Worldwide, one out of every two abortions takes place in secret. As nations around the globe roll back or jeopardize abortion access, we see firsthand the impact of its illegality on women forced into the shadows to have an abortion that might cost them their life. Mirana has been performing them in the middle of the Malagasy rainforest for over 40 years. Madagascar has some of the most restrictive abortion laws in the world, where it is illegal in cases of rape, incest, foetal malformation, or risks to the mother’s life remain illegal. Around 75,000 women resort to clandestine abortions annually on the African island. Wealthier women in cities can access clinics in which trained medical professionals carry out the procedure, but poor women in the countryside seek out the services of bush doctors with no medical training or medical tools. Abortions in the bush, carried out by midwives in appalling sanitary conditions, pose a severe public health challenge alongside the risk of years of imprisonment and fines ranging from 80 to 2,400 euros.