Pro-life activists target rural Nepali women

The family planning and abortion provider Marie Stopes Nepal says pro-life activists, such as Rai, are deterring Nepali women from getting abortions -- especially those in rural areas.

"This issue (of pro-life activists) has stigmatized safe and legal abortion in the communities. The stigmatization of abortion has created discrimination among women seeking abortion and service providers providing safe and legal abortion services," said Marie Stopes Nepal's Media and Communications Manager, Shreejana Bajracharya.

Nepal legalized abortion over 15 years ago, and there are around 1,300 authorized abortions clinics currently operating in Nepal.

Early last year the Nepali government made all abortion services free at public medical facilities but surprisingly almost none of the women CNN talked to in and around the village of Shilaprabat knew about the changes.

Issues such as lack of information, stigma, and distrust of government facilities remain among the chief reasons most women in rural areas don't ask important questions of their healthcare providers.

Many said they didn't know to ask if a clinic or pharmacy has proper authorization from the government, or what they should do in the event of medical complications.

It's that gap in information among rural communities that Pastor Rai and his organization are hoping to plug with their own message.

Rai claims he has taught 32,000 pastors and church leaders throughout Nepal, either directly or indirectly through others, to help spread an anti-abortion message since the inception of his NGO in 2009.

An estimated 323,000 abortions were performed in Nepal in 2014. This number translates to a rate of 42 abortions per 1,000 women aged 15-49, according to information provided by the US-based Guttmacher institute in partnership with Nepalese Center for Research on Environment, Health and Population Activities (CREHPA).

However, more than half of all the Nepalese abortions that were carried out were performed by illegal providers.

"Abortion clinics are not being accessible for rural women because most of the clinics and government sides are near the cities and larger towns. This is one of the reasons there is a high number of illegal abortions," said Nepal's Director of Family Health, Dr. Bikash Devkota.

This compares with Asia as a whole which has an estimated annual rate of abortion of 36 per 1,000 married women of reproductive age (15-44), and 24 per 1,000 for unmarried women.

Rai and his organization initially came to the earthquake-affected area immediately after the quakes in 2015.

He handed out pamphlets, which countered rumors that the shocks could adversely affect pregnant women. He also brought food, blankets, and mosquito nets.

Christians in the affected communities came out to help local villagers rebuild their homes. And international NGOs, including several Christian-based groups, flew in to provide humanitarian assistance.

"What we believe is that everybody has the right to information, that is our fundamental right," says Rai.

"If some pro-choice groups, or pro-abortion groups say that abortion is safe, it's a normal procedure, it's not harmful to any women ... it is not accurate information," says Rai, adding that all Nepalese women, whether in the countryside of cities, have the right to be informed.

"We are not trying to make anyone scared or emotional. We are just sharing with them the truth," says Rai of his work in villages like Shilaprabat.

Following the outreach, congregations at the three churches we visited say they witnessed at minimum a 50% increase in Christian conversions in the last two years, a skyrocketing number in a country where the Christian population remains firmly in the minority.

Barnabas Shrestha, Chairman of Nepal's Christian Society said that according to the 2011 census only around 1.4% of the population was Christian in Nepal but he believes that information is incorrect.

He and his organization estimates the Christian community is around one and half million, which in a country of 26.49 million, puts their percentage around 5% of the population.

Bajracharya, from Marie Stopes Nepal, says those who convert tend to come from the lowest Dalit caste in the Hindu religion.

"The majority of Dalit communities in rural Nepal are converting to Christianity," said Bajracharya. "Anti-abortion activists are active in those part of communities in Nepal."

Though illegal since 2001, caste discrimination remains a problem in Nepal, especially in rural areas, where members of lower castes continue to struggle with instances of exclusion and on occasion, violence. For some, conversion to Christianity can be a means of escape.

The earthquake destroyed the church in Shilaprabat, and it was rebuilt near a Hindu stupa that still bears the signs of the disaster, with its steeple standing askew at a 30 degree angle.

On the morning of Rai's lecture, the men and women coming in from the sweltering heat don't seem to know what abortion is, or that it's even the topic of the presentation.

They've just been asked to come by their local pastor. When asked about abortion, most don't understand a lot about the procedure, and some have never heard of it.

He begins with a simple prayer about following the gospel of Jesus Christ.

He goes on to explain how a woman's body works and shows slides that say life starts at conception. Then Rai pulls out those four models of fetuses at different stages in a pregnancy, although doctors may take issue with their anatomical accuracy -- the model representing the development of a 12 week fetus has perfectly formed fingers and toes.

The parishioners smile and laugh as they hold the doll-like figures, sometimes taking a picture of them before passing them on.

After passing out the fetus models Rai gets to the crux of his lecture: why abortions are the same as killing a baby.

A lot of phrases he uses are common in anti-abortion rights literature the world over.

One slide talks about how abortion clinics are building a "booming business at the expense of lives that were snuffed out before they got the chance to breathe." Another slide shows a pie chart, which explains abortion kills more lives than the combined deaths from the Holocaust, Stalin's regime and Pol Pot's reign in Cambodia.

Rai's slides then become graphic with photos of aborted fetuses; pictures typically seen on posters at pro-life rallies.

A short film follows with a fetus speaking in a childlike voice, asking his mother why she would want to abort him. Many of the women in the room, who minutes before had been happily playing with their plastic models of fetuses, are now crying, and using their scarves to cover their eyes.

According to a 2010 study published in the BioMed Central article database on Pregnancy and Childbirth, Christian and Buddhist women tend to have fewer children on average than Hindus and Muslims in Nepal.

Additionally, Nepalese Christians are more likely to use modern methods of contraception like pills, injections or IUDs.

But for Rai's followers, he wraps up his lecture with this message: these modern contraception methods can cause a woman to have a spontaneous abortion.

While that claim is medically unproven, those listening are led to believe that the only way to prevent an "unintended abortion" is to either use condoms (which he mentions also can fail) or the natural rhythm method of family planning.

He advocates for having the baby and if necessary, giving it up for adoption instead.

With the lines between information and misinformation blurred for a lot of Nepalese, many people rely on leaders of their community to guide them.

The church lecture Rai gave clearly impacted many in attendance. When asked if their views on abortion had changed, most likened it to murder -- and considered using natural family planning instead of medical contraception.

Muna, age 16, who had attended the lecture said Rai's views on contraception must be more accurate than what she had learned in school. When asked why she said "because he's a Christian, so it must be the truth."

But Rai's talks are not just changing the minds of churchgoers, they are also hindering efforts made by aid organizations and the government.

Speaking to CNN last year, Nepal's former Director for Family Health, Naresh Pratap Kc, admitted that it remains a "real challenge" to try and get information out to women in rural areas, especially about the free services available.

"We know that even at the remote places that people don't know that abortion services are legal and free. Our main challenge is trying to tell these people that services are free at public facilities and that it's legal," said Pratap Kc.

Without a large government effort, says Pratap Kc, the potential for misinformation that endangers female health remains vast.