Original research article| Volume 94, ISSUE 5, P453-460, November 2016

Public funding for abortion where broadly legal

  • Daniel Grossman
    Corresponding author. Tel.: +1 510 986 8941; fax: +1 510 986 8960.
    Advancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, 1330 Broadway, Suite 1100, Oakland, CA, 94612, USA

    Ibis Reproductive Health, 1330 Broadway, Suite 1100, Oakland, CA, 94612, USA
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  • Kate Grindlay
    Ibis Reproductive Health, 17 Dunster Street, Suite 201, Cambridge, MA, 02138, USA
    Search for articles by this author
  • Bridgit Burns
    Ibis Reproductive Health, 17 Dunster Street, Suite 201, Cambridge, MA, 02138, USA
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      The objective was to investigate public funding policies for abortion in countries with liberal or liberally interpreted laws (defined as permitting abortion for economic or social reasons or upon request).

      Study design

      In May 2011–February 2012 and June 2013–December 2014, we researched online resources and conducted an email-based survey among reproductive health experts to determine countries' public funding policies for abortion. We categorized countries as follows: full funding for abortion (provided for free at government facilities, covered under state-funded health insurance); partial funding (partially covered by the government, covered for certain populations based on income or nonincome criteria, or less expensive in public facilities); funding for exceptional cases (rape/incest/fetal impairment, health/life of the woman or other limited cases) and no public funding.


      We obtained data for all 80 countries meeting inclusion criteria. Among the world's female population aged 15–49 in countries with liberal/liberally interpreted abortion laws, 46% lived in countries with full funding for abortion (34 countries), 41% lived in countries with partial funding (25 countries), and 13% lived in countries with no funding or funding for exceptional cases only (21 countries). Thirty-one of 40 high-income countries provided full funding for abortion (n=20) or partial funding (n=11); 28 of 40 low- to middle-income countries provided full (n=14) or partial funding for abortion (n=14). Of those countries that did not provide public funding for abortion, most provided full coverage of maternity care.


      Nearly half of countries with liberal/liberally interpreted abortion laws had public funding for abortion, including most countries that liberalized their abortion law in the past 20 years. Outliers remain, however, including among developed countries where access to abortion may be limited due to affordability.


      Since cost of services affects access, country policies regarding public funding for services should be monitored, and advocacy should prioritize ensuring the affordability of care for low-income women.


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