• Sri Lankan law permits terminations only to save mother’s life
• Birth defects account for around 700 of SL’s 2,100 annual infant deaths
• Doctors have pushed for law reforms for over 2 decades
• Up to 1,000 illegal abortions occur daily; unsafe procedures linked to maternal deaths
• Repeated reform efforts since 1995 have stalled amid political, religious opposition
• UN recognises reproductive rights as fundamental human rights

“Trapped inside the womb without even a drop of fluid around him, my little boy suffered. His tiny arms and legs became bent, and his growth slowed more and more. Yet I was told there was nothing that could be done from the outside to help him.” 

A mother, who wished to remain unnamed, said this about her son, whom she lost four hours after he was born.

She had carried him from the 16th week – when a scan first revealed that the amniotic fluid around him had begun to decrease – through nine weeks of intermittent bleeding and fluid discharge, to a 29th-week emergency caesarean section. She had been told, repeatedly and plainly, that her son would not survive.

“The doctor told me frankly to give up hope, saying that his heart could stop at any moment,” she said. “From the 20th week until the 29th week of my pregnancy, I experienced intermittent bleeding and fluid discharge. I endured all of it, but nothing could stop what was happening.” Four hours after birth, her son died.

“It has now been six months, but I still cannot come to terms with losing him,” she said. “I can no longer work as hard as I used to, nor can I lift heavy things. My child is gone, and all that remains is the scar from an operation that has left me physically weaker for the rest of my life. I accept everything that happened for the sake of my son. The only thing that continues to break my heart is knowing that he suffered trapped inside my womb, and all I could do was watch it happen.” 

Her experience is not exceptional in Sri Lanka. It is, for many families, the only legal option available.

Under Sections 303 to 306 of the Penal Code of 1883 – legislation inherited from British colonial rule – abortion is a criminal act, punishable by up to seven years in prison. The sole exception is when the pregnancy poses a direct threat to the mother’s life. There is no provision for pregnancies in which a fatal foetal abnormality has been confirmed, no matter how certain the prognosis, and no matter how early in the pregnancy it is detected.

The law says carry on

Birth defects are the leading cause of infant deaths in Sri Lanka. Of approximately 2,100 children who die within their first year annually, around 700 deaths are attributable to birth defects, according to former President of the College of Community Physicians of Sri Lanka (CCPSL) Dr. Kapila Jayaratne, who spoke at a media briefing at the Sri Lanka Medical Association (SLMA) last week.

Some of these conditions can be detected as early as 18 weeks into a pregnancy. One of the most cited examples is anencephaly – a condition in which a child is born without a brain. Such a child can be born alive. When born, the health system is obligated to respond. The child may be placed in an intensive care unit and kept alive for a month or two before dying.

“By keeping a child in the womb – who is well known to be fatal and will die – the mother, that child, the health system, that family, and society are made to suffer,” Dr. Jayaratne said. “Even after such a child is born, our health system cannot just remain idle. If a child has life, everything must be done regarding that. Consequently, for a child who is going to die, we have to direct our resources towards that child, thereby depriving another child who could live through that opportunity.”

Another mother, speaking to The Sunday Morning, described what that process meant for her family. Her son was her first child.

“If a law is truly introduced to legalise medical termination of pregnancy, it would be a great blessing,” she said. “I went through the same pain for nine months. In the end, all I was left with was suffering. We had to register our son’s birth, give him a name, and then, almost immediately afterwards, obtain his death certificate. That experience left a deep trauma. Because of what happened, we decided not to have any more children. The memories still haunt me every day.” 

Beyond foetal conditions, a doctor who spoke to The Sunday Morning on condition of anonymity noted that there were also situations where a pregnancy was not the result of the mother’s choice, or where a mother was not physically or mentally in a position to care for a child. 

“In such circumstances, even if the baby is born without physical disabilities, serious concerns may arise regarding the child’s emotional well-being and future,” the doctor said. “Similarly, for some women suffering from certain medical conditions, pregnancy itself can pose significant health risks. The combination of the underlying illness and pregnancy-related complications can, in some instances, even threaten the mother’s life.” 

What the medical community is requesting is, by its own account, narrow and tightly safeguarded. Dr. Jayaratne was deliberate about the language: the procedure would not be called abortion but termination of pregnancy, in order to distinguish it legally and socially from criminal acts. 

