Abortion as a practice for ending pregnancy has been documented for thousands of years. Largely a private matter, often euphemistically known as ‘menstrual regulation’, knowledge of how to end a pregnancy has been passed between women and treated as a normal, if mostly secret, part of reproductive life for millennia. Legislative interference into abortion is a more modern phenomenon, and indicates changing perspectives and relationships towards the foetus, the control of women's bodies and the governance of medical procedures.

The status of abortion in national legal systems does not necessarily reflect easy access to the procedure. Issues of stigma, cost, location of clinics, restrictions on who can provide abortion services and gestational limits continue to affect women's access to safe abortion even in cases where the law appears liberal. However, it is clear that in regions where legal restrictions are in place, a number of added complications exist for women wishing to access abortion. These include accessing abortion away from regulated settings, and in doing so, risking unsafe abortion. Added complications include the need to pay for the abortion, which is often at a significant cost, having to travel to other jurisdictions, and most obviously the risk of prosecution if found to have procured an illegal abortion.

In some jurisdictions the increasingly draconian interpretation of abortion laws has seen women prosecuted for illegally procuring abortion pills (Northern Ireland) or imprisoned for having miscarriages (El Salvador). In other settings laws exist which completely criminalise any abortion procedure even where a woman's life is at risk (Malta, the Dominican Republic, Nicaragua), and lawmakers globally continue to put forward laws which will narrow the grounds on which abortion is legal (Poland, the United States).

This chapter considers the adoption of laws criminalising abortion and their effect on women's access to abortion. The case studies of the Republic of Ireland and Uruguay illustrate how women and healthcare providers have had to adapt to restrictive abortion laws and how restrictive laws do little to stop abortion from occurring. The chapter concludes by presenting the case for decriminalisation of abortion laws globally.