KATHMANDU: Abortion refers to the medical procedure or process of ending a pregnancy before the fetus reaches a stage where it can survive independently outside the mother’s womb.

This can be done through various methods depending on the stage of pregnancy and the individual’s health circumstances. The procedure is typically performed for reasons such as protecting the mother’s health, fetal abnormalities, or situations like rape or incest.

Abortion can be conducted medically through medication or surgically, depending on the gestational age of the pregnancy and the available healthcare options.

NepalNews had the privilege of speaking with Dr. Bhola Prasad Rijal, a pioneering gynecologist and professor in Nepal. Dr. Rijal is a Senior Consultant Obstetrician, Gynecologist, and Litterateur.

He is known for introducing in-vitro fertilization (IVF) in Nepal and served as the chairman of Nepal Medical College. Below are the excerpts from our conversation:

What is abortion?

Abortion is the medical process of ending a pregnancy before the fetus can live independently outside the mother’s womb. It can also be referred to as the medical procedure used to terminate a pregnancy.

There are two main types: medical abortion, which involves taking medication to end the pregnancy, and surgical abortion, which involves a procedure to remove pregnancy tissue from the uterus.

This is usually performed under specific medical conditions and with careful consideration of the mother’s health and well-being.

What is unsafe sex?

“Unsafe sex” refers to sexual activity where there is a risk of exposure to sexually transmitted infections (STIs) or unplanned pregnancies. This typically happens when proper precautions, such as using condoms or other forms of birth control, are not taken.

Engaging in unsafe sex can lead to various health risks, including the transmission of infections like HIV, gonorrhea, syphilis, or chlamydia, and unwanted pregnancies.

It is crucial to practice safe sex to protect both yourself and your partner. Unfortunately, unsafe sex is on the rise in Nepal.

Why is unsafe sex increasing in Nepal?

Unsafe sex in Nepal can increase due to various factors. A lack of proper sex education, limited access to contraception, and cultural taboos contribute to risky behaviors.

Many people may not use condoms or other protection, increasing the risk of sexually transmitted infections (STIs) and unintended pregnancies. Economic factors, peer pressure, and the desire for immediate pleasure over long-term health consequences also play a role.

Promoting education, awareness, and access to contraceptives can help reduce unsafe sexual practices.

Is taking medication without a doctor’s advice during pregnancy risky?

As a Nepali doctor, I would advise that it is very important to take proper care and follow medical guidelines when it comes to pregnancy.

If you are considering an abortion, it is crucial to consult with a healthcare provider to ensure the procedure is done safely and under medical supervision.

Without proper consultation or using the appropriate medication, attempting to end a pregnancy can be very risky and lead to complications such as infections, excessive bleeding, or other health issues.

Some medications used for medical abortion should only be prescribed by a qualified healthcare provider after assessing your health and confirming the stage of pregnancy.

Therefore, it is always best to consult a doctor before making any decisions regarding pregnancy. Self-medication or attempting to induce an abortion without proper guidance is dangerous.

What kinds of mistakes by the mother can lead to an abortion?

In the context of pregnancy, certain mistakes by the mother can lead to abortion, either intentionally or unintentionally.

Commonly, these mistakes include neglecting proper prenatal care, consuming harmful substances like alcohol, tobacco, or drugs, or engaging in high-risk activities that could cause physical trauma.

A poor diet and inadequate nutrition can also weaken the pregnancy, increasing the risk of miscarriage. Additionally, untreated infections or chronic medical conditions like hypertension and diabetes may lead to complications resulting in abortion.

For Nepali mothers, specific cultural practices and challenges can contribute.

Moreover, the lack of proper antenatal care, particularly in rural areas, can make it difficult to monitor and address potential pregnancy complications early, leading to a higher risk of miscarriage or abortion.

Can there be complications in the future if an abortion is performed during adolescence?

Yes, abortion during adolescence can lead to potential complications in the future. The body is still maturing during the teenage years, and undergoing an abortion at this stage may cause physical or emotional issues.

There could be an increased risk of infections, bleeding, or injury to the reproductive organs, which can affect future pregnancies.

Teenage abortion can also lead to infertility in the future. Additionally, early abortion may cause psychological stress, depression, or anxiety in some individuals. It is important for adolescents to seek proper counseling and medical advice before making any decisions.

What is the legal validity of abortion in Nepal?

In Nepal, abortion is legally allowed under certain conditions. According to the Safe Motherhood and Reproductive Health Rights Act of 2018, a woman can undergo an abortion within the first 12 weeks of pregnancy with her consent.

If the pregnancy is a result of rape, incest, or if the woman’s physical or mental health is at risk, abortion can be carried out up to 24 weeks. In cases where the fetus has severe abnormalities, abortion is also permitted after 24 weeks, but it requires approval from a medical board.

The law ensures that the procedure is safe and can only be performed in government-approved health facilities. It is important for individuals to be informed about the legal framework and consult a qualified healthcare provider for guidance.

What are the causes of spontaneous abortion?

Spontaneous abortion, also known as a miscarriage, can occur due to various reasons. The most common causes include chromosomal abnormalities in the fetus, which prevent normal development.

Other factors include maternal health issues such as uncontrolled diabetes, hormonal imbalances, infections, and structural problems in the uterus.

Additionally, advanced maternal age and previous miscarriages may contribute. It’s important to seek medical advice if you experience symptoms like bleeding or cramping during pregnancy for proper management and care.