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Self-rated mobility, physical health, and chronic pain among women seeking abortion in a health facility in Nepal (2019–2024): a prospective cohort study

Year: 2026

Type: article

Abstract: Background Women may have adverse physical health following abortion denial and childbirth, particularly where maternal morbidity is high. This study aims to investigate mobility, self-rated physical health, and chronic pain associated with unwanted pregnancy among women seeking facility-based abortion services in Nepal. Methods Women seeking abortion at 22 facilities across Nepal in 2019–2020 completed surveys every six months for five years. This longitudinal cohort study assessed limited mobility, self-rated poor health, and chronic pain using weighted linear and logistic mixed effects regression, including among those seeking abortion for health reasons. We report time-specific marginal predicted probabilities for those denied (who gave birth and did not give birth) and those who obtained abortion. Findings Of the sample (n = 1742), 51% obtained care (Abortions), 15% gave birth (Turnaway-Births), and 33% were denied but did not give birth (Turnaway-NoBirths). Risk of any limited mobility was 15 percentage points higher (95% CI: 7%, 22%, p=0.0001) for Turnaway-Births (predicted probability: 47%) versus Abortions (32%), and 2.5 days longer on average (95% CI: 1.42, 3.59, p < 0.0001; 5.3 versus 2.8 days); differences were larger among those seeking abortion for health reasons. Self-rated poor health, pelvic pain, and head pain did not differ for Turnaway-Births versus Abortions overall. Among the subsample, Turnaway-Births had poorer self-rated health at 18 months (0.09, [0.01, 0.16], p=0.026), more back pain at 24–36 months (maximum risk difference: 0.17 [0.04, 0.31], p=0.012), and less pelvic pain at 6 months (−0.08, [−0.015, −0.01], p=0.036) compared to the Abortions. Interpretation Compared to the Abortions, Turnaway-Births experienced more limited mobility, and, among those who sought abortion for health reasons, poorer self-rated health and more chronic pain. Support for women seeking abortion, especially for health reasons, in obtaining timely care is needed to limit adverse physical health. Funding This study was supported by the National Institutes of Health and the David and Lucile Packard Foundation.

Source: The Lancet Regional Health - Southeast Asia

DOI: 10.1016/j.lansea.2026.100835

Authors: Sarah Raifman, Rachel Murro, W. John Boscardin, Mahesh C. Puri, Diana Greene Foster, Corinne H. Rocca

Institution: University of California, San Francisco

Language: English

Topic: Reproductive Health and Contraception

Subfield: Public Health, Environmental and Occupational Health

Field: Medicine

Domain: Health Sciences

SDGs: Good health and well-being, Gender equality

Open Access status: gold

Estimated APC paid: $2,250