This introductory article argues that the interlinked issues of legal reform, the provision of accessible and affordable services and the strengthening of women’s capacities to exercise agency over their own bodies make safe abortion a development issue. Within this understanding, it reviews these intersections through the multiple framings used in the articles in this IDS Bulletin. Public health arguments for safe abortion services speak to increasing concerns over the toll of maternal morbidity and mortality from unsafe abortion. Rights-based approaches engage with both national struggles for citizenship rights and personal entitlements to agency. Different framings are strategic in different political contexts where policy reform is being debated. This article reflects on the range of strategies and tactics described by contributors that have contributed to successful outcomes or to a more constructive dialogue, while drawing out important cautions for reformers on the still formidable opposition they may face.