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Over the past 30 years, more than 60 countries and territories have liberalized their abortion laws. Only four have regressed, including the United States. Abortion rights are increasingly becoming recognized as fundamental human rights for millions of people worldwide. The global landscape of abortion rights continues to evolve in 2024, with new legislation and feminist movements fighting for better access. Let's take a trip around the world to see the latest developments.

This World Humanitarian Day we reflect on the incredible work undertaken by our humanitarian response teams over the last 12 months. Last year, IPPF reached approximately 5.5 million people in humanitarian crises through our local Member Associations. This achievement would not have been possible without the dedicated and heroic healthcare teams providing vital sexual and reproductive healthcare in the most fragile humanitarian settings. COVID-19 response in Papua New Guinea Papua New Guinea Family Health Association (PNGFHA) PNGFHA responded to the COVID-19 outbreak in PNG, supported by the Australian government. With access to emergency healthcare facilities now extremely limited, PNGFHA health workers travel to hard-to-reach areas providing sexual and reproductive healthcare to the most marginalized communities.Clients like Vavine Kila receive a consultation at the PNGFHA mobile clinic. Share on Twitter Share on Facebook Share via WhatsApp Share via Email The humanitarian response teams taking healthcare into people's homes in Gaza Palestinian Family Planning and Protection Association (PFPPA) On 10 May 2021, Israel launched airstrikes on the Gaza Strip, killing over 220 people (including women and children) and leaving over 75,000 displaced. At the time, an estimated 87,000 women in the Gaza Strip and nearby areas were pregnant. The PFPPA humanitarian response team visited families in their homes, with each household expected to have four to five women of reproductive age needing healthcare. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Offering holistic care to families in Gaza Palestinian Family Planning and Protection Association (PFPPA) Children account for close to 50% of the population in Gaza. As part of the response, PFPPA youth volunteers entertained the children while their family members received life-saving sexual and reproductive healthcare and psychosocial support by the humanitarian response teams in privacy. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Ensuring ante- and post-natal care in the aftermath of an earthquake in West Sulawesi Indonesia Planned Parenthood Association (IPPA) On 15 January 2021, a 6.2 magnitude earthquake struck the West Sulawesi province in Indonesia leaving over 15,000 displaced, including many pregnant people and nursing mothers.As part of its response efforts, the IPPA set up mobile clinics near the shelters to provide vital ante- and post-natal care. Share on Twitter Share on Facebook Share via WhatsApp Share via Email A super cyclone and a pandemic Family Planning Association of India (FPAI) On 20 May 2020, severe Cyclone Amphan hit the Indian state of West Bengal, affecting millions of people in and around the state capital Kolkata. Emergency crises during the COVID-19 pandemic intensifies the impact of the disaster and puts a strain on health systems and access to sexual and reproductive healthcare.FPAI responded by providing emergency sexual and reproductive healthcare to affected communities, particularly focusing on the most marginalized and vulnerable people including the LGBTI community, sex workers, pregnant women, and survivors of sexual and gender-based violence (SGBV). Share on Twitter Share on Facebook Share via WhatsApp Share via Email Providing healthcare to hardest hit communities after Cyclone Yasa The Reproductive and Family Health Association of Fiji (RFHAF) In mid-December 2020, a category 5 severe Tropical Cyclone Yasa hit the island of Fiji and neighbouring Lau group of Islands. IPPF’s Member Association, RFHAF, was supported by the Australian government to provide life-saving sexual and reproductive healthcare in the hardest hit communities, including counselling on STI risk reduction, first-line support for survivors of SGBV, and contraceptive and ante-natal care. Share on Twitter Share on Facebook Share via WhatsApp Share via Email

