Abortion Law in Nepal: Legal Rights, Access, and Health Impact

Abortion law in Nepal is one of the most progressive legal frameworks in South Asia, focusing on safeguarding women's health, human rights, and reproductive autonomy. Over the years, Nepal has moved from a restrictive abortion regime to one that grants legal access under defined conditions, significantly reducing maternal mortality caused by unsafe abortions.

This comprehensive guide explores the legal evolution, key provisions, practical implementation, and persistent challenges surrounding abortion law in Nepal.

Introduction

Abortion intersects complex aspects of health, human rights, gender equality, and social justice. In Nepal, the legal journey of abortion laws reflects a strong commitment to public health and women's empowerment. Despite notable progress, implementation gaps and criminal penalties continue to pose challenges for women seeking safe, legal abortions.

Legal History of Abortion in Nepal

Until 2002, abortion in Nepal was entirely criminalized under the Muluki Ain (National Code of Nepal), with women facing imprisonment even in cases of miscarriage. Abortion-related deaths contributed to 20% of maternal mortality, and nearly one-fifth of imprisoned women were serving time for abortion-related offenses.

Key Milestones

Current Legal Provisions on Abortion

The National Criminal Code 2074 and the SMRHR Act 2075 (2018) guide abortion law in Nepal.

Abortion Up to 12 Weeks

• A woman can obtain an abortion up to 12 weeks of pregnancy with her informed consent.
• No spousal, parental, or guardian consent is required.
• No reason or justification is needed.

Abortion Up to 18 Weeks for Rape/Incest

• In cases of rape or incest, a woman may legally abort the pregnancy up to 18 weeks.
• This respects trauma and autonomy.

Health-Related Abortions at Any Stage

A licensed doctor can approve abortion at any stage of pregnancy if:

• It risks the life of the woman.
• It endangers her physical or mental health.
• The fetus has a severe deformity or disability.

Abortion for HIV or Incurable Disease

• Women with HIV/AIDS or other serious incurable diseases can access abortion legally at any gestational period with medical recommendation.

Service Provider Rules and Guidelines

Nepal’s abortion law emphasizes that only trained and certified professionals can perform abortion services at approved health facilities.

Healthcare Roles and Gestational Limits

• Mandatory post-abortion care and counseling are required by law.

Criminalization and Punishments

Despite progressive reforms, abortion remains partially criminalized under certain conditions.

Penal Provisions (Section 188 & 189 – National Criminal Code)

Miscarriages Wrongly Prosecuted

• The SMRHR Act includes spontaneous abortion under its definition, leading to miscarriages being mistakenly criminalized.

Achievements and Positive Outcomes

Maternal Mortality Reduction

• Maternal mortality dropped from 539/100,000 (1996) to 239/100,000 (2016).
• Abortion-related deaths decreased significantly.

Expanded Services

• Over 1,500 accredited facilities across Nepal.
• Abortion provided free at government hospitals.
• Medical abortion via telemedicine approved post-COVID-19.

Number of Trained Providers (2021)

• 4,500 clinicians trained.
• 1,833 Auxiliary Nurse Midwives.
• 743 Nurses.
• 1,853 MBBS Doctors.
• 92 OB-GYN specialists.

Major Challenges to Safe Abortion in Nepal

1. Contradictory Laws

• The Penal Code allows abortion in rape/incest cases up to 18 weeks.
• The SMRHR Act permits up to 28 weeks—this discrepancy creates legal confusion.

2. Partial Criminalization

• Despite reforms, abortion remains under criminal law, exposing women and providers to legal risks.

3. Lack of Provincial Implementation

• Provinces lack localized policies, budget frameworks, and clear protocols to ensure service delivery.

4. Low Awareness

• Only 41% of women (age 15–49) know abortion is legal.
• Just 23% know it’s legal up to 12 weeks for any reason.

5. Stigma and Gender Bias

• Societal stigma and family pressure dissuade women from seeking abortions.
• Sex-selective abortion continues in certain districts.

6. Limited Provider Availability

• Most certified centers are in urban areas.
• Many approved public health centers do not offer abortion services despite being accredited.

Key Recommendations for Legal and Policy Reform

Legal Amendments

• Fully decriminalize abortion, including removing punitive clauses from the Penal Code.
• Harmonize contradictions between the Penal Code and SMRHR Act.

Public Awareness

• Launch nationwide campaigns on:

  • Women’s legal abortion rights.
  • Availability and cost of services.
  • Location of certified facilities.

Service Expansion

• Integrate pharmacies and mid-level providers into legal abortion service networks.
• Expand telemedicine-based abortion access in remote regions.

Free Abortion Policy Enforcement

• Ensure all public facilities understand the reimbursement process.
• Prevent service denial due to drug shortages or policy confusion.

Address Sex-Selective Abortion

• Implement the National Strategy to Prevent Gender-biased Sex Selection (2021–2030).
• Educate against son preference while maintaining access to abortion.

Conclusion

Nepal's abortion law reflects significant strides in recognizing women’s reproductive rights. With the Safe Motherhood and Reproductive Health Act, 2018, Nepal has set a model for progressive reproductive legislation in South Asia. However, full decriminalization, improved implementation, and public education are essential to ensure that every woman can access safe, legal, and stigma-free abortion services.

Frequently Asked Questions

Is abortion legal in Nepal?

Yes. Abortion is legal in Nepal under defined conditions up to 12, 18, or 28 weeks, and anytime in health-threatening situations.

Can abortion be done without a husband’s consent?

Yes. A woman above 16 years of age can decide on her own.

Is sex-selective abortion legal?

No. Identifying or aborting based on fetal sex is criminalized under Nepali law.