In the quiet corridors of a district court in Siraha on 8 Feb 2026, a verdict brought a fragile sense of justice to a woman known here as Kalpana.

Months earlier, in late 2025, Kalpana arrived at a local hospital suffering from a painful miscarriage. Instead of receiving immediate care, she was met with suspicion. Hospital staff contacted police, and she was arrested from her hospital bed on suspicion of inducing an illegal abortion.

For months, Kalpana fought the case while recovering from the physical and emotional trauma of pregnancy loss. The court eventually ruled that her miscarriage was a natural biological event and cleared her of all charges. But the consequences remained.

She had spent months in detention, her privacy exposed and her reputation damaged in her community. Her case has since drawn attention from reproductive health advocates who say it reflects deeper legal contradictions surrounding abortion in Nepal.

A Legal Paradox

Nepal is often described internationally as one of South Asia’s more progressive countries on reproductive rights. Abortion was legalized in 2002, and the Safe Motherhood and Reproductive Health Rights Act expanded protections for women seeking reproductive healthcare.

Under the law, abortion is allowed on request up to 12 weeks of pregnancy, up to 28 weeks in cases of rape or incest, and later if the pregnancy poses risks to the woman's health or involves severe fetal anomalies.

However, abortion-related offenses still exist within the National Penal Code, creating what activists describe as a legal contradiction.

“The law recognizes abortion as a right in certain situations, but it also retains criminal penalties,” said reproductive rights advocates. “This ambiguity often leads to confusion among police, healthcare workers, and local officials.”  As a result, cases like Kalpana’s continue to surface.

Geography and Access

Access to abortion services varies widely across Nepal. While clinics in cities such as Kathmandu offer relatively accessible care, women in remote provinces face significant barriers.

A 2025 report from Nepal’s Ministry of Health found that in districts such as Kalikot District and Bajura District, more than 60 percent of health posts lacked trained providers for second-trimester abortion services.

 In remote areas, geography and poverty can delay access to care. A woman living in a mountainous village in Jajarkot District may need days to reach a facility. By the time she arrives, she may already be beyond the 12-week window for abortion on request.

According to estimates by the Guttmacher Institute and Nepal’s Center for Research on Environment Health and Population Activities, nearly 58 percent of abortions in Nepal still occur outside approved health facilities.

Health experts say such circumstances often push women toward unsafe methods.

In September 2024, for example, a 22-year-old woman in Nepalgunj was hospitalized with severe infection after using an herbal remedy to terminate a pregnancy. She had reportedly been turned away from a government hospital because she was already 13 weeks pregnant and did not qualify under the existing legal exceptions.

Fear Among Health Workers

Legal ambiguity also affects healthcare providers. Although the Safe Motherhood and Reproductive Health Rights Act does not require a police report for abortion services, some doctors and nurses still request police involvement in sensitive cases.

Advocates say this stems from concern that providers themselves could face criminal liability under provisions of the penal code. The issue extends to pharmacists as well.

In July 2025, authorities conducted a sting operation in Butwal, arresting three pharmacists accused of illegally selling medical abortion pills. While officials say such actions are intended to regulate medications, reproductive health groups warn that criminalizing pharmacy access may limit safe and affordable options for women.

The Rights Debate

At the center of the debate is a broader question of bodily autonomy.

Pregnancy is a complex medical and personal process involving significant physical and emotional changes. Supporters of decriminalization argue that decisions about continuing or terminating a pregnancy should remain within the healthcare system rather than the criminal justice system.

A 19-year-old student from Lalitpur, who spoke anonymously, described the stigma many women still face. “The law says I have a right, but society still treats it like a crime,” she said. “If I cannot decide what happens in my own body, then what kind of right is it?”

 A Landmark Court Decision

Much of Nepal’s current abortion policy traces back to the landmark Lakshmi Dhikta v. Government of Nepal ruling.

In that decision, the Supreme Court of Nepal held that access to abortion services should not be limited by financial barriers and recognized reproductive healthcare as a fundamental right.

The court also warned that forcing a woman to continue an unwanted pregnancy could amount to cruel or degrading treatment. However, many advocates say the decision’s broader principles have not been fully reflected in Nepal’s criminal law framework.

Global Context

Globally, abortion laws have been shifting.

Countries such as Argentina legalized abortion in 2020, while courts in Mexico moved toward nationwide decriminalization in 2023. Ireland liberalized its abortion laws in 2018 following a national referendum.

The World Health Organization updated its abortion care guidelines in 2022, recommending that countries remove criminal penalties related to abortion and focus on healthcare-based regulation.

At a regional health summit in Bangkok in Nov 2025, some experts cited Nepal’s overlapping legal framework as an example of the challenges created when abortion laws exist simultaneously within health legislation and criminal codes.

Calls for Reform

Reproductive rights advocates say reform could include several steps. One proposal is removing abortion-related penalties from the penal code entirely and regulating the procedure solely under healthcare legislation.

Others call for improved access to trained providers in rural districts, clearer legal guidance for healthcare workers, and nationwide public awareness campaigns about reproductive health rights. For many advocates, the goal is ensuring that women seeking care are treated first and foremost as patients.

Kalpana’s case in Siraha, they say, illustrates the consequences when healthcare and criminal law collide.

As debates continue in Nepal’s legal and political circles, the question remains whether the country’s reproductive rights framework will evolve further—or continue to operate within the contradictions that led to cases like hers.