10 Things You Should Know about Abortion Service in Nepal

This has been my tagline from my first blog post till today “Abortion is Safe and Legal in Nepal”. Nepal has passed its glorious 10 years and more after liberalizing abortion laws and respecting women’s rights to control their own body. It’s icing on the cake when recent national budget 2015/16 announced abortion service in government institutions being free of cost. Also, the NEW CONSTITUTION DRAFT of Nepal has “Guaranteed women’s right to reproductive health and has removed of the term BHRUN HATYA.”

The previous article 43(2) had stated…every women shall have right to safe-motherhood and reproductive right. Bhrun Hatya done on the basis of sexual identification will be punished. Now the new and current provision in the constitution draft in the very same article number i.e. 43(2) states EVERY WOMEN SHALL HAVE THE RIGHT TO SAFE MOTHERHOOD AND THE RIGHT TO REPRODUCTIVE HEALTH.

map-about-bigtext1Yes, it’s my body and I’d rather not have anyone telling me what to do with it. Motherhood is an especial feeling but women could not only be judge on the essence of pregnancy and delivering babies. Unwanted pregnancies can cause many issues and effect health of women as well. But even if the pregnancy is not caused by a rape or causing health issues on woman, my body is mine and i have full right to decide what I want. I know that this is very hard concept for many people to grasp but it’s just the way I feel.

Having said that I am a pro-choice and I support women’s right to safe abortion, I would like to share 10 things you should know about abortion service in Nepal.

  1. Legalization of Abortion:

You should be aware of legal conditions for safe and legal abortion in Nepal. There are legal conditions under which you can go ahead with abortion service in Nepal.

Abortion http://www.asap-asia.org/country-profile-nepal.html is legal in Nepal on the following grounds:

  • Up to 12 weeks of gestation for any women,
  • Up to 18 weeks of gestation if pregnancy results from rape or incest, and
  • At any time during pregnancy, with the advice of a medical practitioner or if the physical or mental health or life of the pregnant woman is at risk or if the fetus is deformed and incompatible with life

Abortion is punishable on the following conditions:

  • Sex selective abortion, and
  • Abortion without the consent of the pregnant woman

Sex selective abortion is big “NO”. This is  important for everyone and especially for young people to be aware of legality of abortion in Nepal. Young people are innocent and often they seek abortion service beyond legal limit. OR they are subject to family and society pressure to keep their pregnancy secret, pushing those who ultimately decide to seek abortion beyond legal limit. Because of this many young people have been denied of abortion. Therefore, awareness on safe and legal abortion among young people is must so that they go to abortion service centres within legal time frame. The denial of abortion service beyond legal limit has lead to unsafe abortion.

2. Abortion procedures:

In Nepal, as is true for most other countries of the developing world, women are rarely given the opportunity to voice their needs concerning health matters. But legalization of abortion in Nepal undoubtedly has empowered women and health status of women. Comprehensive Abortion Care Services is an additional powerful tool in addressing high maternal mortality.

There are two types of medical procedure that is used in Nepal: MVA-manual vacuum aspiration and MA- medical abortion. Medical abortion is performed within 9 weeks of gestation. Medical abortion is a method of using pills to end a pregnancy through a process similar to a miscarriage. Like vacuum aspiration, medical abortion is very safe and effective. It offers unique advantages. It provides a non-invasive method of ending an unwanted pregnancy that women can use in a range of settings, often in their homes.

Safe and legal abortion services providers should counsel its clients regarding the methods of medical procedure being available in the service centre. It is the choice of woman on going through medical procedure via MVA or MA.

3. Identify safe abortion service centres:

cac

Safe Abortion Logo

Comprehensive Abortion Care Services are made available through the private, non private, semi-governmental sectors to provide abortion services in under served areas and to marginalized populations. Government of Nepal has developed a safe abortion logo. It is a visual symbol to designate facilities offering safe abortion services that is prominently displayed at all abortion service sites. Through its extensive incorporation in safe abortion IEC materials and programs. the logo has been a widely recognized symbol of safe abortion in Nepal, particularly among vulnerable populations such as illiterate women. Perhaps have also used behavior change communication strategies- including evidence based community discussion groups and a serial radio drama to foster discussion about sexual health and to challenge commonly held negative beliefs and stigma around induced abortion.

