Abortion law by country ranges from complete prohibition to unrestricted access, and most legal systems land somewhere between those poles. Roughly 77 countries allow the procedure on request, about 21 maintain complete bans, and dozens more permit it only under specific conditions such as saving the pregnant person’s life, protecting health, or addressing severe economic hardship. Among countries that allow abortion on request, 12 weeks is the most common gestational cutoff, though several nations set the line later.
Countries With Total Bans
A small group of nations prohibits abortion in every circumstance, with no legal exception for rape, incest, or medical emergency. Termination is a criminal offense for the pregnant person and for anyone who assists.
El Salvador enforces one of the harshest regimes in the world. Articles 133 through 137 of the Salvadoran Penal Code impose two to eight years in prison on the person who ends a pregnancy and six to twelve years on a medical professional who performs the procedure. Prosecutors have also reclassified some cases as aggravated homicide, which carries a minimum sentence of 30 years. The reclassification has drawn international scrutiny, particularly when applied to women who experienced obstetric emergencies that authorities treated as intentional acts.
Nicaragua repealed its therapeutic abortion provision in 2006 after more than a century on the books. The current Penal Code punishes anyone who performs an abortion with one to three years in prison when the pregnant person consents, and three to six years when they do not. The pregnant person who consents faces one to two years, and health professionals face additional disqualification penalties.1Legal Information Institute. Código Penal de Nicaragua Artículos 143 a 145 – Abortion The law provides no exception for any medical circumstance.
Malta long maintained some of Europe’s strictest rules. Articles 241 through 243 of the Maltese Criminal Code criminalize causing a miscarriage, with medical practitioners facing 18 months to four years in prison and permanent loss of their license, and the pregnant person also facing imprisonment. In 2023, Malta amended its Criminal Code to add Article 243B, creating a narrow exception when a medical intervention is necessary because the pregnant person’s life is at immediate risk or their health is in grave jeopardy that could lead to death. The fetus must not have reached viability, and a medical team must confirm the necessity of the intervention in a licensed hospital.
Countries Where Abortion Is Legal Only to Save the Pregnant Person’s Life
A larger group of countries prohibits abortion as a general rule and carves out a single exception: when continuing the pregnancy would kill the pregnant person. This “necessity exception” places a heavy burden on doctors to establish that death is the likely outcome without intervention.
Brazil’s Penal Code captures the approach in Article 128, which says a doctor is not punished for performing an abortion if there is no other way to save the pregnant person’s life. Brazil also permits the procedure when the pregnancy resulted from rape, though the life-saving exception is more commonly invoked.2Legal Information Institute. Decreto Federal n. 2.848/1940 – Código Penal Brasileiro Multiple physicians typically must document the threat before the procedure can proceed.
Nigeria follows a similar model. Section 297 of its Criminal Code provides that a person is not criminally responsible for a surgical operation performed on an unborn child to preserve the mother’s life, so long as the operation is reasonable given the patient’s condition. Anyone who attempts to cause a miscarriage outside that narrow exception faces up to 14 years in prison.3Harvard University Berkman Klein Center for Internet & Society. Nigeria Criminal Code Act The strict interpretation means doctors often hesitate even in real emergencies, worried that prosecutors will second-guess their clinical judgment.
Life-saving-only jurisdictions usually require the agreement of at least two physicians before the procedure goes forward. That requirement is meant to keep the exception from expanding in practice, but it also introduces delays in situations where time is scarce.
Health-Based Exceptions
Health-based exceptions expand access beyond immediately life-threatening situations. A pregnancy that would cause serious harm to the pregnant person’s physical or mental well-being qualifies for legal termination even if the condition is not imminently fatal. The practical scope depends almost entirely on how a country defines “health.”
Some nations interpret health narrowly, requiring evidence of a specific diagnosed condition that the pregnancy would substantially worsen. Others adopt the World Health Organization’s broader definition, which includes complete physical and mental well-being. That reading gives doctors room to consider severe depression, anxiety disorders, or chronic illnesses aggravated by pregnancy. A medical certificate stating the specific risk is typically required and functions as legal protection for both patient and provider.
