Introduction
Nepal has made significant strides in ensuring safe abortion services for women under legal and medical guidelines. Rooted in the Safe Motherhood and Reproductive Health Rights Act, the legal provisions and services focus on women’s reproductive autonomy, safety, and access to care. This blog will explore Nepal’s abortion laws, approved methods, and service providers.
1. Legal Provisions for Abortion in Nepal
Under the Safe Motherhood and Reproductive Health Rights Act, 2075, pregnant women are granted the right to terminate pregnancies under specific conditions:
Conditions Allowing Abortion:
- (a) With the consent of the pregnant woman, abortion is allowed up to the permissible gestational weeks.
- (b) If continuing the pregnancy poses a risk to the woman’s physical or mental health or could result in a malformed fetus, abortion can be performed based on medical consultation.
- (c) In cases of rape or incest, abortion can be sought up to 28 weeks of gestation.
- (d) If the pregnant woman is diagnosed with a severe illness (e.g., HIV/AIDS), abortion is permissible.
- (e) In the event of fetal abnormalities or genetic defects where survival post-birth is unlikely, the woman can seek abortion upon medical evaluation.
2. Methods of Safe Abortion Services
Nepal has outlined four key methods for safe abortion services depending on gestational age and healthcare resources:
(a) Medical Abortion (MA)
- Involves the use of medications like Mifepristone and Misoprostol.
- Applicable for pregnancies up to 10 weeks.
(b) Manual Vacuum Aspiration (MVA)
- A safe, non-surgical method performed using a vacuum aspirator.
- Applicable for pregnancies up to 12 weeks.
(c) Dilatation and Evacuation (D&E)
- A surgical method suitable for pregnancies between 13–16 weeks.
- Performed at healthcare facilities equipped for emergency obstetric care (CEmONC).
(d) Medical Induction (MI)
- Recommended for pregnancies between 17–28 weeks.
- Requires advanced medical supervision, often performed at tertiary-level hospitals.
3. Service Providers and Facilities
Safe abortion services are provided by qualified healthcare professionals at approved facilities:
| Gestation Period | Method | Service Providers | Health Facilities |
|---|---|---|---|
| Up to 10 weeks | Medical Abortion (MA) | Trained ANMs, staff nurses, and doctors | Approved health facilities |
| Up to 12 weeks | MVA | Trained staff nurses and doctors | Approved health facilities |
| 13–16 weeks | D&E | OB/GYN specialists and doctors | CEONC-equipped health institutions |
| 17–28 weeks | MI/D&E | OB/GYN specialists and surgeons | Specialized hospitals and tertiary centers |
4. Ensuring Accessibility and Safety
To ensure safe abortion practices and minimize complications:
- Training: Health professionals receive specialized training to perform safe abortions.
- Certification: Only approved and certified healthcare institutions can provide abortion services.
- Awareness Programs: Community programs are conducted to educate women on their reproductive rights and available services.
5. The Role of Safe Abortion in Public Health
Safe abortion services are crucial to reducing maternal mortality and preventing unsafe procedures. Nepal’s government ensures that:
- Women’s autonomy over their reproductive health is respected.
- Safe and affordable services are accessible to all socio-economic groups.
- Regular monitoring and evaluation enhance service quality.
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