It would be permitted only within Government hospitals. It would require the unanimous agreement of three separate doctors, based on confirmed medical tests. It would generally apply before 18 weeks, where the chance of survival is minimal.

“There is absolutely no room for misuse,” he said.

30 years of trying

The first serious parliamentary discussion on reforming Sri Lanka’s abortion law took place in September 1995, when then Minister of Justice Prof. G.L. Peiris introduced a bill to amend the Penal Code. The bill initially addressed abortion, proposing to permit it in cases of rape, incest, or foetal abnormality, with strict safeguards. The abortion provisions were removed before the vote – but not before a six-hour debate that laid bare the attitudes shaping the law. 

Some MPs, including United National Party (UNP) MP John Amaratunga, opposed any form of reform, arguing it would lead to widespread misuse. Others, including UNP MP Tyronne Fernando, went further, arguing that women could fabricate rape allegations, and proposed requiring corroborative testimony as a safeguard against false accusations. MP Mahinda Samarasinghe similarly advocated for medical evidence as corroboration in rape cases.

Not all opposition was as stark. Some MPs who supported the amendments nonetheless framed them in paternalistic terms, presenting reform as necessary to protect poor and vulnerable women rather than to uphold their autonomy. Minister of Health and Women’s Affairs Renuka Herath broadly supported liberalisation while cautioning against measures that might inadvertently encourage societal rape, and proposed a time limit on abortion before the foetus developed further.

MP Neelan Tiruchelvam emphasised evolving societal attitudes towards gender equality and the need for corresponding legal adjustments, highlighting the class dimension: impoverished women, he noted, suffered most from unsafe abortions and deserved a more compassionate regulatory framework.

Minister Peiris himself acknowledged the difficulty plainly. In withdrawing the amendment, he said the controversy had revealed a tension “between those traditions that regard all life as being sacrosanct and those voices that believed in the independence and autonomy of women”. He added: “We have tried to accommodate different points of view, different religious convictions, and different cultural and moral traditions. In the end, no one was willing to challenge legal norms and values based on religious belief.”

The matter was not discussed in Parliament at that length again.

The debate was revived in 2011, when the Minister of Child Development and Women’s Affairs raised abortion law reform in Parliament. The National Action Plan for the Protection and Promotion of Human Rights 2011 included a specific goal to decriminalise abortion in instances of rape and significant foetal anomalies. In 2013, the Law Commission of Sri Lanka prepared a draft bill permitting termination in cases of rape, incest, or significant foetal impairment. It did not pass. 

In 2017, a Special Committee recommended allowing termination in cases of rape, incest, serious foetal anomaly, or where the pregnant person was below 16 years of age. A Cabinet-approved bill followed – and was then shelved after sustained opposition from religious groups, including a significant push from the Catholic Church.

On 21 March 2025, Minister of Justice and National Integration Harshana Nanayakkara told Parliament the Government had restarted the process of examining the Law Commission’s proposals. He acknowledged that reform had previously failed due to inadequate stakeholder and public engagement, and said that such engagement was now necessary before any legislation could move forward. He confirmed, however, that there was no timeline and that no decision on the final form of any proposal had been made.

Former Secretary to the Ministry of Child Development and Women’s Affairs Sumithra Rahubadda, who was centrally involved in the earlier reform effort, described how it collapsed.

“It actually stopped in 2012 due to a religious perspective,” she said. “At the time, we were even prepared to educate some of those religious leaders. We had a few people in Parliament ready to help convince them. However, while that was happening, I retired. After that, the work just stopped right there.” 

She was direct about where institutional responsibility lay. “Politicians don’t push for it because there is no initiative. Ministers alone cannot do this; they will agree if it is presented to them, but officials must lead the way because ministers come and go. I worked under a male minister who was very traditional, but I convinced him to the point where he was speaking in favour of it. If an official stays with the cause and doesn’t retire like I did, it can be done. If a country like Bhutan can do it, why can’t we?” she questioned.

The cost of the law that stays

Sri Lanka’s restrictive legal framework has not prevented abortion. It has made it dangerous, and it has made safety a privilege of the wealthy. 

