Abstract
Background
Sex-selective abortion is expressly prohibited in Nepal, but limited evidence suggests
that it occurs nevertheless. Providers' perspectives on sex-selective abortion were
examined as part of a larger study on legal abortion in the public sector in Nepal.
Methods
In-depth interviews were conducted with health care providers and administrators providing
abortion services at four major hospitals (n = 35), two in the Kathmandu Valley and two in outlying rural areas. A grounded theory
approach was used to code interview transcripts and to identify themes in the data.
Results
Most providers were aware of the ban on sex-selective abortion and, despite overall
positive views of abortion legalization, saw sex selection as an increasing problem.
Greater availability of abortion and ultrasonography, along with the high value placed
on sons, were seen as contributing factors. Providers wanted to perform abortions
for legal indications, but described challenges identifying sex-selection cases. Providers
also believed that illegal sex-selective procedures contribute to serious abortion
complications.
Conclusion
Sex-selective abortion complicates the provision of legal abortion services. In addition
to the difficulty of determining which patients are seeking abortion for sex selection,
health workers are aware of the pressures women face to bear sons and know they may
seek unsafe services elsewhere when unable to obtain abortions in public hospitals.
Legislative, advocacy, and social efforts aimed at promoting gender equality and women's
human rights are needed to reduce the cultural and economic pressures for sex-selective
abortion, because providers alone cannot prevent the practice.
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Biography
Prabhat Lamichhane, MSc, is a Research Associate at Center for Research on Environment Health and Population Activities (CREHPA), Kathmandu, Nepal. His work focuses on maternal and reproductive health and gender-based violence research.
Biography
Tabetha Harken, MD, MPH, is an Assistant Professor in the Department of Obstetrics & Gynecology at the University of California, Irvine. Her most recent work focuses on increasing the use of long-acting reversible contraception in adolescents.
Biography
Mahesh Puri, PhD, is Associate Director at the Center for Research on Environment Health and Population Activities (CREHPA), Kathmandu, Nepal. His recent research focuses on reproductive health and rights.
Biography
Philip Darney, MD, MSc, is a Distinguished Professor in the Department of Obstetrics, Gynecology & Reproductive Sciences at the School of Medicine at University of California, San Francisco, and a founding director of the Bixby Center for Global Reproductive Health.
Biography
Maya Blum, MPH, is a Project Director at the UCSF Bixby Center for Global Reproductive Health. She has extensive experience designing and implementing reproductive health research studies in the United States and internationally.
Biography
Cynthia C. Harper, PhD, is an Associate Professor in the Department of Obstetrics, Gynecology & Reproductive Sciences at the School of Medicine at University of California, San Francisco, and a faculty member of the Bixby Center for Global Reproductive Health. Her research focuses on the impact of health policies and individual behaviors on reproductive health outcomes, specifically in the areas of contraception and sexually transmitted infections (STIs), including HIV.
Biography
Jillian Henderson, PhD, MPH, is an Assistant Professor in the Department of Obstetrics, Gynecology & Reproductive Sciences at the School of Medicine at University of California, San Francisco, and a faculty member of the Bixby Center for Global Reproductive Health. She conducts research on women's access to health care, contraception, and reproductive health.
Article info
Publication history
Accepted:
February 2,
2011
Received in revised form:
January 7,
2011
Received:
October 25,
2010
Footnotes
The authors acknowledge funding from an anonymous donor that made this study possible.
Identification
Copyright
© 2011 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.
