Young Women's Health Seeking Behavior and Abortion Experiences in Nepal

Background: Abortion has been legal in Nepal since 2002, giving all women the right to induced abortion up to 12 weeks of pregnancy. However, young women are still not likely to access abortion care through the official health sector. This descriptive study explores the ways young women access safe and legal first trimester induced abortion services and identifies opportunities for community outreach. Methods: Data were collected from a cross-section of women presenting for first trimester induced abortion at three facilities purposefully selected to represent urban/rural and public /private variation. Eligible women were recruited during their initial visit and had a follow-up interview approximately 4 weeks later. The response rate was 80% (231/289); 30% of respondents were young women under the age of 25. Results: Young women had higher literacy than older women (94% of youth could read or write compared to 73% of older women). Disadvantaged castes/ethnic groups comprised 63% of young women, as compared to 47% of older women. Young women (80%) were also less likely than others (93%) to identify themselves as the main decision-maker to have the abortion or to choose the facility or provider. When asked about their preferred method of receiving abortion information, 79% of young women selected television, as compared to 64% of adults. Conclusions: Strategies for improving abortion access and care to young women must take into account the lack of agency experienced by Nepal's youth. In addition, abortion-related information targeting younger women could be targeted through the preferred medium of television.