Abortion is not something welcome, let alone unsafe abortion. However, increasing number of women, both married and unmarried, in towns as well as villages, seem to be resorting to this aberration. According to figures released by Ipas Nepal, a non-profit international organisation, over 186 thousand women and girls undergo unsafe abortions every year. According to Ministry of Health and Population (MoHP), more than 500 women are terminating their pregnancies every day. The actual number may be much higher than this because many cases go undocumented. This is because in absence of adequate market monitoring, abortion pills are easily available in drugstores and women and girls unprepared for pregnancy can purchase them without a doctor’s prescription. Though abortion was legalised way back in 2002, illegal unsafe abortions do go unabated.

The Right to Safe Motherhood and Reproductive Health Act allows abortion until 28 weeks of pregnancy in cases of incest, rape, serious mental and physical risk to mother’s health or if the baby is likely to be born with deformities or is infected with HIV. But not all unwanted pregnancies meet these criteria. Consequently, as many as 58 per cent women seeking abortion services rely on over-the counter medicines or people lacking necessary skills for the same. Such unsafe abortions involve a number of risks including excessive bleeding, injury and infection in uterus or intestine, infertility and even end of life. According to MoHP, 13 per cent of maternal mortality stem from unsafe abortions.

How can this problem be minimised? Obviously, prevention is always better than cure. Since unwanted pregnancies are likely to end in unsafe abortions, it would be sensible to prevent such pregnancies in the first place. However, a large number of women are either unaware of the use of contraceptives to prevent conception or are unwilling to do so. So when they get pregnant, they tend to visit a nearby pharmacy and consume abortion pills the pharmacist offers them. Hence the onus lies on the government to raise awareness among women to use contraceptives to avoid unwanted pregnancies. For those conceiving anyway but wishing to terminate the pregnancy, the MoHP must provide proper counselling so that they can avail of the free abortion services. And girls must be extra cautious about physical relations that may result in pregnancies. In case they conceive, they should seek services from experts rather than buy and consume any medicine the pharmacist gives them. Unsafe abortion is equally common among educated women, who don’t hesitate aborting the foetus if it is a girl child. The preference for son is a fixation responsible for significant number of unsafe abortions. This tendency is so entrenched that it may take years or even decades before it is eliminated.

Meanwhile, the government must take effective measures to check everyone’s access to abortion pills. The MoHP has approved four types of medicines for the termination of pregnancies. But a survey a few months ago in the eastern part of the country showed as many as 18 brands of such medicines were sold in the market. Surprisingly, the number of unapproved medicines was higher in the rural areas, posing greater risk to women living there. So the government needs to take steps to regulate the market and those found selling unregistered drugs must be punished. Similarly, those involved in unsafe abortions without holding a liscence should be brought to book.