KATHMANDU, NEPAL – Inside a dark corner room in a house on a busy street in Nepal's capital, Kathmandu, Bhagwati Sharma lies listlessly on a red blanket on a small bed. A 5-watt bulb in a fluorescent lamp casts a dim light on her as she watches a folk music video on a clunky television set.
Sharma says she is in the second month of her pregnancy and she is anxious.
“I hope it’s a son this time,” she says.
In Nepal, economic, cultural and religious practices make sons more desirable than daughters. While many families repeatedly conceive in hopes of having a son, others resort to sex-selective abortion. Abortion was legalized here in 2002, and, as a result, the practice has become safer. Sex-selective abortion remains illegal, but the procedure is common. Many women here admit to having multiple abortions after ultrasounds reveal the sex of the fetus. Pregnant women like Sharma are trapped by societal pressures that demand sons but frown on abortion and give women little say in the use of contraceptives.
Sharma is lean and petite. She is wearing a red blouse, a matching lungi – a garment worn around the waist – and a shawl. A red vermilion line of sindoor – a red powder applied to the part in a woman’s hair – marks her brow. Her eyes are dull, and her arms and legs bear pronounced blue veins. She is weak. She says she is “suffering the nauseating fits of pregnancy.”
“More than my physical condition, I’m bothered by the thought of the sex of the child inside me,” she says. “What if it’s a girl and I have to undergo abortion again?”
Sharma says she is in her late 30s. She hails from Nepal’s southeastern district of Jhapa, some 500 miles from the capital city. She is the mother of two daughters. Her oldest daughter is married and recently gave birth to a baby girl, making Sharma both a grandmother and an expecting mother.
Sharma says she has had five abortions in the past three years. When a doctor informed her that the baby inside her womb was female, she says she and her husband, Krishna Prasad, 58, made the choice to abort.
“This is my seventh pregnancy,” the mother of two says.
Sharma used to work as a cleaning woman but was forced to quit her job last year because she said she was too weak from the repeated abortions.
“For the want of having a son, my health and physical strength have deteriorated,” she says. “I have no option since everyone is pressing me to bear a son.”
In Nepal, sons are considered to be more economically viable than daughters, says Prakash Rai, a social scientist. He says that because of poverty, illiteracy and social practices, such as the dowry tradition, women in Nepal do not have equal value in society. The emphasis on men, he says, stems from the patriarchal family system and the primary religion here, Hinduism, which grants more authority to men.
“Our society does not give importance to daughters,” Rai says.
Sharma’s husband is a taxi driver. Sharma is his second wife. He says he fathered five daughters with his first wife, Manjari, but left her because she could not give him a son. He says a visit to a fortune-teller informed him that his wish to have a son would be fulfilled only if he married a woman 20 years his junior. So he left Manjari and married Sharma, a decision he says was endorsed by his friends, family and even Manjari.
“I married Bhagwati for the want of a son,” he says. “Everyone wanted me to.”
So when Sharma’s first child was a girl, Prasad says the whole village was disappointed.
When Sharma had a second daughter, he says the humiliation was too much to bear. So he moved with Sharma and their two daughters to Kathmandu. Prasad says the desire to have a son continued to churn inside him. As the father of seven daughters by two wives, he says he was overjoyed to learn that in Kathmandu a machine existed that could determine the sex of the baby before it was born. From then on, Prasad and Sharma began their routine of conceiving and aborting babies after the sex was revealed.
“There is no point having another daughter, so we’ve been resorting to abortion every time we find a girl child is inside my wife's womb,” Prasad says.
Sharma says she is very nervous because her next ultrasound is in just a few days.
The decision to abort when the gender of the fetus is female is becoming increasingly popular here. Gayatri Sah lives in the Lalitpur district south of Kathmandu. She admits to having “numerous” abortions after learning that the gender of the fetus was female. She and her husband already have two daughters, which she says will eventually become a financial burden on the family.
“Too many daughters will prove [to be] a burden when they reach marrying age,” Sah says. “We cannot afford dowries, so it is best we try for a son while we could and not repent in the future.”
Sex-selective abortions are rising every day in Nepal. The United Nations Children’s Fund, UNICEF, estimates that 20 percent of the more than 70,000 abortions that take place in Nepal each year are carried out by women who prefer a son to a daughter.
Abortions on the Rise
Om Hospital and Research Center in Kathmandu is one of the most expensive and well-equipped medical facilities in the country. Dr. Bhola Rijal, the hospital chief, says they perform 100 abortions, on average, every month. Rijal says the hospital does not perform abortions on the basis of gender.
“If patients go to other heath institutions to determine the baby’s sex and come to us for a safe abortion then we cannot help that, but here we do not practice any kind of prejudice,” he says.