Women around the world have faced multiple barriers to accessing safe abortion care during the COVID-19 pandemic including the de-prioritization of sexual and reproductive healthcare, overwhelmed health systems and restrictions on movement. The COVID-19 crisis has sparked innovation among IPPF Member Associations who responded swiftly by developing new approaches to reach women with safe abortion care including telemedicine and home-based provision of medical abortion. Strong evidence generated from this work supports the continuation and strengthening of these approaches beyond the end of the pandemic. Cameroon Cameroon National Planning Association for Family Welfare (CAMNAFAW) To ensure that quality abortion care can be provided to women during travel restrictions, CAMNAFAW’s service providers travel to partner clinics in underserved areas and to clients’ homes to provide medical and surgical abortion care. This model of taking safe abortion care closer to women will continue even with easing of travel restrictions, as this has been found to be an effective and acceptable approach to increasing access.Photo: IPPF/Xaume Olleros/Cameroon Share on Twitter Share on Facebook Share via WhatsApp Share via Email Guinea Association Guinéenne pour le Bien-Etre Familial (AGBEF) Building on lessons learned during the Ebola crisis in Guinea, AGBEF quickly took measures to prevent infection in its clinics to continue providing sexual and reproductive healthcare, including surgical and medical abortion, in a safe environment. AGBEF donated protective materials to communities, including hand-washing stations, face masks and antibacterial gel, alongside messaging on infection prevention. This community visibility reassures clients they can safely attend AGBEF clinics for abortion and contraceptive care.Photo: AGBEF/Guinea Share on Twitter Share on Facebook Share via WhatsApp Share via Email India Family Planning Association of India (FPA India) FPA India and partners advocated to have sexual and reproductive healthcare, including abortion, recognized as essential by the government, which meant FPA India could continue healthcare delivery during the national lockdown. To reduce in-person clinic visits, FPA India established teleconsultation and counselling for abortion care, and is continuing to provide in-clinic care for both medical and surgical abortion. Photo: IPPF/Alison Joyce/India Share on Twitter Share on Facebook Share via WhatsApp Share via Email Nepal Family Planning Association of Nepal (FPAN) FPAN and partners advocated for interim approval of home provision of medical abortion and telemedicine for abortion counselling during COVID-19. FPAN is now implementing these approaches, ensuring continued access to abortion care in Nepal, where many people live in remote locations with limited mobility, which has been further restricted by COVID-19 lockdowns. Photo: FPAN/Nepal Share on Twitter Share on Facebook Share via WhatsApp Share via Email Pakistan Rahnuma – Family Planning Association of Pakistan (Rahnuma-FPAP) Rahnuma-FPAP and partners successfully advocated for the government to class sexual and reproductive healthcare as ‘essential’, which enabled the team to continue providing post-abortion care during the pandemic. Rahnuma-FPAP expanded its telemedicine and home-based provision for menstrual regulation counselling and post-abortion care. These new approaches have ensured continued access to services for clients unable to reach clinics.Photo: Rahnuma-FPAP/Pakistan Share on Twitter Share on Facebook Share via WhatsApp Share via Email Palestine Palestinian Family Planning and Protection Association (PFPPA) In response to the government-mandated closure of its clinics, PFPPA quickly established a toll-free call centre which provides consultations, counselling, referrals and follow-up, including consultation for abortion care through a harm reduction approach, ensuring that women are provided with accurate information. Due to its success, PFPPA is exploring options for continuing this healthcare delivery model beyond the pandemic, with the aim of keeping it free of charge for users.Photo: SAAF/Samar Hazboun/Palestine Share on Twitter Share on Facebook Share via WhatsApp Share via Email Sudan Sudan Family Planning Association (SFPA) Following a nation-wide shutdown in April, SFPA  established  a call centre to increase access to healthcare, including abortion and contraceptive counselling and referrals.  