At 185 deaths per 100,000 abortion, Africa had the highest abortion fatality rate of any world region in 2019. Ongoing efforts by different African countries to both improve abortion safety and expand access to quality post-abortion care through abortion laws in Africa, have contributed to a decline in the rate of maternal deaths due to unsafe abortions in individual countries.
A woman’s decision to have an abortion is rarely simple, as many factors can influence or necessitate a woman’s need or decision to have an abortion. The circumstances that can lead to it varies: contraceptive failure, limited access to family planning, rape, incest, fetal anomalies, illness during pregnancy, or exposure to medications that pose serious risks to a developing fetus. In some cases, the decision is not a choice at all. Pregnancy complications such as placental abruption and severe cardiac or renal conditions can escalate to the point where terminating the pregnancy is not an option being considered, it is the only measure that can preserve a woman’s health or save her life.
Yet most African countries do not acknowledge this reality and continue to impose restrictive laws that do not include or consider certain conditions that affect women. However, women who do not fit into the categories or restrictions do not stop seeking abortions. They simply seek them in secret, use harmful substances, without post abortion care, and in the hands of quacks with no training or accountability. The laws do not prevent abortion, it exposes women to unsafe, illegal abortions.
Not all African countries take such a restrictive approach to abortion, some countries in the South, North, and West have expanded access to safe abortion. Here are five of them
1. South Africa
On December 11, 1996,South Africa enacted the Choice on Termination of Pregnancy Act. It gives women of any age or marital status access to abortion on request for the first 12 weeks, and, under certain conditions, up to 20 weeks. This law replaced a 1975 rule requiring physician or magistrate approval. Its passage marked South Africa’s first democratic recognition of reproductive rights.
The law lets women seek care early, without approval from doctors or courts, removing delays and control. The law also made abortion part of a wider reproductive healthcare system. Services were included in both public and private facilities, along with counseling and post-abortion care. By doing this, the law recognized something often ignored in stricter settings: abortion is part of the full range of care, not separate from it.
Before legalization, unsafe abortion caused many maternal deaths in South Africa. After the law, abortion-related mortality fell by over 90%. These numbers prove that safe access not only expands choice but also saves the lives of women. Importantly, women do not have to justify their decisions in cases like rape or financial hardship early in pregnancy. This changes the focus from needing permission to having autonomy, putting decisions in the hands of women instead of institutions.
2. Benin
In Benin, abortion has been made legal up to 12 weeks of gestation in cases where the pregnancy is likely to worsen or cause a situation of material, educational, professional, or moral distress which is incompatible with the woman’s interests.
Before this amendment, a woman could have a pregnancy terminated if the pregnancy would threaten her health or life, in case of fetal malformation, or when the pregnancy was a result of incest or rape. The new law expands this to protect a woman’s education or career, making Benin one of the countries in Africa to allow voluntary termination of pregnancy for socioeconomic reasons.
By allowing abortion for socioeconomic reasons, the law recognizes situations that are often overlooked, such as students who might drop out, women facing financial problems, or those whose lives would be deeply affected by continuing a pregnancy. It moves the conversation from extreme cases to everyday realities.
Women can request voluntary termination of pregnancy services at formal health centers instead of turning to unsafe methods, moving abortion into regulated, safer systems. Reports following the reform point to a reduction in unsafe procedures and to a system in which healthcare providers feel more able to act without fear of legal consequences.
3. Tunisia
Tunisia stands apart in North Africa and is the most progressive in the region by far with its abortion laws. Since the Tunisia abortion law amendment in 1973, abortion has been legal on request in the first trimester, and allowed for health reasons. The law also states that public facilities must provide abortion as a healthcare service for free, making Tunisia one of the few African regions with legal and institutionally supported abortion.
But Tunisia’s story does not follow the same pattern as many other countries. Abortion was not first framed as a women’s rights victory. It arose from a broader demographic strategy after independence. The country aimed to cut birth rates and spur economic growth, thereby enacting a law permitting women with more than five children to receive an abortion with spousal consent. This was before the amendment in 1973 extending legal abortion to all women and lifting the requirement for spousal consent.
For many years, the policy worked within an organized healthcare system, supported by government family planning programs and international partners. However, over time, access has become less consistent, especially after the demographic changes of the late 1990s and the Tunisian Revolution of 2011, which opposed abortion, increasing conservatism, and an economic crisis led to a decline in abortion access.
