Moldova | Abortion law | Women, adolescents, migrants | Implemented | Ensure safe abortion | Broader social grounds (e.g., rape, violence) | Some equity measures, but barriers remain | Partially aligned |
| 41 | Family Planning Act; Constitutional Tribunal rulings | 1993–2020 | National | Poland | Penal restrictions | Women, providers | Implemented | Protect “foetal rights” | Most abortions criminalised; women travel abroad | Severe inequities | Strongly misaligned with WHO |
| 42 | Law on Protection of Human Life; Decree on Foetal Life | 1992–2022 | National | Hungary | Abortion restrictions | Women, minors | Implemented | Protect foetal life | Mandatory counselling, waiting periods | Structural barriers | Partial misalignment |
| 43 | Law on Abortion; Criminal Code | 1986–2011 | National | Czech Republic | Abortion law | Women, providers | Implemented | Ensure safe abortion | Broad access, publicly funded | Strong equity compared to region | Mostly aligned with WHO |
| 44 | Ordinance No. 2; Criminal Code; Health Insurance Law | 2000–2017 | National | Bulgaria | Abortion law | Women, providers | Implemented | Protect health & regulate provision | Some admin barriers | Regional disparities | Partial alignment |
| 45 | Law on Healthcare; Criminal Code; Abortion Directive | 1999–2014 | National | Belarus | Abortion law | Women, providers | Implemented | Regulate safe abortion | Abortion broadly accessible | Counselling sometimes required | Partially aligned |
| 46 | Abortion Act 1967 (as amended 1990) | 1967–1990 | National | England, Scotland, Wales | Abortion law | Women, providers | Implemented | Clarify lawful abortion | >90% ≤13 wks; NHS access | Socio-economic/geographic disparities | Partial alignment |
| 47 | Abortion (NI) (No. 2) Regulations | 2020 | National | Northern Ireland | Abortion law | Women, providers | Implemented | Align with human rights law | Access newly available but underdeveloped | Commissioning delays; uneven access | Closer to WHO but still limits |
| 48 | BMA – Law & Ethics of Abortion | 2020–2025 | National | UK | Medical ethics | Doctors, women | Implemented | Ethical guidance for providers | Clarifies consent, conscientious objection | Emphasises equity & non-discrimination | Fully aligned with WHO/FIGO |
| 49 | DFID Safe & Unsafe Abortion Policy | 2014 | National and global | UK (Global) | Safe abortion in LMICs | Women & girls in LMICs | Implemented | Reduce unsafe abortion mortality | Recognises high maternal death burden | Targets poorest & most vulnerable | Fully aligned with WHO, ICPD |
| 50 | Isle of Man Abortion Reform Act (2019); Jersey Law (1997); Guernsey Law (2021) | 1997–2021 | Regional | Crown Dependencies | Abortion law | Women | Implemented | Modernise abortion frameworks | Improved access; less need for travel | Variations across islands | Broadly aligned but with limits |
| 51 | Organic Law No. 01/2012/OL amending Penal Code; Ministry of Health Guidelines | 2012 | National | Rwanda ( | Abortion regulation | Women, providers | Legal for rape, incest, forced marriage, health/life risk | Reduce maternal mortality, update law | Ambiguity, stigma, liability | Stigma and provider fear hinder access | Misaligned – grounds-based, not on request |
| 52 | Maternal Protection Law (1948, amended); MHLW approval of MEFEEGO Pack | 2023 | National | Japan | Abortion & medical abortion regulation | Women, providers | Implemented | Introduce safe medical abortion | Very low uptake (1.5%), restrictive hospital rules | Equity issues: only hospitals with beds allowed | Partial alignment – WHO recommends broader access |
| 53 | Population Policy (One-/Two-/Three-Child); Family Planning Law | 1979–present | National | China | Population control & abortion access | Women, couples | Implemented | Control population growth | High abortion rates; coercion & surveillance | Minority women disproportionately impacted | Misaligned – coercion violates WHO/UN standards |
| 54 | Medication Abortion Policy (Mifepristone unapproved until 2015) | 2008 | National | Canada | Medication abortion & right to health | Women, providers | Implemented | Assess right-to-health compliance | Only 1–2% abortions medical before 2015 | Rural/remote inequities | Misaligned – WHO recommends mifepristone availability |
| 55 | Penal Code; Health Regulations; Post-Abortion Care Guidelines (2016); Mifepristone registration (2024) | 1981–2024 | National | Tanzania | Abortion law & post-abortion care | Women, providers | Implemented | Provide limited lawful grounds | Unsafe abortion major contributor to maternal mortality | Rural, young women highly affected | Misaligned – WHO opposes restrictive grounds |
| 56 | Criminal Code Act (1916); Penal Code (1960) | 1916–1960 | National | Nigeria | Abortion law | Women, providers | Implemented | Restrict abortion | Unsafe abortion = ≈11% maternal deaths | Adolescents and poor women most affected | Strongly misaligned – near-total ban |
| 57 | Pakistan Penal Code (1860, amended 1990); National Abortion Study (2023) | 1990–2023 | National | Pakistan | Abortion law & health outcomes | Women | Implemented | Monitor abortion trends | 3.8M abortions in 2023; ↑25% since 2012 | Misoprostol improved safety but inequities remain | Misaligned – restrictive, unsafe burden |
| 58 | Penal Code (2014); Fiqh Academy Fatwa (2013); Nat. Reproductive Health Strategy (2014–2018) | 2013–2018 | National | Maldives | Abortion restrictions | Women, providers | Implemented | Recognise unsafe abortion burden | Only 387 hospital admissions recorded (2016) | Husband/guardian consent required | Strongly misaligned – spousal consent, limited grounds |
