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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.

Dr Ratni Palullungan is a fearless doctor, mother, and selfless volunteer providing sexual and reproductive healthcare to marginalized groups in fragile humanitarian settings.  Currently she is deployed with the Indonesian Planned Parenthood Association’s (IPPA/PKBI) response team in Majene District, West Sulawesi, following a magnitude 6.2 earthquake which occurred in January 2021.   In an open diary, Dr Ratni shares what a day in the life looks like for a volunteer doctor providing care to those affected by the earthquake.   5.30 – 8.30am I get up quite early and have my quiet time (prayer), then I gather my dirty laundry. Currently, I live with other volunteer teams in a place called PKBI Post in Majene, and there is a cooking schedule for everyone. After prayers, chores and breakfast, I get my daughter ready for the day as she accompanies me to work temporarily. After that, the team and I prepare medical equipment and medicine for the day's humanitarian mission. 8.30 – 11am Today the first location is Maliaya Village Health Centre, in Malunda District, Majene. Here, I attend to and examine 25 pregnant women. The pregnant women, on average, get married at a fairly young age. There are definitely risks to their reproductive health. There is a 43-year-old mother who is currently pregnant with her 11th child. To limit health risks, we advise her on the various safe family planning options.   There is also a 38-year-old woman who is eight months pregnant. However, the size of her belly is very small for a woman in her third trimester. In fact, I initially thought that she was only four or five months pregnant. After I examined her, it turns out that she is categorized as a ‘malnourished’ pregnant woman. It is very unfortunate because she admitted that she eats food without paying attention to her nutrition intake. In fact, she tends to eat instant noodles. So I advised her to drink milk, eat only nutritious foods, and always taker her vitamins.  11am – 2pm After visiting Maliaya Village, I travelled to Kabiraan Village. This village was severely affected by the earthquake. Here, I walk around the evacuation camp, most of which is still occupied by displaced people in this post-earthquake period. Even under the evacuation tent, I continue to conduct health examinations for pregnant women.  Due to the large number of cases of young marriages in Kabiiran Village, the team and I decide to conduct counselling sessions for the teenagers here. I advise the teenagers to get to know the risks that might occur to their reproductive health if they marry too young.  2 – 4pm The health volunteer team and I are finally able to take the time for lunch. We have our lunch near the beach, and get to enjoy local seafood as our menu. Enjoying the seafood while looking at the beautiful sea view is a precious time. I certainly won't forget this moment. 4 – 6pm We continue our journey to East Lombong Village. We have many elderly patients here. Yet interestingly, during one of the patients’ examination, there is one mother who wants to get the contraceptive implant. For me, this is quite a shock, given that we rarely find women in this village who want to do family planning. The mother admitted that she did not know much about the family planning program and has many children. She is grateful that the PKBI volunteer team and I came to their shelter camp for the health examination. 6pm The team and I decide to return to the PKBI Post. Today’s journey is quite tiring but there is a sense of pride and emotion for having carried out a humanitarian mission for teenage girls, mothers, the elderly and even toddlers who still stay in the shelter camp. 7 – 8pm At the PKBI Post, after cleaning and tidying up the medical equipment again for the next day’s program, I  prepare dinner for the team and assist my child with her studies. I am so grateful for each and every day that I am involved in this program. I feel encouraged to continue to provide sexual and reproductive healthcare to marginalized groups

Dr Ratni Palullungan is a fearless doctor, mother, and selfless volunteer providing sexual and reproductive healthcare to marginalized groups in fragile humanitarian settings.  Currently she is deployed with the Indonesian Planned Parenthood Association’s (IPPA/PKBI) response team in Majene District, West Sulawesi, following a magnitude 6.2 earthquake which occurred in January 2021.   In an open diary, Dr Ratni shares what a day in the life looks like for a volunteer doctor providing care to those affected by the earthquake.   5.30 – 8.30am I get up quite early and have my quiet time (prayer), then I gather my dirty laundry. Currently, I live with other volunteer teams in a place called PKBI Post in Majene, and there is a cooking schedule for everyone. After prayers, chores and breakfast, I get my daughter ready for the day as she accompanies me to work temporarily. After that, the team and I prepare medical equipment and medicine for the day's humanitarian mission. 8.30 – 11am Today the first location is Maliaya Village Health Centre, in Malunda District, Majene. Here, I attend to and examine 25 pregnant women. The pregnant women, on average, get married at a fairly young age. There are definitely risks to their reproductive health. There is a 43-year-old mother who is currently pregnant with her 11th child. To limit health risks, we advise her on the various safe family planning options.   There is also a 38-year-old woman who is eight months pregnant. However, the size of her belly is very small for a woman in her third trimester. In fact, I initially thought that she was only four or five months pregnant. After I examined her, it turns out that she is categorized as a ‘malnourished’ pregnant woman. It is very unfortunate because she admitted that she eats food without paying attention to her nutrition intake. In fact, she tends to eat instant noodles. So I advised her to drink milk, eat only nutritious foods, and always taker her vitamins.  11am – 2pm After visiting Maliaya Village, I travelled to Kabiraan Village. This village was severely affected by the earthquake. Here, I walk around the evacuation camp, most of which is still occupied by displaced people in this post-earthquake period. Even under the evacuation tent, I continue to conduct health examinations for pregnant women.  Due to the large number of cases of young marriages in Kabiiran Village, the team and I decide to conduct counselling sessions for the teenagers here. I advise the teenagers to get to know the risks that might occur to their reproductive health if they marry too young.  2 – 4pm The health volunteer team and I are finally able to take the time for lunch. We have our lunch near the beach, and get to enjoy local seafood as our menu. Enjoying the seafood while looking at the beautiful sea view is a precious time. I certainly won't forget this moment. 4 – 6pm We continue our journey to East Lombong Village. We have many elderly patients here. Yet interestingly, during one of the patients’ examination, there is one mother who wants to get the contraceptive implant. For me, this is quite a shock, given that we rarely find women in this village who want to do family planning. The mother admitted that she did not know much about the family planning program and has many children. She is grateful that the PKBI volunteer team and I came to their shelter camp for the health examination. 6pm The team and I decide to return to the PKBI Post. Today’s journey is quite tiring but there is a sense of pride and emotion for having carried out a humanitarian mission for teenage girls, mothers, the elderly and even toddlers who still stay in the shelter camp. 7 – 8pm At the PKBI Post, after cleaning and tidying up the medical equipment again for the next day’s program, I  prepare dinner for the team and assist my child with her studies. I am so grateful for each and every day that I am involved in this program. I feel encouraged to continue to provide sexual and reproductive healthcare to marginalized groups

“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