Two months after Nepal's Parliament passed a progressive women's bill that recognises conditions under which abortion can be done, activists say real change can come only when the root causes that push women to take this step are addressed.

Activists point out that even though the bill is a major achievement in this South Asian society, the ban on abortion remains in force — and the lack of family planning services persists.

This, they say, still pushes women to seek clandestine abortions that are sometimes done by quacks or ill-trained health personnel, or performed under unhygienic conditions.

Laura Katzive, international programme staff attorney for the Centre for Reproductive Law and Policy (CRLP) in the United States, agrees that the bill signals Nepal's entry to the circle of nations that "advocate pro-choice".

But, she adds, ''the violation of the human rights of women will persist until the law is implemented, and women have access to safe abortions''.

Statistics indicate that six women die everyday in Nepal due to unsafe abortions.

This nation already has one of the highest maternal mortality rates in the world. About half of all maternal deaths in the country are attributed to unsafe abortions, compared to the global rate of 13 percent of maternal deaths traced to the same cause.

Complications due to unsafe abortions are among the leading causes for hospital admissions as well.

The Women's bill, which actually seeks to end all gender discriminatory laws in the Country Code, was supposed to help reverse such trends.

According to its provisions, abortion will be allowed if a woman requests it in the first 12 weeks of pregnancy or within 18 weeks in cases of rape or incest, as well as when a woman's life or health is in danger or the foetus is "impaired''.

At the same time, however, punishment awaits those who try to get rid of a foetus on the basis of its gender. Many families in Nepal prefer sons to daughters.

Family planning

The other factor that drives women to abortion is the lack of access to family planning methods — more than 60 percent of Nepali women still do not have access to them, although groups like the Family Planning Association have been in existence since 1956.

And while the government promotes and seeks to popularise the concept of smaller, healthier families though public campaigns, it is not able to meet the needed family planning services. This is turn drives women to clandestine and unsafe abortions.

Still, the mere fact that abortion would be legal under certain conditions would save many women's lives, say activists. They argue that at the very least, women could now go to properly trained doctors for it.

Dr Durga Pokharel, chair of Nepal's newly formed National Women's Commission, also says that a conditional legalisation of abortion gives victims of sexual abuse an option besides enduring a life of stigmatisation.

She notes that in cases of pregnancy resulting from rape or incest, ''the present law further victimises unprotected women''.

''(Our) lopsided definition of character — one for women and another for men — makes it impossible for women to live in this society if she abides by the law and decides to keep her foetus,'' says Pokharel.

But many observers and even some activists say it would not be wise to assume that legalising abortion would necessarily mean there would no longer be risky abortions in Nepal.

''An act alone is not sufficient to ensure safe abortions,'' points out Dr Nirmal K Bista, director general of the Forum for Women's Law and Development (FWLD). ''We require by-laws, a medical code of conduct, and well-trained medical staff to effectively implement such legislation.''

''Legalising abortion is the first step,'' agrees Dr Aruna Uprety, a reproductive rights campaigner. ''But don't expect improvements overnight.

It has to be socially accepted, too. And there should be safe access. In India, where abortion was legalised in the 70s, there are still seven unsafe abortions for every safe one.''

To prevent a replication of what is happening in countries such as India, some non-government organisations are already preparing this early for abortion becoming legal in Nepal.

The Family Planning Association of Nepal (FPAN), for example, is currently doing surveys of its existing facilities, equipment and location and lay-out of its outreach clinics around the country.

One concern is that even legal abortions would be out of reach of Nepal's teeming poor. As it is, women in poor, rural areas often resort to quacks or unsafe methods like inserting glass, sticks, cow dung, or massaging the stomach to get rid of unwanted foetuses.

In comparison, their better-off counterparts in the cities pay anywhere from 7,000 rupees to 10,000 rupees (US$90 to US$130 ) for an early abortion in private clinics.

Pregnant prisoners

In the meantime, groups like the FWLD and the CRLP are also calling for the release of women now behind bars for abortion and infanticide.

As of the latest count, there are some 57 women in jails across Nepal who fall into this category. Just nine of these are detainees, meaning their cases are still being tried.

A fact-finding mission conducted by the FWLD and the CRLP in March 2001 revealed that law enforcement officials often classified abortion as infanticide, a crime that carries heavy penalties.

This is why more than half of the women imprisoned on such charges as of Jan 2001 had received a 20-year sentence.

''Most cases actually involve abortion but are prosecuted as infanticide. . . the fact of abortion creates suspicion and likewise, the police are under pressure to ask for higher sentences,'' said a law enforcement official quoted in the report.

The mission's report said that the most of the women were poor, illiterate and did not have legal representation.

Apparently, too, they had been reported to the police by their neighbours, vengeful relatives who may or may not have basis for their claims. In some cases, husbands who had mistresses filed complaints against their wives.

Worse, the report said, 'Young children of convicted women are often forced to serve their mothers' sentences alongside them, as no other care arrangements are available to them.''