Amendment to abortion law imperative, as 52% abortions are still unsafe

By Laxmi Chaudhary,Janakpurdham, Mar. 14: Although safe abortion has been legally recognised in Nepal for two decades, society’s perception of it has not changed yet. 

While the Constitution guarantees safe motherhood and reproductive health as fundamental rights for women, abortion is still viewed as a crime in many places. This mindset is having a direct impact on women, and adolescent girls.

Rina Sah, 30, (name changed) from Saptari district in Madhes Province, recently went through a painful experience.

Already a mother of two, Sah had no intention of conceiving again, but she became pregnant unintentionally. She realised that she was pregnant when the pregnancy had reached around two and a half months. 

Fearing social stigma, shame and criticism, she did not seek abortion services. Instead, she visited a nearby clinic and took medicine to terminate the pregnancy. 

The medicine did not terminate the pregnancy; instead, it caused severe pain. Two days later, she reached the same clinic and the pharmacist inserted another medicine through the genital tract.

After that, she began to experience unbearable pain. As her condition worsened, she was taken to a hospital in Biratnagar, where doctors carried out a safe abortion. Sah almost lost her life while undergoing an unsafe abortion. 

This incident shows that many women are still unable to openly seek safe abortion services. Due to fear of social stigma, shame and legal uncertainty, women are often compelled to seek unsafe methods to abort, risking their lives. 

Similarly, a 19-year-old Dalit girl, Sugia (name changed) from Dhanusha district, realised she was pregnant only when the pregnancy had reached eight months. The girl, who is mentally challenged, did not know who impregnated her. Due to fear of social stigma and legal hurdles, her family didn’t seek safe abortion services. Instead, they opted for unsafe methods, risking her life. 

Those who can afford it often travel to neighbouring India to obtain abortion services. 

Likewise, a 13-year-old girl from Sabaila Municipality was raped by a relative. Her family came to know about her pregnancy only after seven weeks. 

Because she was pregnant, even her parents refused to take care of her. Later, the case reached the Women’s Rehabilitation Centre (WOREC) in Dhanusa. 

With the coordination of the police, the girl was returned to her parents’ custody. However, her whereabouts afterwards remain unknown. It is suspected that she may have been taken to India for an unsafe abortion. 

Due to social stigma, increasing number of women from Tarai districts tend to seek unsafe abortion services in India. 

This rate is higher among women and girls who become victims of sexual violence committed by family members or relatives. Such incidents not only affect women’s health but also increase the risk of death.

52 % of abortions unsafe 

According to statistics, about 850,000 pregnancies occur annually, of which 53 per cent are unintended. More than 300,000 abortions take place each year. Among them, only about 100,000 are carried out safely at listed health institutions, while the remaining, around 52 per cent are still performed through unsafe methods.

Legal complications related to abortion appear to be even more complex in Madhes Province. 

According to data from the Provincial Police Office, during the current fiscal year, eight cases related to abortion are under consideration in court: four in Saptari District, three in Sarlahi District and one in Parsa District.

In the previous fiscal year, 13 cases of ‘illegal’ abortion were registered across the province. However, there are many such incidents that remain outside official records, hidden within society, which sometimes also lead to violence against women.

These figures represent only the cases recorded in official statistics. Many incidents involving abortions carried out secretly against women’s will, or violence against women related to abortion, remain hidden and do not come to light.

According to studies carried out by FWLD and CREHPA, women still end up in prison due to lack of access to safe services or lack of legal awareness.

As long as society continues to view abortion as a matter of shame or sin, and the legal structure treats it as a crime, the concept of safe abortion cannot be fully implemented in practice. 

Therefore, removing women’s reproductive rights from the scope of criminal law and clearly recognising them as a health right has become an urgent necessity today.

Legal rights, practical difficulty 

According to the Safe Motherhood and Reproductive Health Rights Act, 2018, a pregnant woman may obtain a safe abortion up to 12 weeks with her consent. 

In cases where the pregnancy threatens the life or health of the mother, pregnancy from rape or incest, involves HIV infection or an incurable disease, or where severe fetal abnormalities are detected, abortion is permitted up to 28 weeks. 

The law prohibits abortion carried out through coercion, threats or inducement. It also bans sex-selective abortion and those responsible can face legal action.

Though abortion is legal under the Safe Motherhood and Reproductive Health Rights Act, 2018, the National Penal Code, 2017, still contains criminal provisions related to abortion performed outside the legal conditions. 

Due to this, women and health workers sometimes fear legal consequences, which can hinder access to reproductive health services, says women's rights activists. 

Hence, women activists underscored the need to amend the Safe Motherhood and Reproductive Health Rights Act, 2018, to fully decriminalise abortion services, in line with the constitutional provision and international commitments. 

They claimed that amending the law is not sufficient; the real implementation of constitutional commitments lies in creating an environment where women can access the service, safely and with dignity.

Nabin Kumar Shrestha of Forum for Women, Law and Development said society still strongly views abortion as a sin or a crime. 

“Although the Safe Motherhood and Reproductive Health Rights Act recognises abortion as a right, cases related to abortion are still being registered with the police and the courts,” he added. 

He said studies show that women’s freedom to make independent decisions about abortion remains limited. 

Due to pressure from families and society, women are sometimes forced to give birth even in cases of unwanted pregnancy, he said, adding, “In some instances, women have even faced legal action for natural events such as miscarriages.”

Hence, it is necessary to increase public awareness that abortion is a right rather than a crime, expand access to sexual education and family planning services,and remove legal barriers to fully decriminalise abortion, he stressed. 

Women's activist and advocate Rekha Jha, who has long advocated for women’s rights in Madhes Province, said society in Nepal still holds negative attitudes towards safe abortion. 

Although the law grants women this right, families and society do not readily accept it, forcing women to face stigma and questioning. 

Social pressure, fear of defamation and lack of family support make it even more difficult to access services, particularly in Madhesh and rural areas, she added. 

She said, “To ensure women’s reproductive rights, the state must increase public awareness alongside implementing the law. Civil society, the health system and stakeholders should also jointly conduct campaigns to change the mindset of society and families.”