Abortion: The thin line between legal and illegal

Abortion in Nepal was legalised in Nepal in 2002 which has contributed to the declining maternal mortality rate. Before that, Nepal's 1854 legal code ‘Muluki Ain’ banned abortion except when the woman's life was at risk. In all other cases, the edict equated pregnancy termination with homicide and send women to prison under charges of infanticide. Up to one-fifth of women in Nepali prisons before 2002 were convicted on the basis of illegal abortion, with many branded as murderers

Specifications of Nepal's 2002 Abortion Law

Pregnancy termination is available under these circumstances:

Up to 12 weeks gestation for any indication, by request

Up to 18 weeks gestation in the case of rape or incest

At any time during pregnancy if mental/physical health or the life of the pregnant woman is at risk (approval from a medical practitioner required)

At any time during pregnancy if the fetus is deformed and incompatible with life (approval from a medical practitioner required)

Additional considerations:

Only providers certified in safe abortion care are eligible to provide induced abortion services;

The pregnant woman alone has the right to choose to continue or discontinue her pregnancy

In the case of minors (< 16 yrs of age) or mental incompetence, a legal guardian must give consent

Pregnancy termination on the basis of sex selection is prohibited

According to Knoema, in 2017, the maternal mortality ratio for Nepal was 186 deaths per 100,000 live births. Between 2003 and 2017, the maternal mortality ratio of Nepal was declining at a moderate rate to shrink from 470 deaths per 100,000 live births in 2003 to 186 deaths per 100,000 live births in 2017. However, we have yet to gain the recent statistics reports.

As per The Right to Safe Motherhood and Reproductive Health Act, abortion can be done up to 12 weeks’ gestation on request, up to 18 weeks’ gestation in cases of rape or incest, and at any time if the pregnancy poses a danger to the woman’s life physically and mentally or if there is a fetal abnormality.

While it is reported by a study by Guttmacher, 2014, there are around 1100 government-approved health facilities providing legal abortion, postabortion care, or both in Nepal. And it is estimated that around 137,000 legal abortions were done in public-sector facilities with 34% performed in NGO and private-sector facilities.

However, despite the number of legal health facilities many women in Nepal face barriers to obtaining safe and legal procedures and sadly there are no reports of safe and unsafe abortions. Obstacles include lack of awareness of the legal status of abortion, lack of services, lack of transport to approved facilities, gender norms that hinder women’s decision-making autonomy, the often-prohibitive cost of the procedure, and fear of abortion-related stigma.

There are two types of Abortion, in-clinic, and medication abortion, and which to choose depends on the personal preferences of the person. And it is said that abortion is one of the easiest procedures to go through, but there are still a few risks one can face from the abortion not succeeding to blood clots in one’s uterus.

With the lack of proper study reports on Nepal’s abortion and clinics performing abortions makes one wonder if Nepal is lacking sex education and research.