AWARENESS REGARDING ABORTION AMONG REPRODUCTIVE AGE GROUP WOMEN: A STUDY FROM KAILALI, NEPAL

AWARENESS REGARDING ABORTION AMONG REPRODUCTIVE AGE GROUP WOMEN: A STUDY FROM KAILALI, NEPAL

Anita Kumari Bohara, Nirmala Neupane

1. Research Scholar, School of Health and Allied Sciences, Pokhara University

Abstract

Introduction: Abortion is the termination of pregnancy before fetal viability. Despite legalization of abortion in Nepal and the nationwide availability of Comprehensive Abortion Care (CAC), unsafe abortions still contribute 7% of maternal deaths. Although the law permits abortion under various conditions, many women remain unaware of their rights and available services. This study aims to assess the awareness regarding abortion among women of reproductive age group women.

Methodology: A cross-sectional descriptive research design was carried out for this study. A total of 108 women of reproductive age were selected using simple random sampling. Data were collected through a structured face to face interview schedule and analyzed using Statistical Package for Social Sciences (SPSS) version 16 using descriptive and inferential statistics.

Results: More than half 58.3% of the respondents had a moderate level of Awareness regarding abortion. Almost one third (32.4%) of the respondents had low level of Awareness, while only 9.3% demonstrated a high level of Awareness.

 Conclusion: More than half of the respondents had moderate level of Awareness, nearly one third of the respondents had low level of Awareness, while nearly one in ten respondents demonstrated high level of Awareness regarding abortion These results highlight the need for targeted awareness programs to improve comprehensive understanding of abortion-related issues among women of reproductive age.

Keywords: Abortion, Abortion policy, Awareness, Reproductive age women

Corresponding Author

Nirmala Neupane 

School of Health and Allied Sciences, Pokhara University

Received: 27/03/2026

Revised: 04/04/2026

Accepted: 16/04/2026

DOI: http://doi.org/10.66204/GJPSR-553-2026-2-4-3

Copyright Information 

© 2026 The Authors. This article is published by Global Journal of Pharmaceutical and Scientific Research.

How to Cite

Neupane N, Bohara AK,  Awareness regarding abortion among reproductive age group women: a study from Kailali, Nepal. Global Journal of Pharmaceutical and Scientific Research. 2026; 2(4):553–565. ISSN: 3108-0103. http://doi.org/10.66204/GJPSR-553-2026-2-4-3

1. Introduction

Abortion is the expulsion of the product of conception before time of fetal viability that is before 22 weeks of gestation and weigh less than 500 grams and unsafe abortion is a noteworthy cause of maternal mortality and morbidity globally (Gyawali et al., 2020). Nepal reported the high maternal mortality ratio of 281 deaths per 100,000 live births, attributable to pregnancy related complication, and 7% maternal death related to unsafe abortion. An abortion can occur spontaneously in which case it is usually called a miscarriage, or it can be purposely induced. The term abortion most commonly refers to the induced abortion of a human pregnancy and most abortions result from unwanted pregnancies (Bamiyan and Verma, 2018).

Nepal legalized abortion in 2002, passed a procedural law in 2003 and in March 2004, the first CAC services were offered at the Paropakar Maternity and Women’s Hospital, Thapathali, Kathmandu (Ojha and Silwal, 2018). The abortion law permits to terminate pregnancy up to 12 weeks of gestation with pregnant woman’s agreement. Up to 28 weeks of gestation are allowed in cases of rape or incest, if the woman is HIV positive or suffers from an incurable illness, in cases of fetal deformity and to save woman’s life with recommendation of licensed doctor with consent of woman (Right to Safe Motherhood and Reproductive Health Act, 2018).

Women’s reproductive rights are now acknowledged as essential human rights, and abortion is protected by the constitution (Wu et al., 2017). Among 10–50% of women who undergo unsafe surgical abortions need medical care for complications and most common complications are incomplete abortions, infections (sepsis), hemorrhages and injuries to internal organs such as perforation of the uterus. Long term health problems include chronic pain, pelvic inflammatory disease and infertility (Bamiyan and Verma, 2018).

Abortion was legalized under specified conditions in March 2002 in Nepal but still a large proportion of population is unaware of the abortion (Adhikari, 2016). Law of Nepal permit abortion up to 12 weeks of gestation for any woman above 16 years on her request. For women under 16 years of age consent is required from guardian. Abortion is also permitted up to 18 weeks’ gestation if the pregnancy is the result of rape or incest, and at any time on the advice of a medical practitioner if the life or health of the woman is in danger or the fetus is seriously deformed or has a condition that is incompatible with life (Adhikari et al., 2019).

Abortion is one of the five leading causes of maternal death in the developing world and other causes includes obstructed labour, hypertensive disorder during pregnancy, hemorrhage and infection (Tuladhar and Risal, 2010).

Nepal reported the maternal mortality ratios of 281 deaths per 100,000 live births, attributable to pregnancy related complication, and 7% maternal death related to unsafe abortion and most abortions result from unintended pregnancies (Bamiyan and Verma, 2018). Many women who are unaware of the law are nonetheless likely to turn to unsafe abortion practice due to their desire to keep the abortion secret out of concern for legal and social sanctions so that women are not likely to benefit from the legal reform and services on safe abortion (Right to Safe Motherhood and Reproductive Health Act, 2018).

