By Sapana Malla Pradhan
In Nepal, we just culminated a month long celebration acknowledging abortion law reform in this country, including the amendment to the Muluki Ain, Nepal’s Country Code, to permit abortion on broad grounds. During this month of celebration and reflection, Nepalese stakeholders held discussions on key reproductive rights issues, including the urgent need for a comprehensive law on abortion, as mandated by the Supreme Court, and the need to address the persistent barriers that still continue to limit access to safe and affordable abortion services for Nepali women.
The breakthroughs in women’s rights in Nepal over the last decade have been remarkable. Nepal previously had one of the most restrictive and harshly implemented abortion laws in the world. Abortion was prohibited in all circumstances, except when the pregnancy put a woman’s life at risk. However, this provision was not put in practice. There were numerous instances of women being imprisoned for having illegal abortions, while countless others died from complications due to unsafe abortion procedures. As late as 1996, unsafe abortion accounted for half of all maternal deaths in Nepal. After years of advocacy and lobbying by health activists and civil society groups, on September 26, 2002 the government amended the Muluki Ain to permit abortion during the first 12 weeks of pregnancy upon request, within 18 weeks in cases of rape and incest, and throughout pregnancy in cases of a severe fetal impairment or when the woman’s health is at risk. Key findings from a report released by the Center for Reproductive Rights and the Forum for Women, Law and Development in early 2002 – showing how the criminal ban violated women’s human rights – were critical in lobbying for abortion law reform, and resulted in the release of more than 50 women from prison. The continuing efforts of various stakeholders led to the recognition of reproductive rights as fundamental rights for the first time in the Interim Constitution of Nepal, 2007. Since the amendment to the Muluki Ain, the government has been taking steps to provide abortion services to women. As of June 2011, 487 facilities have been deemed “Safe Abortion Sites” and the government has developed new policies and guidelines, including the National Safe Abortion Policy in 2004 and Safe Abortion Implementation Guidelines in 2011. Nevertheless, the 2011 National Demographic Health Survey (NDHS) found that 62 per cent of women in the country still do not know about the legal changes that took place ten years ago. According to a recent survey by the Center for Research on Environment, Health and Population Activities, 19 percent of women from disadvantaged communities said lack of money to pay the abortion fee was a barrier to obtaining a safe abortion. Abortion in Nepal is not free as there is a general misconception that women will use it as an alternative to contraception. For marginalized women access to safe abortion is needed as a back-up method for unplanned pregnancies, which unfortunately occur often due to the lack of access to contraception, or even in cases of contraceptive failure. The price for a safe abortion leads many women from marginalized communities to seek clandestine abortions. In most cases, clandestine abortions lead to complications that require trained medical assistance. One could argue, then, that marginalized women end up paying more to end pregnancies as they risk their health and end up paying for abortion related complications, in addition to paying for the unsafe procedure. All governments have a fundamental responsibility to safeguard reproductive rights and any failure to do so is a serious violation to women’s basic human rights. Nepal has signed and ratified international human rights treaties, including the International Covenant on Economic, Social and Cultural Rights and the Convention on the Elimination of All Forms of Discrimination against Women. These accords obligate the Nepali government to end discrimination with respect to women’s access to a full range of essential health services, including not just safe abortion but also family planning and prenatal care. On behalf of all the reproductive rights activists and organizations, I urge the Government of Nepal to take a critical step to protect women’s reproductive rights. The government must introduce a comprehensive abortion law that codifies the legal principles and establishes a concrete, rights based legal framework for ensuring access to affordable and high-quality safe abortion services. The month-long celebration of Nepal’s achievements in reproductive health rights has come to a close, but there is still too much work to be done for us to rest on our laurels. All stakeholders need to coordinate their efforts to make enjoyment of reproductive rights a reality for all women in Nepal. We are fully committed to continue engaging with the Government of Nepal to ensure the constitutional and legal protections for women’s reproductive rights in Nepal translate into real change for the health, lives, and rights of Nepali women.