A 2016 Health Ministry estimate placed the number of abortions performed daily at 658. Research published in 2023 by the University of Sri Jayewardenepura cited figures of between 800 and 1,000 illegal abortions daily. A late-1990s national study sponsored by the United Nations Population Fund (UNFPA) placed the number at 650 abortions per day. Unsafe abortion is the third most common cause of perinatal death in the country, accounting for 10–13% of maternal fatalities.

The doctor described the clinical reality. “These illegal abortions, carried out without the guidance of properly trained healthcare professionals, can lead to serious complications, including infections of the reproductive system, excessive bleeding, and in some cases, death,” they said. 

“Even when they do not result in death, unsafe abortions can cause long-term complications such as reduced fertility and ectopic pregnancies, potentially depriving women of the opportunity to have children in the future. Many of these procedures are carried out without adequate pain management, proper medical supervision, or accurate information, leaving women with deeply traumatic experiences and lasting psychological scars.” 

Rahubadda pointed to the class fault line running through the issue. “In the city, there are plenty of doctors who do it secretly. Only people with money can afford these safe but illegal removals. It is the poor and those who are victims of rape and incest who truly suffer.” 

In villages, she said, women resorted to methods including traditional herbal decoctions and physical interventions. “By not allowing legal abortion, people seek illegal and unsafe alternatives. When that happens, either the mother dies, or both the mother and child die. This solves the problem in the wrong way.”

A matter of consensus and responsibility

Government Medical Officers’ Association (GMOA) Spokesperson Dr. Chamil Wijesinghe told The Sunday Morning the GMOA had not formally taken up the issue yet, and emphasised the need for broad stakeholder consensus before any reform proceeded.

“This is a very complex process. It is an incredibly sensitive decision. There are many different groups with conflicting ideologies. That is why this has been discussed for so long; the difficulty lies in bringing everyone to a common ground,” Dr. Wijesinghe said. “We do not believe it is good to use arbitrary power to bring this in as a law. This doesn’t just involve the Ministry of Justice; health is also a critical factor.” 

He also drew attention to the professional exposure that doctors faced. “Doctors bear a massive responsibility. The professionals involved in the process – whether doctors, other professionals, or even the Judiciary – must not face any prejudice or negative consequences.” 

Government Midwifery Services Association President Devika Kodithuwakku called for a carefully constituted Ministry of Health special committee, including consultant obstetricians and gynaecologists, Family Health Bureau representatives, psychiatrists, midwifery unions, and representatives of those who had previously opposed reform.

“It could be because they have a reason to oppose, which the health sector should learn about,” Kodithuwakku told The Sunday Morning. On the question of the mother’s life, she was unambiguous: “You can have more babies, but a mother’s life is valuable. There might be an entire family she has to leave behind if she is hurt, which would have a significant impact on that family. Therefore, we give priority to the mother in such cases.” 

Internationally, the United Nations (UN) recognises reproductive rights as fundamental human rights under the 1994 International Conference on Population and Development (ICPD) Programme of Action, to which Sri Lanka is a signatory. The UN’s Sustainable Development Goals include specific targets on universal access to reproductive healthcare. 

UN bodies including the Committee on the Elimination of Discrimination against Women (CEDAW) have consistently pressed member states to ensure abortion access, explicitly noting that restrictions disproportionately harm vulnerable populations. Sri Lanka’s current legal framework places it at odds with those commitments.

What remains

The legal drafts have been submitted. The meetings with the Minister of Justice and the Minister of Health have taken place. Dr. Jayaratne said the remaining tasks were not simple, but that the medical community had fulfilled its part.

“Even this year, we have submitted all the legal drafts regarding this,” he said. “There is a positive response, but it gets delayed due to various reasons. We hope that something positive will happen within this year.”

Rahubadda, who had watched the effort stall and restart across multiple governments, was measured but clear. “It is not something that is impossible to achieve, but it must be done step by step. The proposal and draft for this were all finished, as far as I know. It is a tragedy that it remains this way.”

The mother, who carried her son for 29 weeks knowing he would not survive, said she had accepted everything that happened for his sake. What she could not accept was that others would continue to face the same absence of choice.

“No mother should have to endure what I endured. No one should have to watch their child suffer and then lose them after carrying them for so long.”