Access to safe, legal abortion is a fundamental right of women and various reasons for seeking abortion reported ranges from proximate causes such as the desire to limit family size or space pregnancies, preference for a son, medical reasons to distal determinants such as poverty, violence, and belief system (Yogi et al., 2018).

2. MATERIAL AND METHODS 

A community-based descriptive cross-sectional study design was employed to assess the level of awareness regarding abortion among reproductive age group women of Godawari Municipality Kailali, Nepal. The study was conducted in ward number 1,2,4,5 of Godawari Municipality Kailali, Nepal. A total of 108 women of reproductive age were selected using probability simple random sampling. Data were collected through a structured face to face interview schedule and analyzed using Statistical Package for Social Sciences (SPSS) using descriptive and inferential statistics

2.1 INCLUSION CRITERIA

 The inclusion criteria included: The women of reproductive age group (18-49) years residing in ward number 1,2,4, and 5 of Godawari Municipality and women who are willing to participate in the study was included in the study. The sample included all the female of age group 18-49 years from each family and who were available at the time of data collection and women who were willing to participate in the study.

2.2 DATA COLLECTION 

A validated structured interview schedule was used to collect the data. Data were collected through face-to-face interview technique using structured interview schedule after obtaining approval from Institutional Review Committee of Pokhara University. Subsequently when permission letter was obtained from concerned authority of the Godawari Municipality. One eligible respondent from each household was interviewed and if one household has more than one eligible respondent lottery method was applied to select one respondent. The objectives and purpose of the study was explained to the respondents and an informed consent was obtained. Each interview lasted 15 to 20minutes. The interviewer asked the questions to the respondents one by one and ticked the answers given by the respondents. Data was collected in separate places, and the privacy and confidentiality of the information were maintained.

2.3 STATISTICAL ANALYSIS 

Data was edited, coded, and entered in Epi-data version 3.1 with a validated command. All the entered data was transferred to the Statistical Package for Social Sciences (SPSS) version 16 program for further analysis. Data was analyzed by using descriptive statistics (as frequency, percentage, mean, and standard deviation), and an inferential statistical test was applied according to the nature of the data. The findings of the study are presented in tables. The chi-square test was used to find out the association between dependent and independent variables.

3. RESULTS 

The data depicted in table 1 shows that out of 108 respondents, maximum (35.2%) of respondents are 18-29 years of age. The minimum age of the respondents was 18 years, while the maximum age is 49 years, with a mean and standard deviation of 33.03±9.365 years. Regarding marital status, majority (81.5%), of the respondents were married. In terms of religion, all (100%) respondents were Hindus. With regards to ethnicity, about three fourth (73.2%) of the respondents belongs to Brahmin/ Chhetri group and more than half (59.3%) of respondents resides in nuclear family.

The data depicted in table 2 illustrate that out of 108 respondents, more than half (59.0%) of respondents has completed secondary level education while only (17.6%) of the respondents are illiterate. With regards to educational status of respondent's husband, (42.9%) has completed secondary level education, and only (3.4%) are illiterate.  Maximum (39.8%) of respondents were house makers, with regards to occupation of the respondent’s husband (35.4%) were engaged in farming. In terms of monthly family income, more than two-third (63.9%) of respondents earns between 10,000-40,000 rupees/ months, minimum income was 10,000 whereas maximum income is 2,40,000 rupees/months. All respondents (100%) reported that abortion services were available within one hour of travel distance.

The data depicted in the table 3 reveals that only (9.3%) of respondents has high level of Awareness and more than half of the respondents, (58.3%) has moderate level of Awareness regarding abortion. The highest score obtained was 46, while the lowest was 23. The mean Awareness score was 33.37.

The data depicted in Table 4 reveals that among 108 respondents, very few (11%), of the respondents, were able to correctly define the meaning of abortion, Regarding the most common causes of abortion (38%), responded correctly.   However, a majority percentage of respondents, (94%), correctly understood the meaning of safe abortion. Majority (88%), of respondent were familiar with unsafe abortion whereas most (70%) respondents were aware of induced abortion. Regarding the objective of the national safe abortion policy in Nepal, more than one third (38.9%), of the respondents provided the correct answer Similarly (39.8%) correctly identified the commonly used method of abortion.

The data depicted in table 5 shows that among 108 respondents Only (0.9%), respondent correctly identified the year abortion was legalized.  Regarding more than half (64.8%), of the respondents were aware maximum weeks for legal abortion. Majority (85.2%), of the respondents, were aware of abortion penalized. And more than half (68.5%) of the respondents were aware regarding punishment for   sex-selective abortions. Despite this, only (3.7%) of the respondents were aware regarding legal weeks of abortion for major fetal anomalies.  Only (13.9%) aware the legal abortion period for rape or incest case. More than half (60.2%), of the respondents correctly answered about who   can give consent if women is mentally incompetent, and majority (84.3%) of the respondents aware about   parental or guardian consent is required if the girl is under 18 years of age. Additionally (70.4%), of the respondents were aware of under    which condition abortion is prohibited in Nepal. Only (4.6%) respondents correctly identified the   legal abortion weeks for HIV or incurable disease. Nearly half (48.1%) respondent gave correct answer regarding disadvantage of legalization of abortion. Encouragingly, nearly all (99.1%), respondents correctly identified the appropriate steps of safe and legal abortion.

