Safe abortion is essential healthcare and integral to a person’s sexual and reproductive health and rights (SRHR). When people have access to safe, timely and stigma-free abortion services, the risk of complications is greatly reduced. Abortion is safe, when carried out using World Health Organization–recommended methods. In South Asia, unsafe abortion is a major public health and human rights issue. As per the Guttmacher Institute, in Southern and Central Asia together, less than half of abortions are safe. Access to safe abortion services is further complicated by South Asia’s patchwork of laws, commonly situated under criminal law. Abortion regulations in South Asia range from relatively liberal laws in India and Nepal, restrictive laws in Bhutan, Pakistan and Sri Lanka. Innovative ways of regulating abortion like Bangladesh’s menstrual regulation policy, sits outside the legal framework on abortion.
Abortion in South Asia: How does legal regulation look like?
Taking a closer look at the regional legal landscape shows why access varies so widely. India amended the Medical Termination of Pregnancy law in 2021, expanding gestational limits for certain categories and easing some clinical rules. In 2022, a Supreme Court judgement ruled that unmarried women should have the same right to access abortion. However, abortion remains framed as a crime under the Bhartiya Nyaya Sanhita, 2023 (India’s penal law), with statutory exceptions. Abortion continues to operate under a carceral approach instead of being seen as fundamental right and a necessary healthcare service on request. Courts have sometimes stepped in to approve exceptions in difficult cases, though their approach has been inconsistent and recent judgments have rolled back earlier gains.
Nepal took a progressive step in the region by legalising abortion with conditions in 2002, and later strengthened the reproductive health law under the Safe Motherhood and Reproductive Health Rights (SMRHR) Act 2018. Nepal’s Constitution too, encodes a woman’s fundamental right to reproductive health. Yet, penal provisions have not been fully removed from the National Penal Code 2017, and abortion seekers and service providers still face criminal penalties. Legal ambiguity and inconsistencies between the SMRHR Act and Penal Code continue to deprive abortion seekers from accessing safe abortion services and exercising their right to health, life and bodily autonomy. Civil society and safe abortion advocates in Nepal now call for full decriminalization, arguing that abortion is essential healthcare and a right.
Bangladesh presents an interesting policy workaround. Under the Penal Code of 1860, induced abortion is only permissible to save a woman’s life, but the national family planning programme allows “menstrual regulation” (MR). The MR policy allows early termination, i.e., up to 12 weeks, without calling abortion. Framing MR as distinct from abortion has had pragmatic benefits, but access is uneven and many still resort to unsafe methods.
Abortion in Bhutan, Maldives, Sri Lanka and Pakistan remains tightly restricted. Sri Lanka’s penal code criminalizes unlawful termination except to save a woman’s life, and repeated reform attempts to expand the exceptions have failed. Bhutan allows abortion under narrow grounds such as rape or risk to the woman’s life; Maldives permits abortion mainly to save a woman’s life and in cases of rape or incest under its penal code. Pakistan’s criminal code criminalises abortion except to save the life of woman or for “necessary treatment” before the organs of the foetus are formed.
when
region
South Asia
Subject
Abortion Care
When law stops casting abortion as a crime, only then can it be fully realized as a fundamental human right. Decriminalization will lead to equitable access to abortion. - Prabina Bajracharya, Center for Reproductive Rights
The Cost of Criminalization of Abortion and Adolescent Sexuality
While restrictions vary, these legal regimes keep abortion inside the criminal legal system. Criminalizing abortion changes how health systems act and how people behave. When abortion is considered a crime, providers worry about arrest and prosecution, so they avoid offering services, refuse care, or demand complicated and extra-legal approvals. Fear of legal exposure stalls provider training. Funding becomes fragile as donors and governments see it as politically risky. The most marginalized—people from lower socioeconomic backgrounds, of diverse gender identities and sexual orientations, religious minorities, young people—are the most impacted.
Young people face an extra set of challenges. Many countries in South Asia have strong child-protection laws intended to prevent sexual violence, but those same laws criminalize adolescent sexuality by criminalizing consensual sexual activity among adolescents without considering their evolving capacity, right to bodily autonomy and their right to privacy and dignity. These laws deter minors from seeking safe abortion or contraceptive services out of fear of criminal investigations and social exclusion. Service providers also face challenges balancing consent, confidentiality and reporting duties.
Path to Reform: Challenging Criminalization
Criminalization of abortion creates a major challenge for reproductive rights in South Asia. “One of the most important and effective means to achieve reproductive justice is by completely decriminalizing abortion—abortion must be removed from penal codes across the region. When law stops casting abortion as a crime, only then can it be fully realized as a fundamental human right. Decriminalization will lead to equitable access to abortion.” says Prabina Bajracharya, Regional Director, Asia, at the Center for Reproductive Rights (CRR). CRR has been working to advance safe abortion access and SRHR across Asia through legal research, strategic litigation, fact-finding investigations, and national and regional advocacy, including efforts to decriminalize abortion in Nepal.
Challenges beyond criminalization are also mounting. Recent aid cuts and shifting donor priorities threaten the availability of lifesaving, essential abortion services. Global abortion and anti-gender opposition has strengthened homegrown opposition in South Asia. Social media is used to spread misinformation and mobilize people against progressive policies. Pro-life marches in India and protests in Nepal and Sri Lanka underscore the rising opposition to abortion and LGBTI+ rights.
"We're seeing well-funded opposition groups challenge not just future progress for sexual and reproductive rights in South Asia but roll back existing protections. Combined with massive funding cuts, this creates the perfect storm where the sexual and reproductive rights of women, girls and diverse communities are threatened”, adds Tomoko Fukuda, Regional Director (Interim), International Planned Parenthood Federation, South Asia Region.
Yet these same challenges are creating opportunities for coalition building and strengthening, and strategic collaboration. Reproductive rights advocates in the region like the IPPF and Center for Reproductive Rights are increasingly working with LGBTI+ led organizations, disability rights movements, and youth groups, to strengthen cross-movement solidarity.
"The Abortion Rights Alliance for Inclusion, Safety, and Empowerment (ARISE) in India brings together feminist organizations, providers, health advocates, legal advocates, researchers, and youth movements and allies from other social movements to expand access to safe, legal and quality abortion for all. Our solidarity is our strongest weapon against the opposition”, says Dr Kalpana Apte, Director General, Family Planning Association of India, IPPF’s Member Association in India.
Safe abortion saves lives, yet criminalisation, stigma, and restrictive laws put millions at risk. Evidence shows the urgent need to reform. The path forward means not just reforming laws, but fully decriminalising abortion and expanding care. At the IPPF, we acknowledge the powerful impact of social movements coming together and building coalitions for reproductive justice. "IPPF's commitment to ensuring safe abortion access remains unwavering. We will continue fighting alongside our partners, including organizations like the Centre for Reproductive Rights, to drive systemic change across South Asia. At this critical juncture, our solidarity is more important than ever as we work together to strengthen legal pathways, support young leaders, and safe abortion access for diverse communities in our region”, adds Tomoko Fukuda, Regional Director (Interim), IPPF South Asia Region.
