KATHMANDU, April 13: Sex-selective abortions are reportedly rampant. The negative impacts of such abortions have manifested in the recently concluded national census 2022, with a decreasing number of baby girls as opposed to boys. Out of the total 412,935 newborns, 218,074 account for boys (52.8 percent), and 194,861 girls (47.3 percent), according to the census. 

The number of male births is increasing as compared to female births. Naturally, the sex ratio at birth is around 105 newborn boys for every 100 girls, which is a sex ratio at birth of 1.05. But as the age advances, the ratio favors females due to the relatively high mortality rates of males. According to a study carried out in 12 districts of Nepal, the ratio is more than 110 newborn boys per 100 girls. In Arghakhanchi district, the ratio has dramatically surged to 127 boys for every 100 girls. 

In Bhaktapur, the ratio is 123 newborn boys per 100 girls, 117 boys for 100 girls in Kaski, 114 boys in Lalitpur and Palpa each, 113 boys in Kathmandu, Kanchanpur and Rupandehi each, 111 boys in Gulmi and Saptari each, and 110 boys in Jhapa and Parbat each.  

According to doctors, the tendency of parents is that they do not go for a second child if their firstborn is a son, but if their firstborn is a girl, they just opt for the determination of the sex of the fetus of their next baby. Generally, they go for an abortion if the fetus is a girl. 

Abortion services have now been at the accessible reach of the general public that may get a boost in illegal abortions, they said. A widening gap in the number of girls and boys is blamed for factors including sex-selective abortions, and a decrease in the fertility rate, said demographers. This widening gap in the sex ratio could create gender imbalance in the long run, they warned. 

The Safe Maternity and Reproductive Health Act, 2075 BS and the National Criminal Code, 2074 BS have criminalized sex-selective abortion. Section 17 of the Act stipulates that pregnant women should not be forced into the identification of the sex of the fetus under any forms of pressure, intimidation, terror or under any influence and deception. 

Sex-selective abortions are illegal in Nepal and are criminalized. Forcing pregnant women into sex-selective abortions is subject to one to five years in prison and fines depending on the stage of pregnancy. Coercing pregnant women into sex selective abortions up to 12 weeks is punished by one year of imprisonment and Rs 100,000 in fines, between 12 and 25 weeks three years in prison and Rs 300,000 in fines, and above 25 weeks five years of imprisonment and Rs 500,000 in fines. 

Director of the Paropakar Maternity and Women's Hospital Dr Paban Jung Rayamajhi demanded action against those behind sex-selective abortions. "Sex-selective abortions should face action except under the conditions allowed by the law. There is a need to monitor and regulate the illegal activities at the federal, provincial and local levels," he said. He stressed the need for creating awareness about gender equalities. 

"We have heard that sex-selective abortions are taking place in private health institutions. The government should monitor and regulate it," he said.  According to him, 1,200 pregnant women underwent safe abortions in the previous fiscal year, 2021/22. Sex identification can take place in the conceivable period of 12 and 14 weeks, he said, adding that abortions cause physical and mental health problems in women. 

Sunalaxmi Karmacharya, a senior community nursing officer at the Gender Equality and Social Inclusion Section under the Ministry of Health and Population, said gender disparity has resulted in the preference of sons over daughters, leading to sex-selective abortions. "Our society still prefers sons. Sex-selective abortions are taking place rampantly. This has resulted in the comparatively low number of girls," she said. 

The constitution has legalized safe abortions through the Safe Motherhood and Reproductive Rights Act, 2018 which stipulates various five conditions for safe abortions. According to the Act, a pregnant woman has the right to seek safe abortion under the following conditions: 

Up to 12 weeks of pregnancy with the consent of the pregnant woman, 

Up to 28 weeks of pregnancy with the consent of the concerned woman, if an abortion is not performed, there may be danger, according to a licensed physician involved, to the life of the pregnant woman or her physical or mental health may deteriorate or a child born will be impaired. 

Up to 28 weeks of pregnancy with the consent of the pregnant woman in case the conception is a result of rape or incest.

Up to 28 weeks of pregnancy with the consent of the pregnant woman who is infected with a virus that deteriorates the immunity system like HIV or suffering from any similar incurable diseases. 

Up to 28 weeks of pregnancy with the consent of the pregnant woman, if the fetus, due to fetal impairments, is likely to become non-viable or unlikely to survive after birth or become deformed due to any genetic disorder or any other reasons according to the health provider involved. 

The government has set a goal of ending sex-selective abortions by 2030 by bringing and implementing a 10-year national strategy. 

It has also brought and implemented many other policies, plans and programs in this regard. With the implementation of the strategy at all the three levels - federal, provincial and local - sex-selective abortions would gradually come to an end, according to undersecretary of the Ministry Roshani Karki. "The figure of sex-selective abortions was higher in Vietnam and Georgia in the past. Now, this has eased in these countries after providing opportunities to girls as well," she said. 

The Nepali society should be ready to end gender disparities, she said, adding that monitoring could in part help control sex-selective abortions. 

Doctors involved should not ask parents for the selection of the sex of the fetus in the name of safe abortions, according to Karki. 

"Abortions should take place only in the conditions allowed by the law. Health institutions providing abortion services should specify that they provide safe abortions and do not resort to the identification of the sex of the fetus," she said.

 
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