Kenya's Court of Appeal has overturned a landmark 2022 High Court ruling that had declared access to abortion a fundamental constitutional right, setting the stage for what is expected to become a Supreme Court battle over reproductive rights in East Africa's most populous democracy.

The case originated with a teenager who sought hospital care in 2022 after suffering pregnancy complications. A doctor determined she had already lost the pregnancy and provided emergency post-abortion care. Both the patient and the healthcare provider were subsequently arrested and prosecuted — and then acquitted by the High Court, which went further by ruling that access to abortion was a fundamental right and that prosecuting women and healthcare workers for seeking or providing such care was unconstitutional. It was that broader ruling that was challenged on appeal by the Kenya Christian Professionals' Forum and the attorney general.

Friday's appellate decision drew a sharp line around the constitution's provisions, ruling that abortion denies a child the right to life and is prohibited except in narrowly defined circumstances. "In effect, abortion is not a fundamental right guaranteed under the constitution. On the contrary, the constitution expressly prohibits it but provides exceptions in limited circumstances where it may be permissible," the ruling stated. Kenya's penal code currently criminalises abortion, with sentences of up to 14 years in prison for those who attempt or procure one. The constitution does, however, permit abortion when a trained healthcare worker recommends it as emergency treatment to save the life or health of the mother. Charles Kanjama, lawyer and former chairperson of the Kenya Christian Professionals' Forum, welcomed the verdict, saying it had "restored constitutional balance which had been distorted by the high court ruling."

Reproductive rights advocates swiftly condemned the decision. The Center for Reproductive Rights, a global human rights organisation, called the ruling a "setback" and confirmed it would appeal to Kenya's Supreme Court. The stakes are significant: an estimated 792,000 induced abortions took place in Kenya between April 2023 and May 2024, according to a 2025 report by Kenya's Ministry of Health, the African Population and Health Research Center, and the Guttmacher Institute. Unsafe abortion remains a leading cause of maternal deaths in the country.

The ruling underscores the deep tension between Kenya's constitutional health protections and its colonial-era penal code, a conflict that courts have yet to definitively resolve. With the Center for Reproductive Rights preparing a Supreme Court challenge, the legal battle over who bears the burden of proof — and who holds the right to decide — is far from over.