Doctors take exception to new law that allows late-term abortions in exceptional cases  

- ARJUN POUDEL, Kathmandu

Jul 2, 2019-

Doctors and health experts have expressed concern over a provision in a new abortion law that allows the termination of pregnancies at up to 28 weeks in certain special cases.

Section 4 (15) of the Safe Motherhood and Reproductive Health Rights Act, passed by Parliament in September last year, allows abortions as late as 28 weeks in cases of rape, incest, serious health risks to the mother or if the fetus is found to have genetic defects. 

Officials at the Safe Motherhood Unit under the Family Welfare Division, which prepared the draft of the new law, said they were surprised by the 28-week provision in the Act.

“We had proposed extending pregnancy terminations to 22 weeks, up from the existing provision of 18 weeks,” Dr Punya Poudel, chief of the Safe Motherhood Programme at the Family Welfare Division, told the Post. “We checked and rechecked several times, but could not find any mistake on our part.”

At 24 weeks and beyond, there is a roughly 50 percent chance of the foetus surviving outside of the uterus, according to doctors. The World Health Organization recommends abortions only up to 22 weeks.

“We had proposed 22 weeks as per the recommendation of the UN health agency,” said Poudel. “But the law has gone beyond our recommendation.”

The new Act allows women to terminate pregnancies of up to 28 weeks, if a doctor decides that their pregnancy poses a serious risk to their lives or could seriously affect their mental and physical health, if the baby will be born with deformities, or if they are infected with HIV or similarly incurable diseases. Pregnancies resulting from rape or incest can also be aborted for upto 28 weeks. 

General abortions can be conducted at upto 12 weeks, according to the Act.

Officials at the division said that no other country in the world allows termination of pregnancy at 28 weeks, although Canada, some US states, and China have no limit.

Despite the bill being forwarded to Parliament by the Ministry of Health and Population, the ministry itself appeared to have no idea of the new provision. 

“This act amounts to conducting an abortion on a baby,” Mahendra Prasad Shrestha, spokesperson for the Health Ministry told the Post after being informed of the provision. “This cannot happen and we should immediately correct it.”

International agencies involved in consultation over the Act were also surprised. 

“We had recommended an extension of 22 weeks as per World Health Organization’s suggestion, but they made it 28 weeks,” Madhavi Bajracharya, policy advisor at Ipas, an international organisation that advocates for expanding access to safe abortion and contraceptive care. 

It appears that Members of Parliament did not thoroughly study the provision or international standards before passing the Act. 

Khagaraj Adhikari, a member of the Parliament’s Education and Health Committee, said that Health Minister Upendra Yadav had proposed the 28 weeks provision and that Health Secretary Puspa Chaudhary had seconded his proposal.

“We supported their proposal without checking any documents or references,” said Adhikari, who is also a former Health minister. 

Health Minister Yadav, however, said the provision was made to empower women.

Abortion was legalised in Nepal in 2002, a milestone for women’s reproductive rights, their empowerment, and their right to bodily autonomy. With legalisation, persecution and jail terms for women who terminated unwanted pregnancies ended and unsafe abortions decreased dramatically. 

Consequently, between 1996 and 2016, the maternal mortality rate fell from 539 to 239, achieving the Millennium Development Goal—a feat for which the legalisation of abortions played a significant role, doctors say.


Published: 03-07-2019 07:15

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