Each Australian jurisdiction has decriminalised abortion. Despite this, abortion-seekers face multiple barriers to access, among them is encountering objection by individual health practitioners (conscientious objection) or institutions (institutional objection). This article reports on a qualitative interview study that examined 41 key interest-holders’ perspectives and experiences of institutional objection to abortion. Framework analysis resulted in the generation of four themes: (1) institutional variation in different aspects of abortion care; (2) impacts of institutional objection affected multiple interest-holders; (3) attitudes towards accommodating institutional objection; and (4) suggestions for reimagining institutional objection regulation. Our findings suggest that institutional objection manifests in different ways across settings and results in harm to both patients and health practitioners. Consequently, current approaches to regulating institutional objection should be revisited. Such approaches should consider minimum levels of transparency, information provision, and explore other opportunities for service provision and de-stigmatisation.