Despite the legal provisions, unsafe abortions continue to add to the maternal mortality rate.
August 15, 2023
Many Nepali women are in unsafe hands, as evidenced by the death of a 35-year-old woman while seeking an abortion at a local clinic in Dhangadi. No sooner had she died than people found out that the clinic was operating illegally. Every year, around 100,000 women have abortions in Nepal at legally-authorised clinics and health facilities; however, the actual number could be much higher, as many abortions are swept under the rug. Many illicit clinics could be running and taking women’s lives far from the government’s gaze.
The country legalised abortion in 2002, allowing women to terminate up to 12 weeks of pregnancy without any reason being sought, and up to 28 weeks in cases of rape, incest and health complications. Free first-trimester and second-trimester abortion practices were also initiated. The Health Ministry’s Safe Abortion Service Guideline doesn’t recognise private sector auxiliary nurse midwives as authorised persons to provide medical abortions as they are not trained as skilled birth attendants. Nepal allows trained auxiliary nurse midwives (ANMs) to provide medical abortion care up to 10 weeks gestation, even in rural health care centres. Staff nurses can do both manual vacuum aspiration (MVA) and medical abortion up to 10 weeks gestation, while MBBS doctors can perform MVA up to 12 weeks. But only obstetrician-gynaecologists and general practitioners are permitted to do second-trimester abortions (13-28 weeks).