An unexpected outcome of the new call centre is that it has reached an increased number of young women who regularly call to discuss their reproductive health and rights. SFPA  is working  towards institutionalizing this model for continuation beyond the pandemic.Photo: SFPA/Sudan Share on Twitter Share on Facebook Share via WhatsApp Share via Email Togo Association Togolaise pour le Bien-Etre Familial (ATBEF) ATBEF adapted its mobile application ‘Infos Ado Jeunes’, adding a toll-free teleconsultation service for young clients to use to access abortion consultations and pre- and post-abortion counselling. This app has given young clients ongoing access to care when they face challenges travelling to clinics. It has also eased overall client flow in clinics at a time when social distancing is being implemented.Photo: ATBEF/Togo Share on Twitter Share on Facebook Share via WhatsApp Share via Email

“Selling my body doesn’t make me a bad person, but working as a peer educator has helped enabled me to help many like me.” Hasina is one of the estimated 1,500 sex workers living in Haunman Tekri, a red-light area in Bhiwandi, a town near Mumbai. When her husband passed away six years ago leaving behind a three-year-old daughter, Hasina turned to sex work as her only option to earn money. She admits that it came with a feeling of powerlessness. "You don't choose this trade; it is the result of life circumstances.” She works as a peer educator with PSK, one of the Family Planning Association of India's (FPAI) clinics. "Working with Parivar Swasthya Kedra (PSK), has made me feel less helpless; it's given me some control over my body; the ability to choose whether or not to bring another life into this world.” Building trust through education Hasina has been a peer educator for three years, working within the district to educate other women on safe sex, contraception, and abortion. Hasina admits she was once wary of PSK workers. "I used to think that these workers who insist we use condoms, would only sabotage my clientele. But soon I realized they were only looking out for us." When talking with local women, Hasina advocates the use of contraception but says in the case of an unintended pregnancy, abortion is a viable option. "It's easy to judge us, but many of us have no choice; we simply cannot feed another on just Rs. 400 a day."  Hasina is now the go-to woman in the district when it comes to sexual health. "Since I am one of them, the women trust me." This is the secret behind PSK success; a model where sex workers educate their peers, understanding the complexities and prejudices of their daily lives. "I hope one day I am able to put all of this behind me. But I hope that through PSK I am able to make another woman's life just a little bit safer, a little bit better." Do you want to show your support for women and girls to be free to decide what happens to their body? Pledge your voice to our I Decide campaign,IPPF’s movement for safe abortion access for all. You'll be provided with toolkits on how to talk about abortion and you'll have access to a range of content from personal testimonies to videos explaining the different types of abortion available.

In the district of Gwalior in Madhya Pradesh, the summer season has started and the heat in town is already extreme. Here, the Family Planning Association of India GCACI clinic serves many people living in poverty. In the ten years since the GCACI project started there, the clinic has provided 16,301 women with comprehensive abortion care and 202,758 women with contraceptive services. The two-storey clinic is situated in a residential area and, inside, women queue up to see the counsellors and medical staff. Many are accompanied by link workers who have travelled with them from outlying districts. Neelam Dixit is in charge of the branch. “Most women are from marginalised sections of society and are denied the right to make their own decisions. By the time they visit our clinic, the woman is already a couple of months pregnant”. FPA India’s work is making an impact and Dixit is seeing views change on abortion. “There is a shift in attitude among women since FPAI started providing services. Presently, there is little stigma attached to abortion. Our aim is to provide quality health services at low cost. We create awareness about the consequences of unsafe abortion and train volunteers to be sure women in villages are aware of our clinic.” The clinic has served around 300,000 people from rural and semi-urban populations with comprehensive sexual and reproductive health services, and provides both first- and second-trimester abortion services.   

