In Rwanda, abortion is only permitted if the pregnancy threatens the life or health of the mother, risks fetal defects, or if it resulted from rape, incest, forced marriage, or sex with a minor. Abortions must be performed at an approved medical facility before a gestational age of 22 weeks, or later if medically necessary. Parental consent is required for minors. Illegal abortions are punishable by fines or prison. Despite the legality of abortion, illegal and unsafe abortions are common.
Rwanda's 1977 penal code permitted only therapeutic abortions approved by two physicians. In the 2010s, maternal health initiatives of the Ministry of Health addressed unsafe abortion, while pro-abortion advocacy groups such as the Youth Action Movement reported on people imprisoned for abortions. Influenced by such advocacy, the 2012 revision to the penal code included an amendment to the abortion law, which faced opposition from religious groups. This lifted the country's reservation to the Maputo Protocol, reduced prison sentences, and decriminalized abortions if a court ruled that the pregnancy resulted from rape, incest, or forced marriage. The Ministry of Health began a program to implement the law, but legal abortions remained rare, limited by the requirements for court orders and physician approval. These requirements were lifted by a penal code amendment enacted by a 2019 ministerial order, which also added minor status as a legal ground for abortion, established a gestational limit, and required that abortions be performed by physicians at high-level facilities. A 2021 Supreme Court case argued that these narrow requirements were inequitable, and a 2024 ministerial order broadened the requirements. President Paul Kagame pardoned hundreds of people imprisoned for abortions between 2016 and 2023.
Abortion and unintended pregnancy are stigmatized in Rwanda, and many people oppose abortion due to cultural or Christian views. Legal abortions are difficult to access, and many abortions are either self-induced or performed by folk healers, especially in rural areas. Patients seeking abortions at hospitals may face delays or opposition from staff. Post-abortion care is available at public and private non-religious facilities, but only two-thirds of patients receive it.
Legislation The penal code of Rwanda permits abortion in cases of risk to life, risk to health, or fetal defects, as well as pregnancy from rape, incest, or forced marriage. A law also permits minors to have abortions. Judicial evidence is not needed to prove grounds for abortion; abortion patients who are found to have lied about these grounds are liable for illegal abortion. The gestational limit is 22 weeks for abortions that are not medically necessary. Abortions must be performed at approved medical facilities. Parental consent is required for minors who receive abortions. Spousal consent is recommended but not required. It is unclear whether conscientious objection to abortion is allowed—though the law does not mention it, the Code of Professional Conduct of Nurses and Midwives allows objection to any procedure provided it does not violate the professional duty.
Under Article 123 of the penal code, self-induced abortion is punishable by a prison sentence of one to three years and a fine of 100,000 to 200,000 francs. Article 124 sets a sentence of three to five years, which is increased to twenty to twenty-five years if the procedure results in disability or life imprisonment if it results in death. The same article says negligence that results in abortion is punishable by a prison sentence of one to two years and a fine of 300,000 to 500,000 francs. If the provider of an illegal abortion is a medical professional, they may lose their license for three to five years. Advertising abortion is also punishable by a prison sentence of six months to two years. Some cases of abortions are prosecuted as cases of infanticide, which is punishable by life imprisonment.
History Abortion ban The penal code of Rwanda, enacted in 1977, included an abortion ban. The abortion law was similar to Article 317 of the French Penal Code of 1810, including wording from a 1939 amendment. The law permitted abortion only medically necessary abortions, as determined by two physicians, and it set a prison sentence of five to fifteen years for performing illegal abortions. The medical approval of an abortion was required to be recorded in copies given to the provider, the patient, and the two physicians who gave approval. Abortion was widely considered illegal. Rape during the Rwandan genocide of 1994 led many women to receive abortions, while others were pressured to do so by their families. United Nations aid workers began providing reproductive health services in 1996, but they did not provide abortions. After the genocide, the government began initiatives toward gender equality in Rwanda, contributing to abortion reform.
The (ARBEF; Rwandan Association for the Promotion of Family Welfare) began working as an affiliate of Planned Parenthood in 1987. In 2009, the Dutch reproductive rights NGO Rutgers WPF, in collaboration with Planned Parenthood, formed the Youth Action Movement (YAM) with youth groups from several countries, including the youth wing of ARBEF. YAM Rwanda led initiatives on unsafe abortion in 2010 and 2011, collecting data and testimonials from hospitals and prisons; it reported in July 2010 that, 21 of the 114 women at Karubanda Prison were charged with abortion, of which 90% were under 26. The group presented its findings at meetings with university students, youth organizations, and officials. News agencies and radio stations reported from YAM Rwanda's workshops, with some discussing abortion on their front pages. The Ministry of Health began addressing unsafe abortion in 2010 as part of its focus on maternal health. This included a program that introduced post-abortion care to primary healthcare facilities nationwide.
