ABSTRACT:
Globally, abortion laws have predominantly been liberalising since 2000, with over 60 countries expanding the legal indications for abortion.​ Abortion reform advocacy is uniquely complex due to its legal, political, and social dimensions, including criminalisation, stigma, and politicisation.​ Comparative research on abortion law reform is limited, with few frameworks to guide understanding of diverse national experiences and enabling factors.​ Our study objectives were to 1) Examine key drivers of abortion law and policy liberalisation across six diverse countries: Colombia, Democratic Republic of Congo (DRC), Mexico, Mozambique, Rwanda, and Thailand; 2) Compare reform processes, actors, strategies, and challenges; and 3) Develop a practical framework to support analysis of political opportunities and advocates navigating reform efforts.​ We selected six countries with recent progressive reforms and conducted 44 key informant interviews with relevant stakeholders overall. We used a modified framework analysis by drawing on Shiffman’s framework on political prioritisation to identify crosscutting themes and compare country experiences. We developed narrative country summaries and synthesised findings into an adapted framework of key factors. We identified four overarching factors driving progressive abortion law and policy reform across the six countries: political context, actor power, strategic framing, and social mobilisation. While these factors varied in their degree of influence, their specific manifestation, and how they interacted in each context to bring about successful reforms, these factors consistently shaped reform efforts, often at multiple points, regardless of the reform mechanism. This study contributes to the evidence base on reproductive rights and abortion law reform by demonstrating that successful reforms hinge not on a single key factor, but the strategic and dynamic interplay of several factors, which manifest differently across contexts.