Although the law clearly defines safe abortion as a woman's right to health, it has not yet been made effective.
Due to the non-implementation of legal provisions, the health of many women is at risk during an unsafe abortion. In some cases, women's lives have been lost. The government does not have official statistics on how many women die prematurely due to unsafe abortions.
The Family Welfare Division of the Ministry of Health and Population recently issued the Safe Abortion Service Program Management Directive, 2078, authorizing the local level to allow the operation of safe abortion services. Most local levels are still unable to provide that service. Even though there is enough manpower, the Chandragiri Municipality has stated that they have not been able to provide training to the nurses and doctors.
Ram Mani Ghimire, Chief of the Health Department of the municipality, said, “The law has given us rights. We have not been able to provide service even though we wanted to due to a lack of trained manpower. ” He further says that the service will not be effective just by making laws. "The service can be made effective only if there is coordination between the federal, state, and local levels," Ghimire adds.
Tarkeshwar Municipality has also not yet been able to bring safe abortion services into operation. Chief of the Health Department of the municipality, Binod Kumar Sah, said, "The focus on COVID-19 epidemic management has led to delays in addressing other public health issues." Nepal is one of the leading countries in enacting adequate legislation to make safe abortion services effective. The government had given legal recognition to safe abortion in 2059 BS to reduce the maternal mortality rate in Nepal and ensure women's reproductive health rights. To implement this, the Ministry has formulated and implemented the National Policy on Safe Abortion, 2060.
According to Article 38, Clause 2 of the Constitution of 2072 BS, women have been given the right to safe motherhood and reproductive health. The Right to Safe Maternity and Reproductive Health Act, 2075, and Rules, 2077 have been issued to respect and protect the right of women to safe motherhood and reproductive health as provided by the constitution. It has helped establish safe abortion services as a woman's right. It is the responsibility of the federal, state, and local governments to make this service accessible to all women.
Advocate Sabin Shrestha, affiliated with the Women's Development and Law Forum, says that there is a problem as the implementation of the rules and regulations is weak. Along with Nepal, countries like the Philippines, and Uganda are among the countries that have enacted the Right to Reproductive Health Act to help make safe abortion services effective.
Lily Thapa, a member of the National Human Rights Commission, claimed that Nepal was making more progress in the field of women's health than in previous years. She said that the current situation could be improved if sufficient pressure was exerted from the civil society, media, and other sectors.
According to the Family Welfare Division under the Department of Health Services, 95,000 women had abortions in Nepal last fiscal year. 57 percent of them had unsafe abortions. Nisha Joshi, Senior Public Health Officer of the department, said that the number of unsafe abortions has come down after the legalization of safe abortion.
Section 15 of Part 4 of the Right to Safe Maternity and Reproductive Health Act, 2075 provides for abortion from 12 weeks to 28 weeks depending on the condition of the pregnant woman. With the consent of the pregnant woman, a miscarriage of up to 12 weeks can be performed. The law provides for abortion up to 28 weeks gestation with the consent of such licensed physician, as abortion may endanger one's life or impair one's physical or mental health.
In addition to this, the act provides safe abortion for up to 28 weeks with the consent of the woman even if she has contracted a miscarriage or bone marrow transplant, or any other incurable disease of similar nature.
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