The data depicted in table 6 shows that among 108 respondents A majority (88.9%), of respondents understood the importance of post-abortion care for preventing infections and complications, nearly one in four (24.1%), of the respondents were aware regarding need to monitoring overall heath. Almost all (100%) of the respondents correctly identified  excessive bleeding as complication of unsafe abortion. Whereas less than one third (32.4%) of the respondents correctly identified psychological upset is the complication of unsafe abortion. Majority (97.2%) of respondents correctly identified action for post abortion bleeding. Majority (82.4%), of respondents emphasized strict implementation of abortion law and more than one third (36.1%) mentioned improving the availability of abortion service. Encouragingly, all respondents (100%), identified both birth control pills and condoms as effective methods to prevent unwanted pregnancy, and (88.0%) knew about intrauterine contraceptive devices (IUCDs).

The data presented in Table 7 indicates that there was a statistically significant association of level of awareness with selected variables; Age of respondent, educational level of respondent, educational level of husband, Occupation of spouse as its p-value <0.05. There are no association with other variable like Marital status, religion, ethnicity type of family, occupation of respondent, monthly family income as its p- value is >0.05.

Table 1: Distribution of Respondents Based on Socio-Demographic Characteristics (n=108)

Table 2: Socio-economic characteristics of Respondents (n=108)

Table 3: Distribution of Respondents According General Concept on Abortion                                                                                                                                                           n=108

Table 4: Distribution of Respondents Regarding General Concepts on Abortion.

                                                                                                                          n =108

Table 5: Distribution of Respondents regarding awareness on Abortion Policy (n=108)

Table 6: Respondents awareness regarding Post Abortion Care (n=108)

Multiple response*

Table 7: Association on Level of Awareness and selected demographic variables (n=108)

* =significant, p- value is <0.05 is considered statically significant.

4. DISCUSSION

This study was carried with the aim of assessing awareness regarding abortion among women of reproductive age residing in Godawari Municipality Kailali, Nepal. Women within the reproductive age group were included as study participants. The major findings of the study are as follows

The present study revealed that only 9.3% of the respondents had high level of awareness, 58.3%, had moderate level of awareness, and 32.4% had low level of awareness regarding abortion. This finding is supported by a study conducted in Jhapa, Nepal where the majority of women demonstrated a moderate level of knowledge regarding safe abortion practices10. 

Another Study conducted in Mozambique and South Africa reported contrasted result shows higher level of knowledge more than 70% of the respondents demonstrate good knowledge regarding safe abortion11. Similarly, a study conducted in India found that 65% of women had good knowledge, while 28% had average knowledge about abortion and its related services2. 

The current study also found that mass media was the primary source of information about abortion. This finding is supported by a study conducted in Pokhara, which showed that radio, television, and social media were major sources of abortion-related information6. 

Comparison with international studies further highlights variability. Studies conducted in Egypt, Nigeria, and Ghana revealed that women generally had moderate knowledge regarding safe abortion but limited understanding of legal provisions, which is consistent with the present findings12 13 . In contrast, studies from Bhutan and India showed higher awareness levels, likely due to stronger integration of reproductive health and legal education within national health programs. These differences may also reflect variations in policy implementation, health literacy, and cultural acceptance of abortion across countries9. 

Overall, this study indicates that respondents possessed a moderate level of knowledge regarding abortion, with only 9.3% demonstrating a high level of understanding. This finding is supported by studies conducted in Nepal and India, which reported similar moderate knowledge levels among women. In contrast, studies from Bhutan and Mozambique reported higher knowledge, likely due to stronger integration of reproductive rights education, structured awareness programs, and effective dissemination of information regarding safe abortion practices.

5. CONCLUSION

The study revealed that awareness regarding abortion among reproductive age group women is in moderate level. Only one respondent among ten had high level of awareness regarding safe abortion. Although awareness of safe abortion practices was relatively high, understanding of legal provisions and post-abortion care remained limited. Furthermore, significant associations were identified between knowledge levels and factors such as age of the respondents, educational attainment, and spouse’s occupation. These findings highlight the need for targeted educational and awareness programs aimed at enhancing women’s comprehensive understanding on abortion, including its legal, medical, and social dimensions, to promote informed reproductive health decisions.

6. LIMITATION 

The study was limited and confined only in 4 out of 12 wards of Godawari Municipality which may limit the generalization of the results.

7. Acknowledgements

The authors would like to express their sincere gratitude to all the researchers and institutions whose work has contributed to the development of this research. 

8. Conflict of Interest

The authors declare that there are no conflicts of interest regarding the publication of this review. 

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