ABSTRACT
Background and Aims
In Nepal, abortion was legalized in 2002; however, national-level evidence on the factors influencing abortion practices remains limited. This study explored the predictors of induced abortion among women of reproductive age in Nepal using data from the most recent nationally representative survey.
Methods
We analyzed data from the 2022 Nepal Demographic and Health Survey (NDHS), which employed a nationally representative design. The analytic sample consisted of 14,845 women aged 15–49 years. Descriptive statistics were calculated, and associations were examined using the Rao–Scott chi-square test. Adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) were estimated through multivariable Poisson regression to identify determinants of abortion.
Results
Overall, 19% of women reported having ever terminated a pregnancy. The prevalence of abortion was higher among women aged 45–49 years (aPR = 5.009, 95% CI: 3.437–7.302, p < 0.001), those with only basic education (aPR = 1.181, 95% CI: 1.075–1.298, p = 0.001), women with six or more children (aPR = 4.024, 95% CI: 2.950–5.490, p < 0.001), frequent internet users (aPR = 1.141, 95% CI: 1.026–1.270, p = 0.015), and women who listened to radio weekly (aPR = 1.115, 95% CI: 1.021–1.218, p = 0.015). In contrast, reduced prevalence was observed among women from poorer households (aPR = 0.838, 95% CI: 0.741–0.947, p = 0.005), those watching television once weekly (aPR = 0.874, 95% CI: 0.794–0.961, p = 0.006), and Buddhist women (aPR = 0.792, 95% CI: 0.679–0.924, p = 0.003).
Conclusions
Induced abortion remains relatively common in Nepal. Key determinants include maternal age, parity, education level, household wealth, religious affiliation, and media exposure. To reduce reliance on abortion and improve reproductive health outcomes, policies should expand access to modern contraceptives and comprehensive reproductive health services. Interventions must particularly prioritize older and multiparous women, those with limited education, and women from socioeconomically disadvantaged backgrounds who may face barriers to contraception and safe services, alongside populations highly exposed to internet and radio platforms.