Mental health justifications have proven the most flexible pathway. Where psychological harm counts, clinicians can assess whether the pregnancy would cause severe depression, risk of self-harm, or long-term emotional damage. That shifts the decision from a courtroom to a clinical setting.
Social and Economic Grounds
Some legal systems allow doctors to consider the pregnant person’s living conditions, financial circumstances, and family situation when deciding whether to authorize the procedure. Poverty, housing instability, and the strain of caring for existing children count as legitimate factors.
The United Kingdom’s Abortion Act 1967 is the best-known example. Section 1(1)(a) permits the procedure before the 24th week when two registered medical practitioners agree that continuing the pregnancy would pose a greater risk to the pregnant person’s physical or mental health than terminating it. The law directs doctors to consider “the pregnant woman’s actual or reasonably foreseeable environment” when making that assessment.4Legislation.gov.uk. Abortion Act 1967 – Section 1 That phrase opens the door for economic and social factors to influence the decision, and the vast majority of abortions in England and Wales are authorized on this ground.
India’s Medical Termination of Pregnancy Act of 1971 takes a related approach. The Act allows termination when continuing the pregnancy would cause grave injury to the pregnant person’s mental health, and it presumes that a pregnancy resulting from contraceptive failure causes such injury for a married woman.5India Code. Medical Termination of Pregnancy Act 1971 The presumption effectively provides a family-planning pathway. Amendments in 2021 raised the gestational limit from 20 to 24 weeks for specific categories, including survivors of rape, victims of incest, minors, and other vulnerable individuals.6World Health Organization. India’s Amended Law Makes Abortion Safer and More Accessible
Abortion on Request
Countries in this category allow the procedure based solely on the pregnant person’s decision, with no requirement to prove medical or social justification. Almost all of them impose a gestational limit, after which stricter criteria apply. Twelve weeks is the most common line.
France
France extended its gestational limit for abortion on request from 12 to 14 weeks in 2022.7Vie-publique.fr. Loi du 2 mars 2022 visant à renforcer le droit à l’avortement After 14 weeks, two physicians must certify that the pregnancy poses a serious health risk. The national health insurance system covers the cost. In March 2024, France became the first country to enshrine abortion rights in its constitution, amending Article 34 to guarantee a woman’s freedom to terminate a pregnancy.
New Zealand
New Zealand’s Abortion Legislation Act 2020 removed the procedure from the Crimes Act entirely. Before 20 weeks, a qualified health practitioner can provide abortion services without any statutory clinical requirements. After 20 weeks, the practitioner must reasonably believe the abortion is clinically appropriate after consulting at least one other qualified practitioner and considering the person’s physical and mental health, overall well-being, and gestational age.8Ministry of Health NZ. Abortion Legislation The older system, which required two certifying consultants, is gone.
Canada
Canada has no federal gestational limit. The Supreme Court of Canada’s 1988 decision in R. v. Morgentaler struck down the country’s restrictive abortion law as a violation of the right to security of the person under Section 7 of the Canadian Charter of Rights and Freedoms.9Supreme Court of Canada. R. v. Morgentaler No replacement criminal law was ever enacted. Individual hospitals and clinics set their own limits based on medical safety and available resources, so access varies by region despite the absence of a legal prohibition.
Colombia
Colombia moved into this category with Constitutional Court Ruling C-055 of 2022, which decriminalized abortion up to the 24th week and declared that criminalizing the procedure before that point was unconstitutional.10Constitutional Court of Colombia. Ruling C-055 of 2022 After 24 weeks, the three exceptions established by the earlier 2006 ruling (C-355/06) still apply: risk to the pregnant person’s life or health, severe fetal malformation, and pregnancy resulting from rape or incest. The 2022 ruling made Colombia one of the most liberal regimes in Latin America.
The United States After Dobbs
The United States no longer fits into a single category. In June 2022, the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization overturned Roe v. Wade and Casey, holding that the Constitution “does not prohibit the citizens of each State from regulating or prohibiting abortion” and returning authority to state legislatures.11Supreme Court of the United States. Dobbs v. Jackson Women’s Health Organization The result is a fractured landscape where neighboring states may have radically different rules.
