The impact of abortion denial on women's empowerment in Nepal (2019-2024): a prospective cohort study.

Authors

Nadia G Diamond-Smith, Diana Greene Foster, Mahesh C Puri, Rachel Murro, Anupama Ale Magar, M Antonia Biggs

Published in

The Lancet regional health. Southeast Asia. Volume 52. Pages 100833. Epub Sep 03, 2026.

Abstract

There has long been an interest in the association between family planning (contraception and abortion) and women's empowerment, with mixed evidence as to an association and most studies relying on cross sectional data. Within this body of work, less focus has been on how family planning impacts women's empowerment The aim of this study is to understand the impact of abortion denial resulting in having an unwanted birth on women's empowerment, measured by education, mobility and decision-making.
In the Nepal Turnaway Study, we followed women seeking abortions from 2019 to 2020 in Nepal and assessed whether receiving versus being denied an abortion was negatively associated with women's empowerment over five years (longitudinal cohort). We used linear and logistic mixed effects regression models to assess the effects of obtaining an abortion compared to carrying an unwanted pregnancy to term on education, mobility outside the home and household decision-making power.
We followed 1742 for 5 years and find that women who did not give birth were more likely to be in school (Risk Difference (RD) = 0.2 starting 18 months post-abortion seeking) and have greater decision-making power over five years (Risk Difference (RD) = -0.2 starting 12 months post-abortion seeking) and both of these continued for the remainder of the time period. We find no evidence that giving birth affects a woman's freedom to leave her home for shopping or connections to family and friends.
These findings suggest that being able to decide the timing and circumstances of childbearing has wide-ranging effects on women's empowerment (as measured by schooling and decision-making).
This study was supported by the National Institute of Health David and Lucile Packard Foundation.

PMID:
42948305
Bibliographic data and abstract were imported from PubMed on 28 Oct 2026.

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