Is abortion legal in Nepal? Many Nepali women don’t know the answer.

Photos and text by Tara Todras-Whitehill. Interactive quiz by Tara Todras-Whitehill. Reporting by Rojita Adhikari and Tara Todras-Whitehill.

N, 23, who asked only to be identified by her first initial, nurses her young son at her in-laws’ house where she lives in Janakpur, Nepal, July 9, 2017. N was raped by her husband’s friend and forced by her family to abort the child.

N lives in the city of Janakpur, Nepal with her in-laws. She speaks softly and, as a new mother, takes care of her five-month-old son with quiet devotion, patience, and an ever-ready smile. N was married at 17, and for six months she stayed at her parents’ house. During that time, her husband would visit her, sometimes alone and sometimes with friends. One day, while she was cooking at home alone, a friend of her husband’s stopped by, supposedly looking for him, but when he found her by herself, he raped her.

When N learned she was pregnant, she didn’t know if the father was her husband or his friend. She told her parents and her husband, and they demanded that she abort the baby. Although N had never understood much about abortion, she knew she wanted to keep it; however, her parents insisted, saying her husband might not love the child. Bowing to the demands of her family, her mother-in-law used a homeopathic method that some believe is effective for abortion — she gave N only papaya to eat for three days. After the third day, N lost the baby, which she insists was the result of eating the fruit.

Abortion has been legal in Nepal for over 15 years, but a study released by Nepal’s Center for Research on Environment Health and Population Activities (CREHPA) earlier this year concluded that over half of women are still getting illegal or unsafe abortions. In part because of this new data, I decided to apply for a European Journalism Centre grant to help document the stories, using text and photos, of the women behind the statistics. Over the course of two weeks, a Nepali journalist, Rojita Adhikari and I, conducted hour-long interviews with more than 20 women.

Ramshakhi Dev, age 32, second right, stands with her youngest child, Bibek, age 7, left, and her eldest daughter Mamata, age 18, at the entrance to their home in their village, Hariharpur 10, outside Janakpur, Nepal, July 7, 2017. Dev had an abortion after getting pregnant again for the fifth time. She went to a pharmacy and got the pills, but has no idea if it was legal or not — the pharmacy did not suggest any follow-up care.

When I arrived in Nepal in July, I learned a surprising fact — all abortion services that are provided by the government have been free since January. I also soon discovered that many women hadn’t heard about the new program, including Rojita, who worked with me on this project and specializes in reporting on gender issues. This lack of knowledge, which was especially persistent in rural communities, was a glaring example of the many issues surrounding Nepali women’s access to legal and safe abortions.

A woman is seen outside of a doctor’s office, at the Paropakar Maternity and Women’s Hospital in Kathmandu, Nepal, July 18, 2017. Many Nepalis feel that the public doctors take no responsibility for their patients, while private doctors will insure their services in case anything goes wrong.

It has gotten more difficult to address these issues since January 2017, when, in one of his first executive orders after taking office, US President Donald Trump reinstated the Mexico City Policy, known in activist circles as the Global Gag Rule. The policy received this nickname because it stops US-funded foreign NGOs from talking about or providing any services related to abortion worldwide.

Additionally, Trump has expanded the policy beyond family planning to include almost all health sectors from HIV/AIDS to nutrition, among others.

For countries that receive US assistance, past incarnations of this policy have had detrimental consequences, such as the closure of clinics and cutbacks for reproductive rights programs.

Take our interactive quiz to test your knowledge on the Mexico City Policy.

Sarah, 30, who asked to not be identified except for her first name, poses for a photo at the NGO she works at in Kathmandu, Nepal, July 12, 2017. Sarah is an ex-sex worker and now helps provide services and rights for other sex workers regarding HIV. The NGO that Sarah worked at used to be able to to counsel women about abortion, but in February, they were directed to no longer talk about it. Sarah had two abortions, one 8 years ago and one 3 years ago. The first time she was past the government allowed limit of 12 weeks, so she had to get it done illegally. She went to a clinic and paid 6,000 rupees for pills that didn’t work. Eventually she went to the hospital, where they told her the baby had died in utero, and they performed the procedure there.

Even without the added restrictions of the Mexico City Policy, globally, abortion is a complicated topic. In Nepal, for example, where the procedure has been legal for over a decade, women still face many issues, such as stigma related to abortion, trouble getting medicine at authorized clinics, distrust of governmental hospitals, or even just difficulty understanding what options are available to them.

There is the added problem of the lack of government monitoring of private clinics — many places provide unauthorized abortion services. Dr. Ram Ekbal Singh, who has a clinic in the Janakpur district, initially told us he had his doctor’s license from Nepal and Canada. We were able to find his abortion certification and a Russian certificate, but were unable to verify his medical degrees in Nepal and Canada. On follow-up, he said he got his degrees from Russia, Canada, and Nepal, although serious questions remain as to the accuracy of his information.

Empty beds are seen in the Dr. Ram Ekbal Singh’s clinic, in Bhimdatta, in the Janakpur district of Nepal, July 9, 2017. Dr. Singh said he received his medical degrees from Nepal and Canada, which he wrote on all of his business cards. After calling the doctor registrar’s office we couldn’t verify those medical licenses, but found a doctor by the same name who received a degree from Russia. On follow-up Dr. Ram said he had received that degree in Russia but also got degrees from Nepal and Canada.

Marie Stopes International (MSI), an NGO focused on women’s reproductive health, and similar organizations in Nepal are trying to combat these issues in different ways. Working with local partners, MSI has recently completed several campaigns that tried to address the lack of information about abortion, contraception, and sex. This includes one humorously named Rockets and Space, which uses spaceships shaped like condoms. They also have a program called NewlyWed, where they work with vendors such as beauty salons to educate women about contraception before they get married.

Although Marie Stopes still hasn’t calculated the impact of their latest campaigns, these programs are making only small inroads into the problems surrounding abortion. The Family Health Division of the Nepali Ministry of Health conceded during our interview that it’s a real challenge to inform women about free abortion services, especially in rural areas, and that securing international assistance is an issue. However, they are trying to find support by applying for additional funding from other countries.

The stories of N, Sarah, and Ramshakhi highlight the fact that, although Nepali women might have access to legal abortion, they still don’t have full, safe reproductive rights. In order for legislative action to be effective, local governments and NGOs must make a prolonged and concerted effort to combat the problems around this issue. Without the devotion of time and energy, laws and free services go unheard, unread, and unused.

Click here to download a pdf of the Mexico City Policy data visualizations.

This project has been funded by the European Journalism Centre (EJC) via its Innovation in Development Reporting Grant Programme (www.journalismgrants.org).

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