Bangladesh currently lacks a comprehensive abortion law, permitting the procedure only in circumstances aimed at saving a woman's life, as outlined in the Bangladesh Penal Code of 1860 (sections 312-316).
Instead, the government offers Menstrual Regulation (MR), a service included in the national family planning program since 1979. MR can be performed by trained midlevel providers within 10 weeks of a missed menstrual period and by a doctor within 12 weeks.
This MR policy significantly reduces the impact of the penal code for pregnancies during the first trimester. However, it poses serious challenges for safe abortion services for pregnancies beyond 12 weeks.
The limitations on access not only contribute to unsafe practices but also reinforce the social stigma associated with abortion. Furthermore, the restrictive laws complicate efforts to raise awareness, increasing stigma surrounding reproductive health.
Sayed Rubayet, country director of Ipas Bangladesh that promotes safe abortion, emphasizes the importance of prioritizing access to quality services over judgment or stigma.
“It’s a reproductive right and a matter of autonomy. Restricting access doesn’t stop abortion. We should increase access to and availability of safe abortion care through a comprehensive national scale-up to address preventable maternal deaths. Instead of judgment or stigma, we should focus on access to quality service and support a woman in making informed, safe choices,” he told Dhaka Tribune.
The international safe abortion day, observed on September 28, serves as a reminder of the ongoing global need to decriminalize abortion and ensure safe access for all who need it, aligning with the promises enshrined in the Sustainable Development Goals (SDGs).
According to an analysis published in the BMJ Global Health journal, in Bangladesh in 2015–2019, there were a total of 5,330,000 pregnancies annually. Of these, 2,630,000 pregnancies were unintended and 1,580,000 ended in abortion.
The Bangladesh Demographic and Health Survey (BDHS) 2017 found that about 72 percent of women of reproductive age are aware about MR services.
Gynecologist Dr Fahmida Naz told Dhaka Tribune that many women suffer due to a lack of safe abortion options.
“We have a dual problem. First, the campaign to promote contraceptive use is not widespread, leading to many unwanted pregnancies. Second, women often do not have access to safe procedures for abortion,” she explained.
“Although we don’t refer to it as abortion, we call it menstrual regulation (MR)—a procedure to manage the menstrual cycle when menstruation is absent for a short duration.”
“There are specific medications used for MR, but they must be taken within two months. However, we often see women in shock after taking these medications three or four months into their pregnancy, typically prescribed by quacks (unqualified individuals). They suffer from heavy bleeding that has led them to shock," she said.
“This situation can become life-threatening. While there are government facilities where MR can be performed safely, many women avoid these options due to social stigma and lack of acceptance. Instead, they often seek help from unskilled providers. Additionally, many senior doctors refuse to provide assistance or refer patients based on religious beliefs, thinking that MR should not be performed,” she said.
Access to safe abortion affects women's overall health and well-being. It not only improves the reproductive health outcome but also socio economic and emotional well-being. Safe access prevents unsafe abortion, hence decreasing maternal mortality and morbidity. It also reduces stress and anxiety associated with unplanned pregnancies.
The control over their bodies and informed choice by the woman reduces the gender inequality. When women are denied safe access, it also increases financial burdens.
Melissa Cockroft, Global lead for abortion at the International Planned Parenthood Federation (IPPF), in a webinar on safe abortion day, said: “Abortion can be provided safely even if it is provided or occurs in a country where abortion is legally restricted. Similarly, an unsafe abortion can be provided in a country context where abortion is legally permitted. So legal status of abortion does not always predict that an abortion will be safe or unsafe – however restrictions are known to be more likely to lead to unsafe abortions. And legal restrictions do not prevent abortion from occurring. When women, girls and pregnant people want an abortion they will find a means to obtain it, even if it is unsafe.”
Globally, six out of 10 unplanned pregnancies end in induced abortion, and around 45% of these abortions are unsafe, said Shobha Shukla, Coordinator of SHE & Rights (Sexual Health with Equity and Rights) Media Initiative, in the webinar.
“The next year 2025 marks 30 years since Beijing Declaration and Platform for Action was signed in 1995 – it highlighted the impact of unsafe abortion on women's lives and health, and the need to reduce recourse to abortion through expanded family planning services. Governments need to walk the talk on the promises for gender equality and human rights – with equity and justice,” she said.