Islamic opposition to abortion is currently widespread in Tunisia. Abortion is considered haram, even though the law remains. Public facilities, once central to free abortion care, grew strained over time. Budget cuts, provider resistance, and religious conservatism further reduced service availability, especially in rural and underserved areas. The gap between public and private care widened. Medical abortion is the most common method in public facilities, while surgical abortion is more common in private facilities. Only private facilities provide abortions after the first trimester. Many medical providers have negative attitudes about it, contributing to false interpretations of the law. Today, Tunisia has a taboo surrounding abortion, and many women are unaware that it is legal.
4. Namibia
Namibia takes a middle-ground approach to legalizing abortion laws. Its laws are more flexible, but not fully liberal. Abortion is allowed in certain cases, such as rape or incest, when the pregnancy seriously threatens the woman’s physical or mental health, or if there is a high risk of severe fetal anomaly. These rules, carried over from the 1975 Abortion and Sterilisation Act, create a broader legal framework than in countries where abortion is only allowed to save a woman’s life.
The law recognizes that pregnancy can involve many different situations, and sometimes continuing it can be harmful. But the process is tightly regulated. To get an abortion, approval usually requires certification from multiple doctors, and procedures must occur in designated medical facilities. Though this was meant to be a safeguard, these requirements often become barriers, delaying access and making legal abortion difficult in practice.
Despite legal exceptions, many women remain unaware that abortion is permitted at all, while others are unable to navigate the system in time. This has contributed to the persistence of unsafe abortions, contributing to an estimated 12 to 16% of maternal deaths and thousands of annual complications. With mostly, poor, rural, and marginalized women affected.
In recent years, advocacy efforts have grown more visible. A 2020 petition calling for expanded access gathered over 60,000 signatures, signaling a shift in public conversation. Grassroots organisations, researchers, and activists have continued to push for reform—framing abortion not only as a legal issue, but as one tied to health, education, and reproductive autonomy. In 2025, Namibian women, in collaboration with the Ministry of Health and Social Services in the country, took to the streets to protest against the restrictions placed on abortions, arguing that the 1975 law violates constitutional rights to dignity, life, equality, health, and privacy, and also used the opportunity to create awareness for women and girls. The outcome led to a draft policy on abortion laws recommended for reform, which is still pending approval to date.
5. Burkina Faso
In Burkina Faso, abortion is not completely banned, but it is very tightly controlled. The Penal Code of 1997 permits abortion in specific circumstances: to save the life of the woman, protect her physical or mental health, in cases of rape or incest, and if the child will potentially be born with an incurable disease. These exceptions are limited to only the first ten weeks of pregnancy.
Abortions on all other grounds are illegal, but widespread. Illegal abortions are punishable for both the woman and the abortionist. They face up to 5 years’ imprisonment, as well as a fine of between 300,000 and 1,500,000 CFA. However, it is uncommon for both the abortionist and the pregnant woman to be tried for illegal abortions.
In practice, accessing these legal exceptions is difficult. For cases of rape or incest, legal proof must be obtained through a state prosecutor, and the process must be completed within a limited timeframe. These requirements make legal abortion under these grounds nearly impossible to access in a timely manner. Many Burkinabe women turn to having their abortions in secrecy because they are faced with several obstacles, such as access to the proper facilities when they want to have an abortion, whether legal or illegal.
Even in cases where abortion is legally permitted, many women are unaware of their rights or avoid formal healthcare systems out of fear of judgment, of prosecution, or of exposure. In response, Burkina Faso has taken a different approach. Rather than expanding legal access, much of the country’s policy response has focused on post-abortion care, treating complications from unsafe procedures as a way to reduce the mortality rate without directly confronting the legal framework. This has created a system that acknowledges the consequences of unsafe abortion, even while maintaining restrictions on access.
In Africa, abortion laws are mostly restrictive but are different based on region. Most African countries restrict abortion solely to be implemented in life-threatening situations. West Africa shows the most progress in terms of the law and minimal restrictions, allowing abortion on request, rape, incest, or health risk. Countries like Senegal, Gambia, Mauritania, and Nigeria allow abortion only to save the mother’s life. The countries with less restrictive laws still struggle with creating awareness, and that gap between law and lived reality is where women continue to be affected.
Abortion laws on paper mean very little if women are ignorant of their rights, have no access to adequate healthcare, and healthcare providers refuse to perform the procedure due to personal or religious reasons. Stigma also does not disappear because of the existence of a law, in many of these countries, women still seek abortions in secret, fearing judgment from people, and even the doctors. Legalizing abortion is the first step, but without investment in public education, trained providers, and accessible facilities, laws remain out of reach for the women who need it most.
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