In 2002, Nepal made abortion legal during the first trimester of pregnancy. But the law states that the “aborting period” can be extended with a doctor's recommendation. To date, 245 health care institutions across the country have received government permission to perform abortions. Hospitals and health centers typically charge between 1,000 and 1,600 rupees, or $20-$35 USD, for the service. Om Hospital and Research Center charges 6,000 rupees, or $130 USD, for the procedure for fetuses up to 20 weeks old.
“With the necessary tools and medicines at hand, an abortion could be conducted within half an hour and the mother could return home without having to stay for [an] observation period,” he says.
But despite the legalization of abortion, many health care providers here say they are against the procedure. Dr. Shilu Aryal says abortion is very dangerous. If not done properly, there is a chance of infection, bleeding and damage to the mother. She says that in some cases, the procedure can be fatal.
“Abortion is not always safe, so it is best not to have it at all,” she says.
According to a study by the Family Planning Association of Nepal, one in every three women in the country is aware of abortion law and the facilities that perform safe abortions.
Sushma Baidyawar Rayamajhi, a senior community nurse administrator at the national Family Health Division, says that before legalization in 2002, abortion was often deadly, as women used to abort their unborn babies in secret. With the relaxation of abortion law, the abortion rate rose significantly. Today, an estimated 70,000 legal abortions are carried out in Nepal each year. Despite the legalization of abortion, Rayamajhi says many of these abortions are illegal because they are sex-selective.
“We’ll have a dearth of [the] female population this way,” Rayamajhi says.
Prenatal sex determination for the purpose of sex-selective abortion is illegal in Nepal. A doctor found guilty of performing or facilitating a sex-selective abortion can receive up to a year in prison. Existing abortion law also prohibits providing ultrasound scans to reveal the sex of the fetus if doctors suspect that the client may abort the fetus as a result of that knowledge.
“But people find their ways and abort the female fetus,” Rayamajhi says.
During her 32-year career in the health sector, Rayamajhi has served in all 75 districts of the country. Based on her experience, she says that the rate of illegal abortion is alarmingly high in Nepal.
Dr. Anand Shrestha of Om Hospital and Research Center says that the gender of a fetus could be determined after eight weeks inside the mother’s womb. The easiest and cheapest procedure for knowing a baby’s gender is through an ultrasound, and Shrestha says he meets many couples eager to discover the sex of their child.
“We have a strict policy of keeping the baby’s gender a secret, but there are many health institutions in the country,” Shrestha says. “Our effort alone cannot control illegal abortion.”
Efforts and punishments remain minimal, in part because advocates say many women are receiving ultrasounds in India. Sharma says she frequents Siliguri, an Indian city on Nepal’s border. Sah says she received her ultrasound and abortion in Gorakhpur, another Indian city on the border.
“Once they learn that the baby inside the womb is a girl, they go and abort the child,” Rayamajhi says.
Sah says she gets an ultrasound to learn the sex of the fetus in one hospital, then she goes to the other hospital for the abortion to avoid suspicion.
“Those doctors ask lot of questions so I keep on switching the hospitals,” Sah says.
Reproductive Decisions Remain Elusive for Women
Nepali women are largely deprived of decision-making roles when it comes to family planning. Married women are generally not allowed to use contraceptives without the approval of their husbands and families. So the cultural impact of sex-selective abortion here is interesting, says Rai, the social scientist.
Nepali society does not condone abortion, and Hindu religion, the most prominent in Nepal, considers abortion immoral. A survey conducted by the Network for Addressing Women’s Reproductive Rights in Nepal last year found that 56 percent of the country’s population thinks abortion is against Hinduism. So despite the rise in abortions here, the taboo forces women to keep their abortions a secret.
Sharma says she has not told anyone that she has had five abortions; it is a secret between her and her husband. But with her sixth ultrasound scheduled in just a few days, she says that her body is too tired and weak for another abortion, yet she has to go through with it.
Because the issue remains taboo and little discussed, few organizations are bringing awareness to sex-selective abortion here. One small organization called Jain Shwetamber Terapanth Mahila Mandal is made up of a group of women who campaign against abortion in various parts of the country. Led by Usha Naulakha, the organization held rallies against the abortion of female children in the districts of Nepalgunj, Biratnagar, Birgunj and Kathmandu last year. As a part of the campaign, the activists also offer counseling for the couples who have resorted to abortion in pursuit of a son.
For Sharma, counseling is not an option. Prasad has seven daughters and says he will not tolerate an eighth. The stress of waiting for her next ultrasound is wearing on Sharma.
“Of late, I’ve developed a fear of doctors,” she says. “If the [fetus] is a daughter this time as well, I think I might die during abortion.”
Sharma curses God for not placing a baby boy in her womb.
“My life could end for the want of having a son,” she says.
