- Kalpana Poudel
Kathmandu, Twenty-year-old Seema Rana (name changed) is a bachelor level third year student in a Kathmandu-based college. Seema was recently found at the Thapathali-based Maternity Hospital seeking abortion. She is unmarried and she conceived as her boy friend did not apply any means of family planning as he was reluctant to do so during sexual intercourse, as she said.
She just represents a noticeable number of school and college girls who visit the Valley-based health clinics in search of solution to unwanted pregnancies. Though the legalisation of (safe) abortion in 2002 in Nepal has been boon for (married) couples especially women in case of unwanted pregnancy, unmarried girls and women are equally the users of this provision, but the concern is that in most of the cases it seems that that are not aware of and do not care about post-abortion complications. Sometimes, they have no way except to undergoing abortion to end a unwanted pregnancy despite its after affects.
The data from the health facilities where the abortion service is available show that among the service recipients, girls under 20 are atop.
According to the District Public Health Office Kathmandu's data of the fiscal year 2073-74 BS, a total of 13,017 underwent abortion in this period, the number of girls below 20 surpassed 3,000.
At this backdrop, senior gynecologist Prof Dr Achala Baidya stressed the need of abundant sexual and reproductive health education to girls and body since the school level.
"Physical intimacy between girl and boy is being taken as a means of entertainment which is responsible for increasing rate of abortion among the unmarried girls and women pushing them to adverse health complications," she viewed.
DPHO Kathmandu chief Mahendraman Shrestha said pregnancy before 20 can bring various complications so the minimum age for marriage has been determined above 20 due to the same reason. But such issue has been overlooked and (unsafe) heterosexual relation before marriage is being taken lightly and as a means of brief entertainment which ultimately end to negative health and psychological impacts on girls/women.
The recently-launched Nepal Population and Health Survey 2016 also proved that abortion was being adopted as an alternative to birth control method. The Survey shows that 71 per cent of the abortion is done as a method of family planning.
It was found previous year also that more than 25 per cent of those undergoing abortion were women below 20 years of age. According to the law, a woman can get rid of the foetus of up to 12 weeks. The government has also opened the way for undergoing abortion to get rid of foetus of up to 18 weeks old in special circumstances.
The number of women undergoing abortion in Kathmandu is more than 15 thousand annually, as per the Kathmandu Public Health Office data.
Thirteen thousand 609 women had abortion in Kathmandu in the fiscal year 2014/15. According to Statistics officer at the Kathmandu District Public Health Office, Pushkar Bijukchhe, 15 thousand 503 women underwent abortion in Kathmandu in the fiscal year 2015/16. Around 24 per cent of those undergoing abortions are below 20 years of age, it is stated.
In the view of doctors, the reason for the increasing number of women below 20 years age undergoing abortions is unsafe sex, not using the temporary family planning devices and lack of knowledge of reproductive health.
Most of the girls who come for having abortion are said to prefer medication abortion. It is estimated that the number of girls choosing medication abortion in Kathmandu is almost half the total number of women undergoing abortions.