Although abortion was legalized in Nepal in 2002, many women
are not able to obtain legal services. Using qualitative data from women who
were denied legal abortion services, we examined reasons for seeking an
abortion, options considered and pursued after being denied an abortion,
reasons for delaying seeking care, as well as complications experienced among
women who were denied legal abortion.
After obtaining authorization from two health facilities in
Nepal, we requested informed consent from all women who were seeking abortion
services to complete a case report form to determine their eligibility for the
study. We then recruited all eligible and interested women in to the study. Two
months after recruitment, we conducted in-depth interviews with 25 women who
were denied abortion services from the two recruitment facilities due to
advanced gestational age (>12 weeks). Interviews were translated and
transcribed, and the transcripts were analyzed through an iterative process
grounded in thematic analysis, involving both a priori and
emergent codes.
Eleven women were recruited from the government hospital and
14 from an NGO facility. The majority of women (15 women or 60 %) were
living rural settings, ranged in age from 18 to 40 years and had an average of
2 children. None had completed any post-secondary education. Women most
commonly cited financial concerns and health concerns as reasons for seeking
termination. Not recognizing pregnancy, uncertainty about how to proceed,
needing time to coordinate the trip to the facility or raise money, and waiting
to know the sex of fetus were the commonly cited delays. Among the women
interviewed, 12 decided to continue their pregnancies following denial, 12
terminated their pregnancies elsewhere, and one self-induced using medication.
At least two women experienced significant complications after obtaining an
abortion. Most women who continued their pregnancies anticipated negative
consequences for their health, family relationships, and wellbeing.
Barriers to seeking early abortion need to be addressed in
order to reduce utilization of abortion services that may be unsafe and to
improve women's health and wellbeing in Nepal.
adverse events were reported.
Full article
at:
1Center for Research on Environment Health
and Population Activities (CREHPA), Kathmandu, Nepal
2Advancing New Standards in Reproductive
Health, University of California, San Francisco 1330 Broadway, Oakland 94612,
CA, USA
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