Kuala Lumpur, 23 May 2025 — The recent nine-month custodial sentence imposed by the Ayer Keroh Magistrate’s Court on a young woman who ended a five-month pregnancy with medication obtained online, highlights the urgent need to modernise laws that continue to criminalise women while failing to address the root causes of unplanned pregnancies.

“No woman or girl should face prison for exercising autonomy over her body,” emphasised Azrul Mohd Khalib, Chief Executive of the Galen Centre for Health and Social Policy. “Malaysia’s Penal Code still contains provisions dating back from and written in the 19th century. They do not reflect current medical practice, World Health Organisation (WHO) recommendations, human-rights standards, or the realities faced by women, especially young women, the poor and the unmarried.”

Access to safe and legal abortion is an essential part of sexual and reproductive health services.

“Abortion has been lawful in Malaysia since 1989 when Section 312 of the Penal Code was amended to allow termination of pregnancy to preserve a woman’s life or physical or mental health. Yet confusion, stigma and uneven service availability push many, such as this young woman in Melaka, to unsafe, clandestine and illicit options.”

The National Health & Morbidity Survey (NHMS) in 2022 on Maternal and Child Health by the Ministry of Health found that one in three pregnancies in 2022 was unplanned, while 26.7% of women could not obtain family-planning services when they needed it. Modern contraceptive use remains below 35% which is very low for an upper-middle income country such as Malaysia, and unmarried women and girls often encounter refusal of services.

“Evidence has shown that medical abortions save lives. The WHO recommends that individuals in the first trimester (up to 12 weeks pregnant) can self-administer mifepristone and misoprostol medication safely without direct supervision of a health-care provider,” Azrul pointed out. “Despite being on the WHO’s Essential Medicines List, mifepristone has not been registered in Malaysia and is not legally available, while misoprostol is strictly used for the treatment of stomach ulcers. Self-managed abortion using these medicines is not currently permitted in this country.”

“Criminalisation drives individuals underground, delays care and increases desperation and complications. When individuals do not have access to safe abortion care, they may and will resort to unsafe abortions. Tragically, in some cases, women and girls will lose their lives as a result. Unsafe abortions account for up to 13% of global maternal deaths. With the exception of a spike in 2021, Malaysia’s maternal mortality rate has stagnated around 25 per 100,000 live births for several years.”

The Galen Centre puts forward the following three recommendations:

• End the punishment paradigm. Conduct an immediate review of existing legislation and regulations which create obstacles or hurdles towards the safe and legal availability of medical abortion and termination of pregnancies.
• Increase awareness among healthcare professionals of the Guideline on Termination of Pregnancy for Hospitals in the Ministry of Health, with an emphasis on guaranteeing affordable, confidential abortion and post-abortion care in health facilities, consistent with current clinical guidance.
• Expand contraceptive access, including long-acting reversible methods, regardless of marital status, and integrate contraceptive counselling into all primary-care visits.

“When a third of pregnancies are unintended, the solution cannot be prison walls,” added Azrul. “Evidence shows that liberalising laws, expanding contraception, and normalising safe abortion cut maternal mortality and improve families’ futures.”