Advancing Safe Abortion Access: No Progress without Innovation
October 2025
As global threats to sexual and reproductive rights intensify, innovation can help drive the path forward for safe and equitable abortion care. It’s clear that the safe abortion community must remain open to experimentation, adaptation, and iteration, because the threats we face demand nothing less.
At the OPTions Initiative, we’ve seen firsthand how innovative approaches can help to deliver bold new models of care, support system resilience, and shift power to women, girls and people with diverse gender identities. We invest in bold ideas aimed at increasing access to safe abortion care and expanding the variety of methods available, particularly where access is most limited. In its first few years, the initiative has supported over 60 projects across 30+ countries, reaching over 500,000 women.
Next week we are heading to the International Conference on Family Planning, where we will be meeting with innovators, partners, and leaders in safe abortion. Here are the critical messages we’re bringing to these discussions.
Innovation Is Essential for Progress in Access to Safe Abortion
Over the past two decades, the global health community has made measurable strides in expanding access to safe abortion. However, these gains remain fragile. From shifting political landscapes to legal rollbacks and supply chain disruptions, the barriers to safe abortion access are persistent and evolving. In this environment, innovation is not optional. Innovation helps us adapt to dynamic contexts to ensure safe abortion care remains resilient and equitable.
In places where access to medication abortion is limited due to market or social barriers, innovators like Women on Web enable online access to abortion pills through their global pill-by-mail service or referrals to feminist midwife networks in several countries. Vitala Global’s Aya Contigo is a digital abortion companion—with the option to chat with a trained counsellor—assisting people with self-managed abortion and personalized contraceptive decision-making in Latin America and Latinx communities in the United States, so that people in more remote or restrictive settings can access quality services.
While the Mifepristone + Misoprostol combination remains the gold standard for medication abortion, growing legal restrictions, misinformation, and stigma underscore the need to expand the evidence base and explore complementary regimens. Several innovators are evaluating new and repurposed drugs that may improve feasibility through simpler protocols, fewer side effects, lower costs, and greater regulatory flexibility. Gynuity Health Projects has been conducting exploratory clinical research to evaluate the safety and efficacy of ulipristal acetate + misoprostol for medication abortion, with early findings indicating it as a promising alternative where access to mifepristone is limited.
Innovation Does Not Work in Isolation
Innovation alone cannot overcome the deeply rooted barriers to safe abortion access. To drive lasting change, innovation must be embedded in a broader ecosystem that includes legal reform, policy change, health systems strengthening, and market shaping. That means working hand-in-hand with those advocating for reproductive rights, reforming restrictive laws, and building the infrastructure that supports wide-scale service delivery. It means understanding and influencing regulatory pathways, supply chain systems, and financing models to ensure that new solutions reach the people who need them.
These partnerships are crucial. Most successful innovations are grounded in strong collaboration with in-country actors, including providers, advocates, and health systems leaders. For instance, thanks to the work of various organizations in Mexico and the social movement of the Green Wave in Latin America, significant progress has been made in the decriminalization of abortion in Mexico, particularly with the federal ruling of September 2023. As a result, Mexfam is able to expand its Solidarity Pharmacies model – training pharmacists as key actors to provide safe and confidential access to medication abortion – from three to eight states, and is identifying partners to scale nationally.
With funding from the OPTions initiative, Concept Foundation is working to strengthen the conditions for global Mifepristone access by strengthening the regulatory case for Mifepristone to be prescribed as an emergency contraceptive, offering a 120 hour protective window. The goal is to facilitate more reliable access to the drug by approving it for multiple indications and ideally allowing for deregulation to the level of pharmacies.
Together, we must Strengthen the Ecosystem for Innovation
As we gather in Bogota with the safe abortion community, we are calling on others to embrace a more integrated and medium-term approach to innovation. Funders must invest not only in novel ideas but in the advocacy and systems work that makes them viable. Innovators must collaborate with partners who can help navigate policy and market environments. Advocates and policymakers must build a movement that recognizes innovation not as a standalone endeavor but as a strategic lever in the broader fight for reproductive justice.
Safe abortion access is a dynamic, ongoing pursuit that requires bold thinking, strategic partnerships, and sustained commitment. Let’s celebrate the innovations that are changing lives and recommit to integrating them into the systems, laws, and cultures that shape reproductive health worldwide.