Some states banned or severely restricted the procedure. Others codified access into state law. Colorado and New Jersey provide abortion without gestational limits and without requiring justification beyond the patient’s decision. Many states that allow the procedure set the line at fetal viability, generally around 24 weeks. About two dozen states require a waiting period between an initial consultation and the procedure itself, usually 24 to 72 hours.
Federal law adds another layer. The Hyde Amendment, which Congress re-enacts annually, bars the use of federal Medicaid funds for abortion except when the pregnancy threatens the person’s life or results from rape or incest. The Emergency Medical Treatment and Labor Act (EMTALA) requires hospitals that accept Medicare to stabilize anyone with an emergency medical condition, and the federal government has argued this includes emergency abortions even in states with bans. In Moyle v. United States (2024), the Supreme Court dismissed the case on procedural grounds without resolving whether EMTALA overrides state abortion bans, leaving the conflict unresolved.12Supreme Court of the United States. Moyle v. United States
Recent Shifts in Either Direction
Abortion law is not static. Mexico’s Supreme Court ruled in September 2023 that federal criminal penalties for abortion are unconstitutional and ordered Congress to remove the offense from the federal criminal code. All federal health facilities should now provide abortion care, and no one involved in providing an abortion can be prosecuted under federal law. Individual Mexican states are at various stages of aligning their own codes with the ruling.
Poland moved in the opposite direction. In October 2020, the Constitutional Tribunal struck down the provision of Poland’s 1993 family planning law that had permitted abortion when there was a high probability of severe and irreversible fetal impairment, holding that the provision was incompatible with the constitutional right to life and human dignity.13European Court of Human Rights (HUDOC). Case of ML v. Poland Since the ruling took effect in January 2021, abortion in Poland has been legal only when the pregnancy endangers the mother’s life or health, or when there are strong grounds to believe it resulted from a crime. Fetal abnormality, which had been the basis for most legal abortions in Poland, is no longer a permitted ground.
France’s 2024 constitutional amendment, Malta’s 2023 life-saving exception, Colombia’s 2022 decriminalization up to 24 weeks, and the post-Dobbs realignment in the United States all happened within a few years. Any snapshot of global abortion law has a short shelf life.
Conscientious Objection
Even in countries where abortion is legal, individual healthcare providers may have the right to refuse to participate. Around 80 countries expressly allow doctors to decline based on conscience, religion, or personal belief.14Office of the United Nations High Commissioner for Human Rights. How International Law Protects Access to Abortion Providers who refuse are generally expected to refer the patient to a willing colleague, though referral requirements are inconsistently enforced. International guidance is clear that conscientious objection cannot apply in emergencies when the pregnant person’s health is at immediate risk, and the right to refuse should be limited to individual providers directly involved in the procedure rather than extending to support staff or entire institutions.
Medication Abortion and Cross-Border Telehealth
Medication abortion using mifepristone and misoprostol has become the most common method of early pregnancy termination in many countries, and its availability through mail-order pharmacies and telehealth has created new legal frontiers. In the United States, the FDA requires pharmacies dispensing mifepristone to operate under a Risk Evaluation and Mitigation Strategy program, and the drug must be prescribed by a certified provider. Since the FDA permanently removed the in-person dispensing requirement in January 2023, both brick-and-mortar and mail-order pharmacies can fill prescriptions in states where the procedure is legal.
Telehealth prescribing has triggered a new category of interstate conflict. California, Massachusetts, New York, Vermont, and Washington have enacted “shield laws” that protect healthcare providers who prescribe abortion medication via telehealth to patients in states with bans. These laws treat the virtual encounter as occurring entirely within the provider’s home state, shielding the clinician from out-of-state prosecution or licensing consequences. States that restrict abortion have attempted to reach across borders to penalize these providers, creating standoffs with no clean resolution under existing law.
Internationally, medication abortion has expanded access in countries with liberal frameworks while doing little to change outcomes in nations with total bans, where obtaining the pills carries the same criminal penalties as a surgical procedure. The World Health Organization recommends self-managed medication abortion as safe through the first 12 weeks of pregnancy, which has pushed many countries that allow the procedure on request to integrate pharmacy dispensing and telehealth into their standard care pathways.