Posted on : December 5, 2023 by Clinic One on Ob Gyn
Did you know?
According to the WHO, 6 out of 10 unintended pregnancies and 3 out of 10 intended pregnancies end in induced abortions, and 73 million induced abortions take place every year.
What is Abortion?
Abortion is the act of ending a pregnancy by removing the fetus from the uterus. Not all abortions are safe. According to global estimates, more than half of the induced abortions in developing countries are unsafe.
A study conducted in Nepal in 2019 has revealed that abortion rates were estimated to be 36 (95% CI: 33, 38) per 1000 women aged 15–49, whereas unsafe abortion rates were seven (95% CI: 6, 8) per 1000 women aged 15–49.
What is Medical Abortion?
Medical abortion is an intended medical procedure for terminating a pregnancy with the involvement of skilled health personnel in a safe environment. Medically induced abortion is one of the safest ways to carry out an abortion.
Criteria for a Legal Medical Abortion in Nepal
Pregnancy termination is only legal in Nepal under these circumstances:
- Up to 12 weeks of gestation for any reason, with the request of pregnant women, in the presence of skilled health personnel
- Up to 18 weeks of gestation in the case of rape or incest with the consent of pregnant women in the presence of skilled health personnel
- At any time during pregnancy, if the mental or physical health or life of the pregnant woman is at risk, only with the consent of the pregnant woman and with the approval of a certified medical practitioner
- At any time during pregnancy, if the fetus is deformed and incompatible with life, only with the consent of pregnant women and with the approval of a certified medical practitioner
- Only providers certified in safe abortion care are eligible to provide induced medical abortion services.
- The pregnant woman alone has the right to choose to continue or discontinue pregnancy.
- In the case of minors (< 16 years of age) or mental incompetence, consent from a legal guardian is a must.
- Ending a pregnancy based on gender selection is strictly prohibited, and whoever is involved will be punished by law
- Forcing a pregnant woman to undergo an abortion is prohibited, and whoever is involved will be punished by law.
Types of Abortion
Basically, there are two types of medical abortion:
- Medical Abortion (MA): This method is used for pregnancies up to 9 weeks. This type of abortion includes 2 pills to be administered orally and vaginally. Both of these pills will have to be repeated 24 to 48 hours after taking the first dose. A certified healthcare provider gives you the pills, and you have to take them under their supervision.
- Surgical Abortion: These abortions include surgery to remove the fetus from the uterus. These procedures include light sedation, local anesthesia (numbing a region), or general anesthesia (fully asleep). In-clinic abortions, Manual Vacuum Aspiration (MVA) for pregnancies up to 12 weeks, and Dilation and Evacuation (D&E) for pregnancies beyond 12 weeks (in the case of rape and incest) are some alternative ways for surgical abortions.
Who is responsible for performing medical abortions in Nepal?
Only certified and skilled health personnel can perform legal medical abortions in Nepal.
What needs to be considered before performing a medical abortion?
The first thing to do is to make an appointment with a health professional and allow him or her to perform a few tests, such as:
- A physical examination to confirm the pregnancy
- An ultrasound to view the pregnancy status and possible complications
- Blood test and urine test
- An explanation of the procedure, risks, and side effects of abortion
How is Medical Abortion done?
Medical abortion is performed with the combination of two medicines: Mifepristone works by blocking progesterone production. The uterine lining will become thinner without progesterone, and the embryo can’t stay attached. Misoprostol causes the uterus to contract, bleed, and expel the embryo.
Surgical abortion is performed through light sedation, local anaesthesia (numbing a certain area), and general anaesthesia (fully asleep).
Alternative methods for surgical abortions include in-clinic abortions, aspiration abortions, and dilatation and curettage (D&C) abortions.
Side Effects of Medical Abortion
The side effects of medical abortion include:
- Heavy cramping for several hours
- Heavy bleeding for several hours
- Fever and chills
- Fatigue and tiredness
- Nausea and dizziness
- Bacterial Infection
Services available for Abortion at Clinic One in Nepal?
Clinic One offers the following services for medical abortion:
- Medical Abortion (Pills)
- Manual Vacuum Aspiration (MVA)
How can you book your appointment for a medical abortion at Clinic One in Nepal?
To book your appointment at Clinic One, please contact us at 01-5400400 or 9863393960. Or else you can contact us via email at [email protected] or request an appointment below:.
The decision to have a medical abortion is a personal one. However, some cases of unintended pregnancy may require a medical abortion.
There are various techniques for performing an abortion. However, not all of them are safe. In such a case, selecting a health facility that provides safe medical abortion services is important.
Healthcare providers can guide you through this process and make sure you are well-informed about the procedure. Thus, it is necessary for you to know all the available options for medical abortion, which will help you choose what is best for you.
FAQs about Abortion
Medical abortion is one of the most effective techniques of safe abortion up to 9 weeks of pregnancy in Nepal. This method of abortion is 98% effective when used with the combination of two drugs named Mifepristone and Misoprostol.
In Nepal, abortion is illegal if:
- The abortion is performed forcefully.
- The abortion is influenced by the gender of the fetus.
- The abortion is performed in the absence of certified and skilled medical personnel.
Medical abortion, also known as non-surgical abortion, doesn’t hurt as it is all about taking pills. But there may be some period-like cramps after taking them. However, the intensity of the pain will differ between women.
Surgical abortion is somewhat painful, but your healthcare provider will give you some kind of anesthesia before performing the surgery. The post-abortion period may be painful with cramps. You can take pain relieving medication as prescribed by your healthcare provider.
It’s normal to have heavy bleeding for 2-3 days. But the bleeding will depend on how long you were pregnant. You should gradually recover within 2-3 weeks after the abortion.
You will have to call your healthcare provider if:
- If you have had a fever for more than 24 hours.
- If you have heavy bleeding enough to soak more than 2 sanitary pads within an hour.
- If you get excessive abdominal pain, cramps and back pain.
- If you don’t bleed as much as expected.
- If your bleeding won’t stop after 2-3 weeks.
- If you don’t get your periods after 2-3 months.
The first pill named Mifepristone, blocks the hormone needed for the pregnancy to occur, and the second pill named as Misoprostol which is taken 24-48 hours later causes your body to expel the pregnancy tissues from the uterus.
In Nepal, a licensed pharmacist can only give abortion pills if a valid prescription or order slip is provided by a licensed doctor or health care practitioner to the customer.
All abortion services are provided free of charge at government or public health facilities providing safe abortion services in Nepal.
References: https://www.who.int/news-room/fact-sheets/detail/abortion https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0223385#:~:text=The%20rate%20of%20abortion%20was,%5BTable%20is%20not%20shown%5D. https://reproductive-health-journal.biomedcentral.com/articles/10.1186/1742-4755-9-7 https://www.lawcommission.gov.np/en/wp-content/uploads/2019/07/The-Right-to-Safe-Motherhood-and-Reproductive-Health-Act-2075-2018.pdf https://my.clevelandclinic.org/health/treatments/21899-medical-abortion https://www.mariestopes.org.np/services/safe-abortion-and-post-abortion-care/medical-abortion/ https://www.howtouseabortionpill.org/abortion-laws-by-country/nepal/ https://my.clevelandclinic.org/health/treatments/21899-medical-abortion
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