Safe Motherhood in Nepal

News and Events

Safe Abortion Services

President Obama’s removal of the “global gag rule” was welcome news for everyone supporting women’s access to safe abortion when faced with an unwanted pregnancy. This enlightened step will enable organisations across the world to work more openly and effectively to provide safe and legal services, thereby reducing the toll of death and disability that results from desperate women seeking unsafe “back street” abortions. In Nepal, thanks to the legalisation of abortion in 2002, the national safe abortion programme has made remarkable progress in training service providers and registering both public and private sites to provide safe services at modest fees. The lifting of the global gag rule will be of benefit in enabling services to be provided in family planning clinics, which previously could not be used because they had received US government funding. For women this represents a very positive step as family planning clinics are best placed to provide a comprehensive range of contraceptive and abortion services with counselling in an appropriate environment.

Two new initiatives that will further extend the choice of services available to women are medical abortion and second trimester abortion. Nepal is leading the way in piloting medical abortion in six districts for six months. The results will be evaluated later this year, after which it is hoped to scale up the initiative across the country. A combi-pack of two drugs (mefi-pristone and miso-prystol) is used under the supervision of a doctor or staff nurse who has received specialised training. To date over 800 women have received the service and the rate of demand is increasing as clients and providers gain confidence in its efficacy. Women report choosing the service because it is non-invasive (requires no surgery), has no side effects and can be accessed locally, at primary health care centres.

Second trimester abortion, for women more than 12 weeks pregnant, is legal in cases of rape or incest, if the foetus is not viable or the woman’s physical or mental health is at risk if the pregnancy is continued. The process, known as dilation and evacuation, is based on a similar vacuum aspiration technique to that currently used in the first trimester. It is now available in nine hospitals across the country, and around 120 women have used it for a safe termination, often under difficult circumstances.

The safe abortion programme in Nepal is supported by Ipas (www.ipas.org) and SSMP.