| 59 | Universal Access to Sexual and Reproductive Health and Rights: Gaps in Policies in the Maldives | 2018 | National | Maldives | SRHR incl. abortion | General population, adolescents, women | Implemented | Identify policy & legislative gaps in SRHR access | Family planning access improved but abortion laws remain restrictive under sociocultural/religious influence | Notes inequities for unmarried youth and adolescents | SDGs 3.7 & 5.6, ICPD PoA, Beijing Platform |
| 60 | Abortion Care in Nepal, 15 Years after Legalization | 2017 | National | Nepal | Abortion care & human rights | Women of reproductive age | Implemented | Assess equity & access after legalization | Increased safe abortion uptake, but barriers persist (fees, rural access) | Rural & poor women face inequities | Supreme Court aligned abortion with human rights (2009); ICPD, SDGs |
| 61 | Unsafe Abortion in Zambia | 2009 | National | Zambia | Unsafe abortion burden | Women of reproductive age | Implemented | Review incidence & barriers | Unsafe abortions high, few safe legal procedures due to 3-doctor rule | Poor and rural women most affected | Maputo Protocol commitments unmet |
| 62 | Japan turns pro-life: recent change in reproductive health policy | 2014 | National | Japan | Abortion, reproductive technologies | Women of reproductive age | Implemented | Describe history & policy changes | Abortions used historically for population control; declining fertility shifts debate | Economic grounds once liberalized access; current selective abortion debate | WHO SRHR standards; population policies |
| 63 | Maldives National RMNCAH Strategy and Action Plan 2020–2025 | 2020 | National | Maldives | RMNCAH incl. abortion | Women, adolescents, children | Implemented | Strengthen maternal & reproductive health services | Abortion only under narrow grounds (life-saving, rape, fetal anomaly) | Adolescents face highest unmet need for contraception | Aligned with SDGs, Global Strategy for Women’s, Children’s and Adolescents’ Health |
| 64 | Knowledge and Attitude towards Ghana’s Abortion Law | 2023 | National | Ghana | Abortion law knowledge & attitudes | Female undergraduates | Implemented | Assess knowledge & attitudes | Many unaware of legal grounds; unsafe abortions persist | Students’ knowledge linked to access & equity | CEDAW, SDGs, WHO |
| 65 | Facts on Abortion in the Philippines | 2008 | National | Philippines | Criminalization of abortion | All women | Implemented | Highlight consequences of ban | Unsafe abortion leads to maternal deaths and abuse in healthcare | Poor women disproportionately harmed | Misaligned with WHO, UN human rights standards |
| 66 | Reproducing Inequalities: Abortion Policy and Practice in Thailand | 2002 | National | Thailand | Abortion law & practice | Women of reproductive age | Implemented | Explore lived experiences | Abortions common despite legal limits; inequalities persist | Poorer women resort to unsafe practices | WHO unsafe abortion framework; calls for reform |
| 67 | Shaping the abortion policy – Zambia’s Termination of Pregnancy Act | 2019 | National | Zambia | Termination of Pregnancy Act, Abortion policy, socio-political discourse | Women of reproductive age, policymakers, healthcare providers | Implemented | Explore policy discourse, Examine religious & political debates | Ambiguity limits access despite liberal appearance, Persistent stigma and provider refusal restrict safe access | Rural and poor women disadvantaged, Religious influence creates inequities | Maputo Protocol; ICPD |
| 68 | Kenya’s 2010 Abortion Law Impacts Contraceptive Use and Fertility Rates | 2010 (study 2025) | National | Kenya | Abortion law reform & reproductive health | Women of reproductive age | Implemented | Assess law’s impact on contraceptive uptake & fertility | ↑ modern contraceptive use, ↓ recent births | Rural women, low-education groups face barriers | Aligned with WHO definition of health & Maputo Protocol |
| 69 | Abortion Laws in Pakistan and Around the World: Case Study of Roe v. Wade | 1990 reforms; 1996/97 amendments | National | Pakistan | Abortion criminal law & Islamic jurisprudence | Women | Implemented | Trace evolution of law and global comparisons | Unsafe abortions high; ~900,000 induced abortions annually | Stigma, vague law, rural inequities | Misaligned – WHO/UN call for safe abortion access |
| 70 | Termination of Pregnancy Act (Zambia, Chapter 304) | 1972; amended 1994 | National | Zambia | Abortion law | Women of reproductive age | Implemented | Clarify conditions for lawful abortion | Allows abortion on grounds of life, health, anomalies | Access hindered by 3-doctor requirement, rural inequities | Maputo Protocol – but implementation weak |
| 71 | World’s Abortion Laws (Map, 2024) | 2024 | Global (with Russian Federation focus) | Global / Russian Federation | Comparative abortion law categories | Women, policymakers | Implemented | Provide global classification | Russia categorized as Category I (on request) | Rural access varies | WHO/UN recognition of abortion as human right |
| 72 | Unsafe Abortion Practices and the Law in Nigeria: Time for Change | 2020 | National | Nigeria | Abortion law & unsafe abortion | Women, clinicians | Implemented | Advocate reform to reduce unsafe abortion deaths | Unsafe abortion causes 10–30% maternal mortality | Poor, young, rural women disproportionately affected | Misaligned – WHO, CEDAW call for safe abortion |
| 73 | Supreme Court of India Judgment on Abortion as a Fundamental Right | 2022 | National | India | Abortion rights & constitutional law | Women, adolescents, transgender persons | Implemented | Recognize abortion as reproductive autonomy right | Landmark ruling: unmarried women equal rights; marital rape included; minors protected under POCSO | Structural barriers remain (caste, poverty, provider bias) | Strong alignment – UN/WHO human rights framing of abortion |
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