Safe abortion Services in Nepal

Many women face unwanted pregnancy due to limited access to family planning information and services. Such women who cannot access safe abortion services in a timely way are at a high risk of developing complications due to unsafe abortions, or in the worst case, suicide due to social pressure. Thus, there is a need to make safe abortion services available, accessible and affordable to all women with unwanted pregnancies.

Family Health Division has defined the four key components of comprehensive abortion care as:

  • Pre and post counselling on safe abortion methods and post-abortion contraceptive methods
  • Termination of pregnancies as per the national protocol
  • Diagnosis and treatment of existing reproductive tract infections and
  • provide contraceptive methods as per informed choice and follow-up for post-abortion complication management.

A pregnant woman shall have the right to get safe abortion performed in any of the following circumstances:

  • Fetus (gestation) up to twelve weeks (12 weeks), with the consent of the pregnant woman,
  • Fetus (gestation) up to twenty-eight weeks (28 weeks), as per the consent of such woman, after the opinion of the licensed doctor that there may be danger upon the life of the pregnant woman or her physical or mental health may deteriorate or disabled infant may be born in case the abortion is not performed,
  • Fetus (gestation) remained due to rape or incest, fetus (gestation) up to twenty-eight weeks (28 weeks) with the consent of the pregnant woman,
  • Fetus (gestation) up to twenty-eight weeks (12 weeks) with the consent of the woman who is suffering from H.I.V. or other incurable disease of such nature,
  • Fetus (gestation) up to twenty eight weeks (12 weeks) with the consent of the woman, as per the opinion of the health worker involved in the treatment that damage may occur in the womb due to defects occurred in the fetus (gestation), or that there is such defect in the fetus of the womb that it cannot live even after the birth, that there is condition of disability in the fetus (gestation) due to genetic defect or any other cause.

Abortion should not be conducted forcefully.

Except in the circumstance as referred above, no one shall conduct or get abortion conducted with an intention to get the abortion conducted or knowingly or having reason to believe that the abortion can occur.
No one shall get the abortion conducted by coercing a pregnant woman, threatening, enticing or tempting her.
If any of the following acts is committed, it shall be deemed to have got abortion performed:
Getting abortion conducted pursuant to sub-section (2),
Miscarriage that occurs while something is done to the pregnant woman with some enmity,
While conducting abortion, in case the abortion does not occur instantly but a living infant is born, and if the infant, which is born as a result of such an act dies immediately, it shall be deemed to have got the abortion conducted for the purposes of this Section.

Abortion should not be committed upon identifying gender

Regarding Safe Abortion Service

The licensed health worker who has fulfilled the prescribed standards and qualification shall have to provide the pregnant woman with safe abortion service pursuant to above in the licensed health institution.
Appropriate technology and process of the service to be provided as referred shall be as prescribed.
The pregnant woman who wants to obtain the safe abortion service shall have to give consent in the prescribed format to the health institution which has obtained a license, or to the health worker who has obtained a license.
In the case of a woman who is an insane, who is not in a condition to give consent instantly or who has not completed the age of eighteen years, her guardian or curator shall have to give consent.
In the case of a woman who is below the age of eighteen years, safe abortion service shall have to be provided by considering her best interests.

Confidentiality
The licensed health institution or licensed health worker shall have to keep all records, information, documents related to reproductive health of the pregnant woman and counseling and service provided to her confidentially.
The records relating to such information, document and counseling service may be made available on the following conditions:

  • If information is demanded by the investigation authority or court in course of investigation and hearing of any lawsuit,
  • If it is required to quote without revealing identity of the related woman for the purpose of study, research or monitoring relating to safe abortion