The main driving forces behind society’s changing views on autonomy, disability, and reproductive rights are technological advances, evolving legal systems, and global ethical debates. The changes in these concepts must be understood within a background of a long history of repressive policies, eugenic ideologies, and constant barriers that excessively affect people with disabilities. This chapter addresses the issues of fertility discrimination, limited access to reproductive healthcare, and ableism, which are intertwined with the policies on prenatal testing and abortion to assess their combined negative impact on reproductive justice. It brings the historical background of forced sterilization, the conflicts between the pro-choice movement and the disabled rights, and the social biases that restrict the parenting chances of the disabled population into the discussion. The chapter critically analyses the situation of the legal safeguards for the unborn with disabilities and the institutional disadvantages that disabled people have, advocating for a rights-based and inclusive approach that acknowledges the right to choose and guarantees equal reproductive decision-making for all.