Likewise, the Government of Nepal certifies the health facilities as well as health service providers with trained human resources (doctors, nurses, ANMs) to provide abortion services to women. Abortion service and care is now available in all 75 districts of Nepal, many of which are in remote, mountainous areas, reflecting the government’s emphasis on rapid decentralization.

4. Privacy and Confidentiality and Counseling:

Quality service is the integral part of abortion service centres and it is right of women to receive standard sexual and reproductive health service. Abortion is very sensitive issue to be talked and decide to go for the procedure. Before safe and legal abortion, counseling regarding abortion and its procedure is the most. Woman has right to choose the correct abortion procedures: MVA or MA. For this proper balanced counseling is the most. Similarly privacy and confidentiality is the most. There are evidence which states that young people and women do not prefer to visit their nearby health facilities for any sexual and reproductive health services as they might meet their relatives and friends or service providers might know their family. They prefer travelling far to next districts for even simple SRH service due to lack of privacy and confidentiality in their nearby health facility.

So it is necessary that health facilities and even service providers maintain privacy and confidentiality. If they do not, everyone has right to ask for and if not maintained legal action could be preferred.

5. Hotline service:

Meri Saathi Free Helpline In Nepal, there are limited hotline service centres which offer information on safe abortion: legality, procedures, dos and dons, queries, safe abortion services. But Marie Stopes Nepal offers range of sexual and reproductive health counseling over phone. They have trained and skilled counselors who are available six days a week and provide information on safe abortion. It is call Meri Saathi Free Helpline. You can dial 16600119756 or 9801119756 to get accurate information on abortion service centers. These numbers should be saved in your cell phone. In any emergency regarding sexual and reproductive health issues, the solution could be a dial away.

6. Abortion service centres- Youth Friendly 

All abortion service centres should be youth friendly. Safe and legal abortion is young people’s sexual and reproductive health rights. The service providers should be youth friendly. They should not have their personal values which hold them back when it comes to providing abortion service to young girls. Even the service centres need to be youth friendly with IEC materials being demonstrated, well received in the centre, non-judgmental, privacy and confidentiality.

7. Abortion and Consent:

This is an important topics to be discussed widely. When it comes to abortion and consent, most of the people think that consent from husband, boyfriend, family, etc is compulsory. But in our abortion law it is clear that “Only pregnant woman holds the right to choose to continue or discontinue the pregnancy.” This states that only pregnant woman’s consent is enough to get abortion service. If the pregnant woman is less than 16 years of age or not in a position to give consent (mentally incompetent), the nearest guardian or relative can give consent for abortion services.

8. Accessibility and Affordability:

Abortion should be accessible and affordable. As mentioned above abortion services in Nepal are available in all government institutes like Primary Health Care, Health post and Sub health post in all 75 districts. Service providers are trained to provide both MVA and MA services to women in urban as well as rural areas. Even various organizations like Ipas Nepal has been training Female Health Volunteers to aware community about safe and legal abortion services being available in their nearby health facilities. This is indeed good initiation to prevent unsafe abortion. The fee structure established for public-sector maternal health services set a standard fee of about Rs. 1000 for induced abortion. Although modest, this fee was in contrast to free provision of post-abortion care, delivery, pre-and post- natal cares, and long-acting contraceptives. The safe abortion policy does stipulate that services be provided free of charge to poor or otherwise marginalized women. With continuously advocacy by women’s health advocates, women’s right activists and health organizations “Abortion has been free of cost in government institutions”.

9. Post Abortion Family Planning counseling:

Safe abortion needs good quality abortion services incorporating counseling training human source, infection prevention practices and adequate logistic support. Abortion is also supported by contraceptive services to prevent further unwanted pregnancy. Post abortion family planning benefits individuals, families, communities in many ways: increased modern contraception use and decreased abortion, reduced maternal and child mortality, prevention of mother- to -child HIV transmission and new HIV infections. After abortion procedure, post abortion family planning counseling is the most.

10. You are a champion:

Now you are aware of all the abortion related information, you are indeed great messenger and champion who is responsible to relay accurate message on abortion being safe and legal in Nepal to other people in your circle. You are a Champion.

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