Nepal became model for change globally when abortion was legalized under the 11th Amendment to the Civil Code in March 2002. The bill became law when the Nepal Government affixed the Royal Seal in September 2002. However, there was long delay of 15 months before the procedural order, which authorizes the implementation of legal services, was approved by the cabinet on December 25, 2003.

Short summary of conditions within the law :

According to the new law, only listed (trained) doctors or health workers can provide safe abortion services at listed (approved) health facilities, under the following conditions:

• A woman don’t require permission of husband or guardian above 16 years of age to abort within the first 12 weeks of pregnancy.
• In cases of rape and incest, a woman can abort within the first 18 weeks of pregnancy.
• A woman can abort at any time, if the pregnancy poses danger to the life or physical or mental health of the pregnant woman or the foetus is seriously deformed and it is recommended by a doctor.

(Government policy enabling for the law, enabling beyond the law in practice etc such as population control policy, pro- natalist policy, anti sex selection policy, two child family norm)

In 2004, a Safe abortion policy was developed in order to ensure the availability of safe and legal services which states that pregnancy termination shall not be performed based on sex selection. It will be punishable if abortion is performed without the consent of the pregnant women. There is no pro-natalist policy or norms of the government on the number of child. However, the policy states that abortion should not be used as a method of family planning.

Safe abortion:

• Abortion is the termination of pregnancy by removing the fetus from mother’s womb which may be spontaneous or induced before 20^th week of gestation period or when fetus is less than 500gm of birth weight. However, this defined week/gestational period for safe abortion can vary from country to country and sometimes even in between the states of the countries.
• Abortion is regarded as safe if it is conducted by trained and skilled personnel and carried out in safe, clean environment and also conforms to medical standards such as use of sterilized instruments, maintaining proper hygiene and sanitation etc.
• An abortion is called safe when it carried out:
• By trained and skilled health worker
• With sterilized instruments. Anything that goes into the vagina should be sterile (without any germs)
• Hygiene and sanitation should be attained
• Within 12 weeks of pregnancy
• According to WHO reports, 92% abortions carried out in developed countries are safe but on contrast about 55% abortions are unsafe in developing countries.

Methods of safe abortion:

1. Surgical abortion

• It is method of abortion that involves operation procedure.
• Two types of operations (i.e. Vacuum aspiration & Dilation and evacuation) can be used in surgical abortion.
• Vacuum aspiration can be done up to 14 week of pregnancy and Dilation and evacuation is mainly carried out for pregnancies between 15-24 weeks

2. Medical abortion

• Medical abortion is a method for abortion in which medicines/ drugs are used for terminating pregnancy.
• It is also referred as “non-surgical abortion”.
• Combination of Mifepristone and Misoprostol drugs are used for conducting abortion. It is applicable up to 7 to 9 week of pregnancy.

Safe and unsafe time for abortion:

• Abortion is considered safer in early weeks of pregnancy; 5-7 week of pregnancy is safe to health as suggested by health professional. As fetus is growing day by day, abortion becomes more risky.
• Unsafe time for abortion is when a woman is more than three months pregnant. Longer the time of being pregnant greater is the risk from abortion. After 12 weeks or 3 months abortion should be carried out in hospital or clinics where all necessary equipment are available.

For more information, feel free to contact:

Sukhi Pariwar Clinic

Kalimati, Kathmandu, Nepal

4273180