Before abortion was decriminalized, the legal restrictiveness led many medical providers to avoid abortions even when legal, so women instead received unsafe abortions from illegal providers. A 2009 study estimated that the country had an abortion rate of 25 per 1,000 women of reproductive age, as well as 16,700 cases of post-abortion care. The highest abortion rate was in Kigali, where services were more available. The illegality and stigmatization of abortion often led women in the country to avoid PAC, even for spontaneous abortions. Many women were arrested for abortions after being reported by people they knew personally. In 2008–2013, Rwanda had 227 women imprisoned on abortion charges, out of a total of 7,807 women imprisoned, according to official statistics. However, a 2015 study of five prisons found that over one-fifth of women in each prison faced abortion charges.
2012 penal code revision Human rights organizations and advocacy groups such as YAM Rwanda influenced the inclusion of an abortion law in the 2012 revision to Rwanda's penal code. The African women's rights advocacy coalition SOAWR petitioned President Paul Kagame to reform Rwanda's abortion law in a May 2012 letter. It was opposed by many religious leaders. The abortion article received more attention than the rest of the penal code revision. Several opponents of the law appeared at a news conference at Village Urugwiro in May 2012. The following month, the Ministry of Justice wrote to the Parliament of Rwanda requesting that the country remove its reservation to Article 14 of the Maputo Protocol, which provided for a right to abortion on grounds similar to the proposed penal code. The Principal State Attorney, Frank Mwine Mugisha, said, "Our laws would be contradictory with the Protocol if we don't remove reservations. Once the reservations are removed, then the new Penal Code will be incorporating the Maputo provisions."
The penal code revision was passed on 14 June 2012, including an abortion law in Article 162. This added the legal grounds of rape, incest, and forced marriage, and it reduced the prison sentence for illegal abortions to one to three years. Court orders were required to prove non-medical grounds. The country also removed its reservations to the Maputo Protocol at this time. The Penal Code amendment did not specify whether these grounds also included statutory rape of minors. The passage of this legislation lessened the taboo about abortion. The Ministry of Health, Ministry of Justice, , National Women's Council, and National Youth Council participated in discussions about the subject. The Ministry of Health began the Operationalization of the Penal Code of 2012 Program in January 2013, with the goals of making safe abortion available to everyone and reducing abortion complications by 75% by 2018. With partners including the Rwanda Society of Obstetricians and Gynecologists, this program developed a protocol for implementation and training materials; it trained twenty-four healthcare professionals in 2014 and held orientation meetings with 138 stakeholders across 8 locations. The program also led to the registration and availability of misoprostol and mifepristone.
Under the 2013 abortion law, women seeking abortions were limited by the requirement of a court order, which involved the reporting of an incident within 72 hours, followed by a legal process. Some victims who succeeded in receiving court orders did so too late to receive an abortion. The requirement for the approval of two physicians was also limiting since Rwanda had only one doctor per 16,000 to 17,000 people, concentrated in urban areas; rural areas also lacked facilities that can legally provide the procedure. Abortion activists from ARBEF and HDI said that the penal code amendment did not resolve the issue of unsafe abortion. Lawyer Tom Mulisa said that, a year after the amendment, the courts had heard no abortion cases, with the legal requirements being too difficult for most people to go through.
Misoprostol was added to Rwanda's essential medicines list in 2015, with the goal of the availability of all abortion methods recommended by the World Health Organization. In March 2016, the Rwanda Law Reform Commission proposed that being a minor should be a legal ground for abortion as sex with a minor was illegal. It received support from some legislators and members of the public. In December 2016, Kagame issued 62 pardons to people who had received abortions before the age of sixteen. A 2016 article in The New Times reported that legal abortion remained infeasible, with court cases sometimes lasting over a year. Between 2012 and 2018, there were only five court cases requesting legal abortions.
2018 penal code revision A proposal to amend the penal code's section on abortion was passed by the Parliament in December 2017. The amendment removed the requirement for court orders. Civil society groups such as HDI supported this change. It also allowed minors to get abortions, with the requirement of parental accompaniment. This requirement was supported by members of parliament including Euthalie Nyirabega, saying parents would protect their children against unnecessary abortions. The amendment also removed the requirement for the approval of two physicians. It was enacted in October 2018 and came into effect in April 2019, with the passage of Ministerial Order . This order established a gestational limit of 22 weeks and required abortions to be performed at hospitals or polyclinics. Some members of the public opposed the ministerial order, saying it may make abortion too easy. The Safe Abortion Guidelines were also enacted in 2019. The New Times reported that the amendment to the abortion law had led to an increase in public requests for abortions.