In villages nestled in Nepal's far western Himalayas, women and girls spend days isolated in sheds, separated from their families while they are menstruating and sometimes following childbirth. This practice, known as chaupadi, comes from a Hindu tradition that considers secretions associated with menstruation and childbirth to be religiously “impure."
The sheds can be risky places for women; in 2010 alone, some women observing chaupadi reported being raped, while others died of snakebite, hypothermia and severe bleeding. Religious practices, like chaupadi, and social inequality isolate women from services and complicate attempts to change behavior. More than 99 percent of women still give birth at home or in the cattle sheds used for chaupadi.
Basic clinics are few and distant from many villages. When it matters most, many rural Nepali women, already accustomed to monthly exile from their community, struggle to defend their right to care.
With a current rate of 229 deaths per 100,000 births, Nepal is one of few countries on track to achieve the UN Millennium Development Goal to cut maternal mortality by three quarters by the year 2015. But there is wide regional disparity. In this project Allison Shelley and Allyn Gaestel explore these barriers to reproductive health care for women in rural Nepal.