Abortion has become an ever more controversial issue, provoking strong reactions both ‘for’ and ‘against’. Language used in disputes over whether or not women should have access to safe and legal abortion indicates just how polarised debates have become: pro-choice versus pro-life; pro-abortion versus anti-choice. As the anti-abortion agenda has become coupled with other conservative agendas, such as ‘pro-abstinence’, ‘pro-chastity’ and ‘anti-contraception’, an increasingly assertive movement has evolved. The extension of these conservative forces to parts of the world where thousands of women die every year because they were unable to access safe abortion and protect themselves from HIV infection, has turned this polarized dispute into an urgent development issue. Articles in this IDS Bulletin are unequivocal on the issues at stake: access to safe abortion is a matter of human rights, democracy and public health, and the denial of such access is a major cause of death and impairment, with significant costs to development. All contributors share a commitment to a woman’s right to have access to safe, affordable services for the termination of pregnancy for the widest range of reasons. They bring perspectives from a range of contexts: countries where abortion is not guaranteed, or only under restrictive conditions, and countries where it is guaranteed but there are strong movements of counterattack. Profound inequities of access globally and nationally are highlighted, and the importance of movements to address this. Contributors focus on policy reform and lessons learned from struggles to obtain or retain access to safe abortion services. They reflect on strategies contributing to successful outcomes or more constructive dialogue in countries where abortion is being debated.