Community Perception of Abortions in Different Districts of Nepal.

Abstract

Background: Abortion remains a significant public health concern in Nepal, contributing to maternal mortality and posing a complex challenge to women's reproductive health. This study explores the complex nature of community perceptions regarding attitudes and perceptions on abortion, perceived factors influencing abortion, perceived consequences of abortion, and existing modern and traditional practices of abortion in Nepal.

Methods: A qualitative study was conducted across 12 districts in Nepal, involving 228 community members, including community healers, Female Community Health Volunteers, women leaders, in-laws, and men. Data was analyzed by applying a thematic analysis approach.

Results: Findings highlighted a dichotomy in knowledge of abortion, encompassing both progressive views (considering it a women's right) and regressive notions (viewing it as a sin). Participants also recognized the positive aspects of abortion, such as its role in reducing maternal mortality ratios and improving child health. The study identified factors influencing abortion decisions like the desire to limit family size, entrenched gender dynamics with strong son preference, and pregnancies resulting from relationships outside marriage. Furthermore, abortion was also perceived as a solution for pregnancies arising from rape, incest, or with fetal disabilities. Participants shared a range of consequences associated with abortion, including prevalent misconceptions. They indicated that modern abortion practices like the use of abortion pills were on the rise compared to traditional methods. Nevertheless, unsafe self-medication remained a concern, particularly among rural women.

Conclusions: To address these challenges effectively, it is imperative to understand the underlying reasons behind these perceptions and develop targeted interventions that enhance women's access to safe abortion in Nepal.