Effects of Abortion Legalization: Complications Treated at a Tertiary Care Center in Kathmandu, Nepal 2001-2007

Jillian T. Henderson, University of California, San Francisco
Kasturi Malla, Parokapar Hospital for Obstetrics and Gynaecology
Ashma Rana, Tribhuvan University
Mahesh Puri, Center for Research on Environment Health and Population Activities (CREHPA)
Cynthia C. Harper, University of California, San Francisco
Maya Blum, University of California, San Francisco
Bishnu Choulagai, Center for Research on Environment Health and Population Activities (CREHPA)
Philip Darney, University of California, San Francisco

Abortion was broadly legalized in Nepal in 2002, and the policy implemented in 2004. Before legalization, abortion was treated as a criminal offense resulting in the imprisonment of women; the dramatic policy shift has the potential to reduce morbidity and mortality from unsafe abortion. This study examines the trend in abortion complications treated at a large maternity hospital in Kathmandu. Patient hospital charts were retrospectively abstracted for all women admitted to the hospital with symptoms, medical complications, or death from abortion during the years 2001-2007. To test the trend in the number and severity of abortion cases treated over the study period, we will analyze all abortion cases (over 10,000), coded for severity. The trend analysis will be adjusted for changes in hospital access, fertility, and contraceptive use. Interpretation of the trend, limitations of the study, and advocacy and policy implications will be discussed.