In Nepal, abortion is allowed on request up to 12 weeks of gestation. Under the 11th Amendment to the Civil Code, Nepal legalized abortion in March 2002 where women are allowed to choose between manual vacuum aspiration (MVA) and medical abortion (MA). As of 2014 one third (31%) of all pregnancies ended in abortion with around half being unintended. An enormous number (58% in 2014) of abortions were performed outside government approved facilities while the number slightly decreased to around 52% in 2021.
Sex-selective abortions are illegitimate in Nepal, however, it is still widely practiced preferring sons over daughters in most parts of the country. Public health experts as well as Government officials claim that the problem is serious and immediate actions need to be taken to prevent the gender imbalance in the near future and can bring social and other issues in the country.
Small Private Clinics Performing Sex Selective Abortions
Several studies show that frequent abortions have long lasting issues on a woman’s reproductive and mental health resulting in several complications in future pregnancies. Especially if the abortion is performed under family pressure, the mother can have long term psychiatric effect.
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| Source: The Himalayan Times |
A victim shared her brutal truth,
“Sadly for me, my husband also wanted a son. During each pregnancy I was forced to get an ultrasound done to determine the sex of my fetus by my husband. I was pregnant with a girl thrice but I couldn’t keep them.”
“Three abortions in seven years had a great impact on my health. I have recovered from the physical trauma, my body suffered from frequent pregnancies and equally frequent abortions. But my mental health is still in shambles.”
Further, she added,
“All that has happened to me was done to me by my family. I am happy with my daughters and did not harbor any desire to bear a son but I was under immense pressure to give birth to a boy.”
“They say that it's the wife's obligation to give birth to a son. They say sons are important in our society. They didn’t want to take a chance in case we had a baby girl so I was forced to undergo abortions after sex determination tests revealed I was carrying girls both times.”
According to The Right to Safe Motherhood and Reproductive Health Act 2018, abortion is legally allowed up to 12 weeks of gestation on the request of the pregnant woman and up to 18 weeks of gestation in case of rape.
Talking about the abortion, Nursing in charge at Bheri Hospital Durga Laxmi Shrestha said,
“Abortions should be done within the legal framework. We do the procedure for reasons such as if the health of the mother and her baby is compromised or in case of incest and rape.”
A nurse working in the maternity ward Basundhara Gyawali reported that they don’t see a lot of first time parents seeking for abortion and it is usually prevalent among parents with daughters.
She said,
“But we don’t entertain them and in fact, dissuade them from going for it. Some are not aware of the legal repercussions of sex selective abortions. I think it boils down to social conditioning. In Nepal, boys are celebrated and the birth of a girl is bemoaned.”
Addressing the misuse of sex determination, Ankur Bhandari, gynecologist at Bheri Hospital said that though the procedure is a mark of advancement in the medical field, it is under high risk of getting misused for some selfish desires. He said,
“Prenatal tests such as ultrasounds are important in pregnancies but since it can determine the sex of the fetus, this technology is being widely misused as a gateway for illegal abortions.”
According to the Safe Maternity and Reproductive Health Act 2075, pregnant women should not be forced to perform the sex identification test. The National Criminal Code, 2074 allows imprisonment to parents and service providers between 1 to 5 years for sex selective abortions and a penalty of Rs 10,000 to Rs 50,000 depending on the period of pregnancy.
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| Source: Global Press Jounal |
According to the reports provided by the Ministry of Health and Population, a total of 383,205 babies were born with 206,374 boys and 176,831 girls in fiscal year 2024/25. The figure shows that the girls’ ratio is 16.71% lower than boys.
Dr Uddhab Puri, an associate professor who has carried out many researches on the birth rate of Nepal, said,
“We are headed towards disaster. If we fail to check sex-selective abortions this trend could lead to long-term social and demographic consequences. No agency is working to prevent sex selective abortions and as per the law, our law enforcement agencies do not do anything unless complaints are lodged or accidents take place.”
Puri further stated,
“Not only the government data, several other studies also suggest that Nepal is heading towards a serious gender imbalance. Educated people often talk about gender equality but the birth ratio shows they are not serious about women’s empowerment, and gender equality.”
Some experts say that preference of boys over girls is not new in Nepal but the country is heading towards massive sex selective abortions along with advancement of new technology in the medical sciences. Experts claim that the natural sex ratio at birth should be about 105 boys per 100 girls.
Multiple doctors claim that such illegal abortion has been carried out in the country for many years behind the shade and it’s further inclining. As per the fiscal year 2024/25, 105,000 women terminated their pregnancies adopting medical or surgical measures at government health facilities but there could be many thousands of cases being performed behind the approach of government records.
Hence, strong legal prohibitions, public awareness campaigns for equality of boy and girl child, better monitoring/enforcement could be some of the measures preventing sex selective abortions in Nepal maintaining long-term socio-demographic balance