Konika* Mother of three, Parivar Swasthya Kendra (PSK) client Konika is 20 years old, and the mother of three girls. Like many local young women, she decided to have an abortion when she became pregnant for the fourth time within five years. Citing financial issues as the driving force behind her decision, despite her mother-in-laws desire for her to have another child, hoping this time it would be a boy. Through a neighbour, she approached the PSK clinic in Bhiwandi for an abortion. In Konika’s community, many young women are married and have kids by the time they are 20. Now with PSK, women like Konika have a choice to be pregnant or not. *Name has been changed Share on Twitter Share on Facebook Share via WhatsApp Share via Email Rehkha Parivar Swasthya Kendra (PSK) link worker Family Planning Association of India, works with a network of volunteer link workers, who disseminate information about services available in the PSK clinic, make referrals, and often accompany women to the clinic for support. One of these link workers is Rehkha. Rekha says: "I have been involved with PSK for five years. And today I can proudly say that since the first awareness campaigns, there has been not a single death in the village due to an unsafe abortion." She adds: "These women are my flesh and blood. They know I only want the best for them… Within our communities we spread the message of safe sex and safe abortion through songs and skits which are easily understood. And I think the trick is to include mother-in-laws in our work. We have a high success rate in providing safe abortion care.” Share on Twitter Share on Facebook Share via WhatsApp Share via Email Shajahan Parivar Swasthya Kendra (PSK) link worker Shajahan is a link worker in the nearby Muslim district, where women pack into a house in the narrow village lanes to wait to speak to her. She says: "I am a Muslim. In my community, abortion is frowned upon, and contraception is considered a sin. Initially, the women thought I was going against our customs, and the men thought I was a bad influence on their wives. Some of the men in our area even approached my husband and asked him to order me to stop these efforts." But her husband was supportive, telling other men that it was also their responsibility to be part of the process. It took several years, but eventually Shajahan won the trust of the women and men of her area. "Today, every woman in my area comes to me when it concerns matters of sexual health." Share on Twitter Share on Facebook Share via WhatsApp Share via Email Gauri Family Planning Association of India (FPAI) staff Gauri has worked for FPAI for years and remembers hearing about the experiences of women who’d had unsafe abortions. "I had heard first-hand accounts of [unsafe] abortions that left women reeling in pain, suffering permanent infertility. I had also seen the grief in the faces of men whose wives died. So today when I see women leaving us, after an abortion, in perfect health, I feel like I've done something right with my life." Gauri continues: "My work may have started with one area, but I want to reach every corner of the country with FPAI - so that no woman in India becomes a statistic." Share on Twitter Share on Facebook Share via WhatsApp Share via Email Nisha Mother of two At 23, Nisha Boudh is already a mother to two children and severely anaemic. She feels she is in no position to have a third child, but her in-laws are not supportive. Nisha chose to have an abortion at FPAI’s Gwalior clinic. “I have been weak since childhood and, honestly, motherhood has taken a toll on my health. Doctors in other clinics were not willing help me and I would have died had FPAI not come to my rescue. With their doctors’ advice I have now decided to undergo an operation [tubal ligation] as I do not want to conceive. My mother-in-law was upset with my decision but I want to live to see my other children grow,” said Boudh. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Diti* Sex worker Diti is a sex worker living in Kolkata. She says she, "owes her life to PSK". Diti was forced into an early marriage when she was just 12 years old. "Before my body could even develop, my husband was forcing himself upon me." By the age of 20, Diti had five children. Struggling to cope at such an early age, and married to an abusive husband, Diti ran away. "I don't enjoy having sex with strangers, but I need the money." She makes 300 rupees a day ($4 USD). When Diti became pregnant she didn’t want to continue with the pregnancy. "There's no way I can feed a child. Besides, this is no place to bring a child into the world. Another sex worker recommended the PSK clinic.” Diti was worried about visiting the clinic, fearing stigma and discrimination from staff for working as a sex worker. Her experience was vastly different, finding the clinic team to be welcoming, reassuring and supportive. "They treated me like a human being." Share on Twitter Share on Facebook Share via WhatsApp Share via Email Mala Medical officer “The big problem in this part of India is early marriage and pregnancy. Both of which need to be handled very delicately,” says medical officer Mala Tiwari. “Slowly, things are changing as women are becoming aware of their rights. Previously when GCACI did not exist there was very little interaction with the link workers, and