Sri Lanka is an island country in South Asia, with a population of 21.6 million. The main faith is Buddhism (70.2 per cent of the population), with other denominations of Hinduism (12.6 per cent), Islam (9.7 per cent) and Christianity (7.4 per cent) also prevalent. Economically, Sri Lanka is a lower-middle-income country. It has a well-developed free-to-access health system, with public hospitals and a strong primary care network. While there is a clear focus in government policy on reproductive health, it has an extremely strict abortion law, which stipulates that abortion is illegal unless the life of the mother is at risk (IPPF, 2019). Despite this restrictive law, clandestine abortion services have been reasonably accessible (Kumar, 2013). Post-abortion care is available within the health system, although the standard of this varies. Studies indicate that discrimination, such as verbal harassment by healthcare staff, was experienced and, in some instances, confidentiality was breached, by revealing the abortion status to family members, staff and other patients (Arambepola et al, 2014). Proposed reforms to extend the law in limited cases such as rape and foetal abnormality were criticised as unresponsive to the legitimate needs of women and transpersons (Wijesiriwardena et al, 2020).

In this conversation we sought to address three key questions: how the law impact access to abortion; how the socio-cultural context impacts policy making; and how Buddhism positions abortion. We begin with a consideration of history and the political context.