Abstract
BackgroundDespite liberalization of the Nepal abortion law, young women continue to experience barriers to safe abortion services. We hypothesize that marital status may differentially impact such barriers, given the societal context of Nepal.MethodsWe evaluated differences in reproductive knowledge and attitudes by marital status with a probability-based, cross-sectional survey of young women in Rupandehi district, Nepal. Participants (N = 600) were surveyed in 2012 on demographics, romantic experiences, media habits, reproductive information, and abortion knowledge and attitudes. We used logistic regression to assess differences by marital status, controlling for age.ResultsParticipants, who comprised never-married (54%) and ever-married women (45%), reported good access to basic reproductive health and abortion information. Social desirability bias might have prevented reporting of premarital romantic and sexual activity given that participants reported more premarital activities for their friends than for themselves. Only 45% knew that abortion was legal, and fewer ever-married women were aware of abortion legality. Never-married women expected more negative responses from having an abortion than ever-married women.ConclusionsFindings highlight the need for providing sexual and reproductive health care information and services to young women regardless of marital status.
Highlights
Despite liberalization of the Nepal abortion law, young women continue to experience barriers to safe abortion services
The survey was developed in English and translated into Nepali before being pretested with approximately 20 young women from a nearby geographic area, who were expected to be similar to the target population
Study sample We visited a total of 805 households, of which 611 households had at least one woman 16–24 years of age
Summary
Despite liberalization of the Nepal abortion law, young women continue to experience barriers to safe abortion services. Abortion accounted for an estimated 14% of maternal deaths at health care facilities in 2008–2009 [4], which underscores that even in settings where abortion is legal, women may resort to unsafe procedures. Young women who obtain abortion care tend to access it later in pregnancy than older women [6] and are more likely to delay seeking help for abortion-related complications [7]. These delays likely are attributable, at least in part, to stigma surrounding adolescent sexuality [8,9,10].
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