they [and the community] feared it was illegal to get an abortion. They did not know they did not need the consent of their husbands and in-laws. They now know, women have a right over their body.” Share on Twitter Share on Facebook Share via WhatsApp Share via Email Manju Mother of two, Parivar Swasthya Kendra (PSK) client Manju Rana was forced to marry at fifteen. “I have had two children in eight years of marriage,” she says. “My mother-in-law wanted me to keep having children. She does not understand I would not be able to give them a good education if I had more children. My husband is a driver and we cannot afford to have any more. When I learnt I was pregnant, without taking anyone’s permission, I went with the link worker of my area to the clinic and had an abortion.” Manju adds: “In these affordable clinics we can choose about pregnancy. They also made sure I was counselled, as coming to a decision about abortion is not easy.” Share on Twitter Share on Facebook Share via WhatsApp Share via Email

When garment worker Ny thought she might be pregnant with her first child, a home test kit quickly confirmed her suspicions. But the 23-year-old – who is originally from Takeo province but moved to Phnom Penh to take up a job in the garment industry – did not know where to go to seek prenatal care. After a cousin recommended that she visit a nearby Reproductive Health Association of Cambodia clinic, Ny took her relative’s advice – and has gone back eight times to date. “I come here every month to check on the baby,” she says, cradling her belly. “I had never been before I got pregnant.” During her visits to the medical clinic, Ny says, she has had a raft of standard tests and procedures as part of her prenatal care, including two ultrasounds, blood and urine tests, and vaccinations. “The doctors have also been giving me advice on how to look after myself and the baby [such as] to eat nutritious food and not to carry heavy things,” she says. As well as caring for the health of mother and unborn child, RHAC staff have also offered up valuable family planning information. “I did not know about how to plan to have children before I came to the clinic,” Ny says. “The doctors here told me that there are three different methods of [long-term] contraception: medication, an implant and an IUD.” Ny, who sews winter clothing at a factory while her husband also works in a nearby garment factory, says she was very glad to learn about her options. “This child was unplanned, but I don’t feel any regret because I had already been married for two years. But after having the baby I plan to use birth control, though I don’t know what method I will use,” she says. “I know that I don’t want to have another child straight away. It may be two or three years until I have the next one, as I want to wait until my family’s finances improve.”

Female workers, many of them undereducated migrants from rural areas, dominate the garment sector in Cambodia. And Propitious garment factory in Takhmao, a small city that lies just south of the capital Phnom Penh, is no exception. Women make up more than 90 percent of the factory’s workforce. Helping to oversee the 3,700-strong workforce is human resources manager Kouch Davy, who has worked at Propitious since it opened four years ago. Seeing a need to improve the workers’ sexual and reproductive health knowledge, she says she decided to work with the Reproductive Health Association of Cambodia (RHAC) because of its reputation for providing high-quality services. “I raised it in a management meeting, and the board was happy to explore it,” she says. For almost two years, trained staff from RHAC have been visiting the factory twice a month to meet with workers during their lunch break. They answer questions on topics ranging from birth control to STIs and abortion. The organisation has also provided training to the nurses who work in the factory’s on-site medical clinic. Davy says the factory’s female garment workers have changed as a result. “They are more open to asking questions about sexual health and they have also become more informed about the subject,” she says. “When they don’t dare to ask questions about sensitive health topics, they don’t have the information they need, so they tend to exaggerate their problems and ask for sick leave. But when they go to see an RHAC clinic and get proper treatment, there is less sick leave. “Now that they understand about contraception, there are fewer women getting pregnant and taking maternity leave, so that also helps with the workflow. ” Davy says the factory has seen requests for sick leave drop by an average of between 100 to 200 cases a month – and any decrease in absenteeism is a major boon for productivity. “The factory works like a chain: if just one person on the production line takes a day off, it affects the overall productivity,” she says. “And if a worker comes to work sick, they have problems concentrating.” Even Davy says she has gone to RHAC to seek medical care, visiting one of their clinics a few months ago for a breast examination. Meanwhile, the company that owns Propitious has extended its partnership with RHAC to a second factory in Phnom Penh. The firm has even requested that the NGO starts visiting its largest factory, which is situated in a rural province and has 10,000 workers, in the future.

