Sailtaaj Kunwar | Dr. Biraj Baral

Safe Abortion services must be available to everyone who needs them, and health care professionals are here to provide care without judgment.

Safe abortion is a fundamental right, just like sex as a basic need for humans. It’s crucial to have healthy, open discussions on this topic.

Abortion is one of the sensitive topics that is kept in the dark by society due to misinformation and stigma. However, it is very important to raise awareness among people concerning the need for access to safe, legal, and available abortion services.

Abortion was legalized in Nepal in 2002 in order to guarantee that all women have rights to make free decisions concerning their bodies. Many women from Pokhara remain unaware of the government-approved medical institutions that provide such services at rates within their budgets.

The following article aims to educate women on their legal options and resources at their convenience and needs to ensure women get to utilize their sexual and reproductive rights.

For that purpose, we aim to create awareness among women about the different governmental and non-governmental institutions offering such services in Pokhara for making informed choices on their reproductive health. Making women aware of where to seek help will save lives and minimize unsafe practices.

It is about time we normalize safe abortions and have conversations around them, putting information within reach for every woman.

The services of safe abortion service facilities are available at a very nominal cost in various governmental and non-governmental organizations in Pokhara. For example, the approved governmental facility, Western Regional Hospital (also known as Gandaki Hospital), provides comprehensive reproductive health services, including safe abortion services with confidentiality and special care by trained medical staff.

Similarly, NGOs like Marie Stopes Nepal and FPAN also offer the best services in regard to abortion, supported by professional medical support and counseling. These institutions work for safe environments where women can access medical care without any kind of fear and stigma. It becomes necessary to approach only these authorized centers for safety and legality purposes.

It is about time we normalize safe abortions and have conversations around them, putting information within reach for every woman.

According to the Directorate of Health, Gandaki province, in the year 2079/80, a total of 12,794 abortions were recorded in Gandaki province, comprising 2,770 surgical and 10,024 pill-based procedures. Among these, 589 cases (4.6% of total abortions) involved individuals under 20 years old. There were 148 cases of complications during abortions.

It is, however, a concern that 4.6% of the abortions were for young people under 20 years. This shows that more sexual health education should be provided to the youth, including access to contraception methods, so that unintended pregnancies can be reduced.

Medical abortions from pharmacies haven’t always been effective, with some cases resulting in incomplete terminations and retained products of conception. This has given much trouble than the stinging stigma of society.

That is why, one must consult with the trained medical professional at a legal health institution to perform such abortion practices firsthand. On the other hand, places like FPAN, Mary Stopes, Gandaki and other Governmental hospitals are providing safe and effective abortion care for those who need it.

We have done our research, been to the places, worked at hospitals and with all our experiences we can really say that Gandaki hospital has been a top friendly and economically best in promoting safe abortion services. They first provide counseling on abortion methods, including medical and surgical options, and allow clients to choose the best option for themselves.

After confirming the pregnancy, they guide clients on how to use the medical abortion pills, mifepristone and misoprostol. Trained nurses, under the supervision of resident doctors and consultants, perform Manual Vacuum Aspiration (MVA) up to 12 weeks of gestation.

They report no complications such as uterine perforations or hemorrhages during this procedure. If any complications arise, the necessary expertise is always available to manage them. To prevent failure of medical abortion, a Urinary Pregnancy Test is conducted two weeks after the procedure, and if positive, an ultrasound is performed to check for retained products of conception, followed by MVA if needed. This surgical abortion via MVA is also a day-care procedure, meaning you are discharged within a day if your vitals are stable, so no overnight admission is required.

All these services at Gandaki Hospital are free of charge, including medication with all the supervision provided by trained health professionals and gynecologists. Additionally, Government Health insurances cover about 90% of the fees for necessary blood investigations and ultrasounds. They also offer proper counseling to couples on family planning methods to prevent further unwanted pregnancies.

Likewise, Marie Stopes has been providing sexual and reproductive health services in Nepal since 1994. Marie Stopes Nepal have been offering safe abortion services since their establishment. In Pokhara, Marie Stopes is located at Srijana Chowk.

According to Senior Nurse at Marie Stopes Pokhara, Pooja Karki, she has been performing safe medical abortion and manual vacuum aspiration services appropriate for that period of gestation. Marie Stopes have different youth mobilizers capable of conducting safe abortion programmes in schools/colleges and rural parts of Nepal promoting safe abortion awareness.

Marie Stopes in Pokhara perform Medical abortion services at a minimal rate of Nrs. 2750 that includes all the necessary medications abortive pills, client centered counseling, charges for contraceptive devices and also medications for sexually transmitted diseases if needed.

Also the facility for manual vacuum aspiration is provided at a rate of NRS 6000 including all the necessary amenities. They also have fee waiver provision for clients who are not financially capable of affording those services. Nurse Pooja has been providing safe abortion services with Marie Stopes for 6 years now and is capable of managing any unfortunate complications.

For any mishap they refer clients to other tertiary care centers. They have toll free number 1143 where they provide client centered counseling for their services. The fee structure for such services is nominal with the quality of care they have been providing since decades.

People especially from Pokhara and other districts of Gandaki Provinces are benefitted from their services. Herein, we are referring to Marie Stopes Nepal, an organization under Marie Stopes International. Despite Marie Stopes relocating to Srijanachowk from Prithivi Chowk, many people remain confused and continue searching for services at the old location.

Established in 1959, The Family Planning Association of Nepal (FPAN) is Nepal’s first national family planning service delivery and advocacy organization. FPAN is a non profit organization located in Ramghat, Pokhara. It has also been offering safe abortion services under trained and experienced medical professionals. According to Senior Nurse of FPAN, Anusha Bhujel, they offer Medical Abortion Service under Nrs. 1200 and Surgical Abortion Service for Nrs. 3000.

These safe abortion services are more affordable than those offered by private hospitals. The abortion services mentioned follow Nepal Government health laws. They are available up to 12 weeks of pregnancy and only need the woman’s consent. Also during follow up they provide counseling regarding post abortion care and available family planning services. The environment provided by medical professionals at FPAN is very friendly, calming, and compassionate. They maintain the privacy and confidentiality of the clients.

Therefore, having access to safe abortion services in Pokhara is not just a basic right; it’s a crucial part of women’s health and well-being. Options like those provided by government hospitals and organizations such as Gandaki Hospital, Marie Stopes Nepal, and FPAN offer women the quality care they deserve in a welcoming and private setting.

It is time we raise awareness on this topic so that women can exercise their sexual and reproductive rights and make informed and safe decisions for themselves. By encouraging open conversations and sharing accurate information, we can help break down the stigma around abortion, making it easier for women to seek the support they need.

Together, we can build a community where safe abortion is accepted, and every woman feels confident in her right to make decisions about her own body without fear or shame.