In Zambia, abortion is legal if the pregnancy would threaten the mother's life or physical or mental health or those of existing children, or if it would cause a birth defect. Zambia has one of the most permissive abortion laws in Africa, though its restrictions limit access. The Termination of Pregnancy Act, passed in 1972, legalizes abortion if approved by medical professionals. It requires signatures from three doctors, including one specialist. Amendments to the bill and medical guidelines clarify that the law allows the consideration of situations such as pregnancy from rape, as well as socioeconomic factors.
Legal abortions are available but often expensive or difficult to access. Some critics of Zambia's abortion law believe that its restrictions are barriers to access for most Zambians. Other critics believe that the country provides for abortions in law but not in practice. The majority of women in Zambia do not know about the abortion law, and many healthcare providers do not know its terms. Conscientious objection to abortion by medical providers is common. Public providers provide abortions for free, but unofficial costs are often high. Most abortions are performed unsafely by illegal practitioners. Abortion complications commonly occur. Unsafe abortions cause 30% of maternal deaths. Public health providers legally do not charge money for abortions, but unofficial fees are common. Many women cannot afford safe surgical abortions. Medical abortions are widespread in cities. Rural areas have low access to abortion. Adolescents are likely to have unsafe abortions.
Abortion is stigmatised in Zambia. A majority of Zambians believe abortion should be illegal. Zambia's state religion is Christianity, and churches are influential in opposing abortion on religious grounds. Supporters of abortion believe legal abortion is a solution to public health issues.