Sophorn, a garment worker for the past decade, first visited a Reproductive Health Association of Cambodia (RHAC) clinic when she was pregnant with her first child. She returned for health checks each month until, at five months pregnant, she lost the baby. Her second pregnancy also resulted in a miscarriage, leaving her distraught. Then, she got pregnant a third time, in 2013. “I started to discuss with the doctors how to protect my child,” she says. “They gave me medication to strengthen my cervix, which I took for six months. In the seventh month, I gave birth prematurely.” Doctors told Sophorn that her baby girl was health, but she only weighed in at 1.7 kilograms. The infant was taken to a specialist children’s hospital, where she was cared for an additional two weeks. “During the pregnancy I was very worried,” Sophorn says. “I felt so happy when I finally delivered my child.” Her daughter was born without any complications is now a happy and healthy four years old. In initial stages of her third pregnancy, Sophorn’s friends told her that she would have to undergo surgery on her cervix or have injections to help her carry her baby to term, and doctors at a private clinic confirmed their suggestions. However, she decided to seek a second opinion at RHAC, where doctors instead gave her a prescription to strengthen her cervix. “When I heard I needed to have that surgery I was very scared, so I was relieved when the doctor at RHAC told me to take the medication instead,” she says. “While I was taking the medication I observed my body and any changes to it, so when I felt unwell I would go to the doctors and consult them, so I felt comfortable to continue taking it.” Sophorn also went for appointments at a government-run hospital, but found that their services were also lacking. “I told the doctors about losing my first and second babies, but they only weighed me and measured my stomach. There weren’t any more examinations or very much care,” she says. “When I went to RHAC they did so many examinations and had so many services, so I think it’s really better to go to RHAC for these kinds of services.” She estimates that during her third pregnancy, she had ten appointments at RHAC clinics at a cost of 40,000 to 60,000 riel (£7.40 to £11.15) each time. Compared to just 2,000 riel for an obstetrics appointment at the public hospital, the difference in cost is significant. “It’s expensive for me because my salary is little.” Despite the relatively high prices, Sophorn already knows where she will go for medical care in the future. “I want to have one more child, and I have already planned that when I decide to do it I will go to RHAC to get my cervix checked first,” she says. Until that day comes, Sophorn is taking the oral contraceptive after receiving advice about birth control from RHAC’s clinicians, with a midwife from the NGO making regular visits to the factory.

Pann Chandy gave her first sexual education lesson when she was still at school as a volunteer youth social worker with the Reproductive Health Association of Cambodia (RHAC). She had no qualms about standing up in front of her classmates to discuss culturally taboo topics when she was just a teenager. Now aged 25 and in possession of a Bachelor degree in midwifery, Chandy has been employed by RHAC for less than a year, working as part of the organisation’s health outreach team. The job is demanding: she is tasked with regularly visiting four karaoke parlours, eight garment factories and 20 villages in Phnom Penh, with plans to expand to two universities imminently. Travelling for hours A round trip to some communities can take two hours or more on her motorcycle, travelling alone into areas that are not always easily accessible. “Sometimes I have the clinic staff with me, but rarely,” Chandy says. “I promote the health services provided by Reproductive Health Association of Cambodia as well. If they are interested in going to a clinic, I give them a referral,” she says. One of the factories on her regular roster is Propitious garment factory in Takhmao, a small city south of Phnom Penh. Chandy spends two days a month at the factory, where she speaks to groups of women or has one-on-one discussions about sensitive topics. Passionate about the job “Just yesterday during the outreach service, a woman asked me why she didn’t get her period after having an abortion. She wanted to know what was wrong,” she says. “It’s common for women to use unsafe abortion methods. Mainly they take medicine from a pharmacy, and the pharmacy doesn’t give them any advice on how to use it. Often they go to cheap, unlicensed clinics near the factories for medical abortions.” Chandy is passionate about her job at Reproductive Health Association of Cambodia, and dreams about one day setting up her own pharmacy where she could provide comprehensive advice to clients. “There are a lot of unlicensed pharmacists in this country,” she says, many of which prescribe the counterfeit medicines that have inundated the market. “I think I may have the capacity to become a licensed one."