Transforming abortion stigma in Nepal: One provider’s story

MONDAY, MARCH 25, 2024

Amid the towering Himalayas in Nepal, attitudes about abortion have been changing. In 2002, abortion went from being criminalized to being legal for any reason up to 12 weeks of pregnancy. Since then, access has only expanded.

Dr. Deeb Shrestha Dango, a dedicated OB-GYN and head of health systems and policy for Ipas Nepal, has stood at the forefront of this transformation. Navigating a shifting landscape of abortion rights and stigma, she has fought to expand abortion access in Nepal for over twenty years.


Nepal – Unsafe Abortion: A Silent Threat to Women’s Health

Pawan Mudbhari
December 26, 2023

KATHMANDU: It has been observed that issues such as disturbances in women’s periods, lower abdominal pain, white discharge, uterine infection, and infertility are on the rise.

Women in urban areas, accustomed to regular checkups, can openly discuss their problems and receive timely treatment. However, the scenario is drastically different for rural women, resulting in delayed treatments and, tragically, some losing their lives.


Nepal – Contraceptives shortage looms

Government cites lack of funds. Fears of unsafe abortions, increase in maternal deaths.

Arjun Poudel
September 25, 2023

Health facilities nationwide could soon run out of contraceptives such as condoms, pills, implants and emergency pills as the Ministry of Health and Population lacks funds to procure them.

Officials blamed the reduction in the health budget as the main reason for their inability to purchase essential contraceptives to be distributed from health care facilities. A possible shortage of the items will eventually cause multiple problems including a rise in unwanted pregnancies, unsafe abortions and maternal deaths.


Nepal – Abortive measures

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).


Providing Choice During A Humanitarian Crisis

Aug 1, 2023
By Amanda Seller, President, MSI United States

In the Northern Central region of Burkina Faso, Yvette Yoda is part of a team of mobile midwives working to provide life-saving reproductive healthcare services to women and girls who have been forced from their homes by violence.

More than two million people are internally displaced in Burkina Faso, with many living in camps. Yvette makes the difficult journey to reach them because she knows how important it is for women facing a crisis to be able to control their own futures.

Why is reproductive choice important in emergency settings?


The Forgotten Tragedy Of Unsafe Abortion

Jun 29, 2023
By Amanda Seller, President MSI United States

In the half a century that Roe v. Wade protected the right to choose in the United States, the risks of unsafe abortion became a distant memory. But in countries that liberalized their abortion laws more recently, the deadly consequences of abortion restrictions are still recent. Their experiences are an important reminder that banning abortion endangers women’s lives.

MSI Reproductive Choices is one of the world’s largest providers of sexual and reproductive healthcare, including safe abortion and care after unsafe abortions. Three providers in Cambodia, Ethiopia, and Nepal shared memories of the impact restrictive laws had on women in their countries.


Decriminalising abortion in Asia: Perspectives from India and Nepal

Decriminalising abortion encourages access to safe abortion and proper post-abortion care. It does not mean that the law would no longer regulate abortion, but that no one would be punished for providing or having an abortion, and the law provides a positive framework to ensure access to safe abortion.

MAY 28, 2023

“FIFTEEN-year-old Sita (name changed), who got pregnant due to rape, ended her pregnancy by consuming medical pills her father obtained from a local pharmacist. Sita’s district court statement noted that she sought an abortion to safeguard her and her family’s reputation. The court convicted Sita of illegal abortion and sentenced her based on her admission.” – Center for Reproductive Rights & Forum for Women, Law and Development, Decriminalization of Abortion in Nepal: Imperative to Uphold Women’s Rights, 2021

The ability to make and exercise decisions about one’s body, sexuality and reproduction is at the core of gender, economic and social justice. Under international human rights law, States are obliged to respect, protect and fulfil rights related to sexual and reproductive health, including the rights to life, health, privacy, information, freedom from ill-treatment, non-discrimination and equality. States are also required to guarantee access to quality sexual and reproductive health information and care, including abortion services.


Nepal – Karnali doctors receive training on safe abortion

The Karnali Provincial Hospital organised the training in a bid to reduce abortion-related deaths.

Tripti Shahi
April 24, 2023

In a bid to reduce maternal deaths due to unsafe abortion practices, the Karnali Provincial Hospital organised a training for doctors from April 9-18.

According to the 2021 census of Nepal, around 172 women die per 100,000 live births in the Karnali province.


Nepal – Decrminalise abortion: Rights activists

By Ram Kumar Kamat
Mar 18, 2023

Kathmandu – Article 38(2) of the constitution ensures the right of every woman to safe motherhood and reproductive health thereby acknowledging the right to safe abortion as part of reproductive health right, but in practice, women have not been able to enjoy this right, due to criminalisation of abortion and a number of restrictive measures.

Executive Director of Forum for Women, Law and Development Sabin Shrestha said Safe Motherhood and Reproductive Health Rights Act, which was brought to enable women to enjoy their reproductive health rights, conversely prohibited abortion after 28 weeks of pregnancy.


Abortion Providers From Around the World Share the Dangers of Practicing Under Bans


Over the last 30 years, 59 countries have relaxed abortion restrictions. This includes 18 countries that have overturned complete bans on abortion. In stark contrast, with Roe v. Wade overturned, the U.S. joins the ranks of only three other countries to have restricted access in that time: Poland, El Salvador and Nicaragua.

So, while the news from the U.S. is cause for alarm, it also reminds us of how far we’ve come, and why we cannot turn back the clock in countries that have liberalized abortion. The following stories of abortion providers in Cambodia, Ethiopia and Nepal of life before their countries legalized abortion show the U.S. how restricting abortion rights can endanger women’s lives.