Research Finds Non-Legal Barriers Continue to Limit Access to Safe Abortion Services in Rwanda

Although Rwanda allows safe abortion under specific legal circumstances, new research suggests that many adolescent girls and young women continue to face significant challenges when trying to access these services.

The findings appear in a study published on January 27, 2026, in the International Journal of Women’s Health. The research, titled The Non-Legal Barriers Experienced Among Adolescent Girls and Young Women in Selected Districts of Rwanda Seeking Safe Abortion Services, examines the obstacles that remain despite the country’s legal framework.

The study concludes that legal permission alone does not guarantee timely or equal access to safe abortion services. Social, financial, and healthcare-related barriers continue to affect many women who qualify under the law.

Rwanda’s Legal Framework on Safe Abortion

Rwandan law permits safe abortion under specific conditions. These include pregnancies resulting from rape, incest, forced marriage, pregnancies involving minors, or situations where continuing the pregnancy poses a risk to the life or health of the mother or the unborn child.

Qualified doctors and trained midwives can provide the service in approved health facilities for pregnancies between three and 22 weeks, except where serious medical conditions require different clinical decisions.

Despite these legal provisions, researchers found that many eligible women struggle to obtain services.

Study Explores Experiences Across Four Districts

Researchers conducted the study in the districts of Kicukiro, Nyarugenge, Gatsibo, and Nyagatare. These locations were selected partly because previous national data showed relatively high numbers of teenage pregnancies.

The research included in-depth interviews with 24 adolescent girls and young women who had sought or received safe abortion services. Researchers also held focus group discussions involving parents, teachers, healthcare workers, religious leaders, and local government officials to better understand community perspectives.

Most participants were over the age of 18, while five were aged 18 or younger. The majority reported that they were unmarried.

Long Travel Distances and High Costs Create Major Challenges

One of the most common barriers identified in the study involved limited availability of nearby services.

Several participants reported traveling long distances to reach hospitals or health centers that offered safe abortion services. One participant from Nyagatare explained that reaching a healthcare facility required several hours of travel, while transportation expenses alone reached approximately RWF 50,000.

Financial costs also affected access. Participants reported paying between RWF 50,000 and RWF 60,000 for services, in addition to transportation, medication, and food expenses. One woman said complications following treatment resulted in additional medical costs totaling about RWF 310,000.

Researchers noted that these expenses may discourage low-income women from seeking timely medical care.

Lack of Information and Social Stigma Remain Significant

The study also found that limited awareness about legal safe abortion services continues to influence healthcare decisions.

Some participants said they were unaware that approved health facilities offered legal services. Instead, they initially relied on unsafe traditional methods, which resulted in severe medical complications before they eventually sought professional treatment.

Researchers further identified stigma as another important obstacle. Fear of judgment from family members, communities, healthcare providers, or religious groups discouraged some women from requesting services, even when they met the legal requirements.

Concerns about confidentiality also emerged throughout the study. Several participants worried that personal medical information could become known to relatives, neighbors, classmates, or employers, reducing their willingness to seek care.

Healthcare Experience Influences Access

Some respondents reported feeling judged or criticized by healthcare workers before receiving services. Others said personal beliefs held by individual providers sometimes delayed or complicated access to care.

The researchers emphasized that respectful communication, patient confidentiality, and non-discriminatory healthcare practices remain essential for improving service delivery.

Religious and Cultural Beliefs Continue to Shape Public Attitudes

The study notes that religion plays an important role in Rwandan society. Since many faith communities oppose abortion, women seeking legal services may experience additional social pressure, even when their circumstances meet the conditions established by law.

Researchers suggest that improving public understanding of the legal framework could help reduce misconceptions while encouraging respectful dialogue about reproductive healthcare.

Future Outlook

The findings indicate that expanding legal access alone may not fully address the challenges surrounding safe abortion services. Improving public awareness, reducing financial barriers, strengthening confidentiality, expanding service availability, and supporting respectful healthcare delivery could help eligible women access care more safely and promptly.

The study also highlights the importance of continued research and evidence-based policymaking to improve reproductive health services while respecting Rwanda’s legal framework.