This article considers the decriminalization of abortion in federal systems - decentralised and centralised. While factors external to the governance model influence whether abortion is decriminalized, such as religious views on the fetus’s right to life, this article focuses on governance. Drawing on a range of country examples, it explores opportunities for innovation and policy transfer of abortion reforms in decentralized federal systems. In decentralized systems the country examples suggest it is prudent to target receptive subnational units despite resistance in other subnational units for advocacy and reform. Advocates must also recognize and counter conservative actors stifling reform through multiple access points. The article further considers federal countries where the power to regulate abortion is central and assesses the opportunities for country-wide decriminalization by a unified women’s movement. The article concludes that decentralized and centralized federal systems present opportunities and limitations and examining case examples leads to more effective strategies.