Every day, hundreds of Sri Lankan women risk their lives by having illegal abortions driven by poverty, stigma and the country’s draconian abortion laws.

Harbingers’ Magazine interviewed a nurse who used to work in a maternity clinic and frequently had to deal with women suffering complications from illegal terminations. She described one particular incident in detail.

“I still remember that night clearly,” the nurse recalled. “We got a call about a 42-year-old woman in critical condition. Her fever was sky-high, she was extremely pale – it was obvious she had tetanus. We immediately started her on IV antibiotics.”

Despite their efforts, the woman remained silent. “The doctor asked her what had happened, but she only told us her name and age. Pus was seeping from her vaginal area, and though it was clear she was in pain, she said nothing. A young girl, around 15, who we assumed was her daughter, stood beside her, too scared to speak.”

The medical team urged the patient to share what had led to her condition. “We told her, ‘If you don’t tell us what happened, we can’t help you.’ But she stayed quiet. By 3am, she was gone.”

Only later, after a police investigation, did the tragic cause come to light: the woman had undergone an unsafe abortion two weeks earlier, likely involving a coat hanger. Financial pressures weighed heavily – she and her husband already had six children. Yet when questioned, her husband denied any knowledge of the incident.

The legal landscape

Sri Lanka’s abortion laws are extremely restrictive. The penal code, dating from 1883, states that causing an abortion or miscarriage is a criminal act that can be punishable with imprisonment ranging from three to ten years, with or without a fine. The punishment can be more severe if the woman is in a later stage of her pregnancy – “quick with child” is the archaic term used.

The only exception is if the mother’s life is in danger. The legislation does not allow abortion in cases of rape, incest or foetal impairment.

Compared to other countries in South Asia, this is very draconian. India and Nepal, for example, are more liberal, allowing abortion for a much wider range of reasons. Nepal legalised abortion in 2002 and abortions on request are permitted during the first 12 weeks of pregnancy.

However, any woman who has had an illegal abortion can seek medical care for complications at any government facility without fearing prosecution, according to the guidelines issued by Sri Lanka’s Ministry of Health in 2015.

In the last 50 years, there have been several attempts to liberalise the country’s colonial-era abortion legislation, none of which were successful.

Reasons for abortions

Data on abortions in Sri Lanka is unreliable and often outdated. Records from 2015 show that approximately 660 illegal abortions are carried out daily (240,000 a year), but experts and activists claim the real numbers are likely to be much higher.

Safe abortions are available from specialist clinics – but only if you can afford it. One of the most common reasons for abortions is financial insecurity; many women cannot afford to have a child or cannot afford to have multiple children.

While a family planning authority does exist, conversations around sex are often shrouded in shame and mystery. This taboo approach to the subject, both at home and in schools, is also nourished by some religious leaders, especially from the Catholic church.

There is no formal sex education. The curriculum’s biology textbook contains a chapter on the “reproductive system” and its basic functions, but it is completely inadequate, and some teachers even avoid teaching the chapter altogether out of “embarrassment”. Many schools propagate this avoidance based on the problematic belief that teaching students about sex will result in them having it.

However, anti-abortion messaging is accepted and common in Sri Lanka, often organised by conservative religious groups with support from community leaders.

Public attitudes

Abortion is a highly contentious issue, as this 2023 survey by the Family Planning Association (FPA) of Sri Lanka makes clear.

Those in favour of legalising abortion argue that it would reduce the number of unsafe, illegal procedures that pose serious health risks to women. They also stress the importance of allowing women to make decisions about their own bodies, especially in cases of rape, incest or severe foetal abnormalities.

Opponents often promote better access to contraception and comprehensive sex education as ways to prevent unwanted pregnancies. However, this viewpoint is also debated, as some argue that using contraceptives is akin to ending a potential life.

Abortion in Sri Lanka is a complex issue shaped by legal, cultural and socio-economic factors. Strict laws aim to protect life but often push vulnerable women toward unsafe procedures. The high rates of illegal abortions stem from poverty, sexual violence, stigma and inadequate sex education.

Addressing this issue requires a balanced approach that respects cultural values while safeguarding women’s health and rights. Expanding sex education, improving access to contraception, and tackling root causes such financial insecurity and gender-based violence can reduce the need for unsafe abortions.

Ultimately, compassionate solutions that prioritise both life and dignity are essential for lasting change.