Pregnancy is a transformative journey, and in Nepal, it comes with unique considerations—from navigating the healthcare system to balancing traditional practices with modern medicine. Whether this is your first pregnancy or you're adding to your family, understanding pregnancy care in Nepal will help you make informed decisions for you and your baby.

The First Step: Confirming Your Pregnancy

Home Pregnancy Tests

Home pregnancy tests are widely available at pharmacies throughout Nepal (NPR 50-300). Popular brands include I-Can, Prega News, and others. For best results:

  • Test using first morning urine
  • Wait at least 7 days after a missed period for accurate results
  • Follow packet instructions carefully

Confirming with a Doctor

After a positive home test, see a gynecologist or obstetrician for:

  • Blood test (beta-hCG): Confirms pregnancy; Cost: NPR 500-1,200
  • Ultrasound: Confirms intrauterine pregnancy and estimates due date; Cost: NPR 800-2,500

Even if you feel fine, this first visit is crucial to rule out ectopic pregnancy and establish your baseline health.

Choosing Your Healthcare Provider

Types of Providers in Nepal

  • Obstetrician/Gynecologist (OB/GYN): Medical doctors specializing in pregnancy and childbirth. Recommended for all pregnancies, especially if you have health conditions.
  • Midwives: Trained professionals who can manage normal pregnancies and deliveries. More common in rural areas and government health posts.
  • Traditional Birth Attendants (TBAs): While culturally significant, modern medical care is safer. TBAs lack training to handle complications.

Government vs. Private Care

Government Hospitals/Health Posts:

  • ✅ Free or very low-cost prenatal care and delivery
  • ✅ Safe Motherhood Program provides free delivery services
  • ✅ Paropakar Maternity Hospital, Patan Hospital, TU Teaching Hospital in Kathmandu
  • ❌ May have longer wait times
  • ❌ Limited private rooms (shared wards common)

Private Hospitals:

  • ✅ Shorter wait times and more personalized care
  • ✅ Private rooms available
  • ✅ More flexibility in delivery choices
  • ❌ Higher costs (see breakdown below)

Popular private maternity hospitals in Kathmandu: Om Hospital, Nepal Mediciti, Grande International, Norvic Hospital, B&C Medical College, Medicare National Hospital

Antenatal Care (ANC) Schedule

The Nepal government recommends at least 4 ANC visits, but most doctors advise monthly checkups, increasing frequency in the third trimester:

Recommended Schedule

  • First Trimester (Weeks 1-12): Initial visit as soon as pregnancy confirmed; Follow-up at 8-10 weeks
  • Second Trimester (Weeks 13-28): Monthly visits (around 16, 20, 24, 28 weeks)
  • Third Trimester (Weeks 29-40): Every 2 weeks from 28-36 weeks; Weekly from 36 weeks until delivery

What Happens at ANC Visits?

  • Weight and blood pressure monitoring
  • Urine test (protein, sugar, infection)
  • Fundal height measurement (uterus growth)
  • Fetal heartbeat check (from ~12 weeks)
  • Discussion of any symptoms or concerns
  • Ultrasound scans (typically at 12, 20, and 32-36 weeks)

Essential Tests During Pregnancy

First Trimester (Weeks 1-12)

  • Complete Blood Count (CBC): Checks for anemia; Cost: NPR 300-800
  • Blood group and Rh typing: Important for Rh incompatibility; Cost: NPR 300-600
  • VDRL/RPR (Syphilis): Routine screening; Cost: NPR 200-500
  • HIV test: Offered to all pregnant women in Nepal; Often free at government centers
  • Hepatitis B: Screening test; Cost: NPR 500-1,000
  • Urine culture: Detects infections; Cost: NPR 500-1,200
  • Blood sugar (fasting): Diabetes screening; Cost: NPR 150-400
  • Thyroid function (TSH): Increasingly common in Nepal; Cost: NPR 500-1,200

Second Trimester (Weeks 13-28)

  • Anomaly scan (20-week ultrasound): Detailed scan to check baby's development; Cost: NPR 1,500-4,000
  • Glucose tolerance test (GTT): For gestational diabetes (24-28 weeks); Cost: NPR 300-800
  • Repeat CBC: Recheck hemoglobin

Third Trimester (Weeks 29-40)

  • Growth scan: Check baby's size and position; Cost: NPR 1,200-3,000
  • Non-stress test (NST): Monitors baby's heart rate; Common in last month; Cost: NPR 500-1,500
  • Repeat blood tests: CBC, blood sugar if needed

Nutrition During Pregnancy

Adapting the Nepali Diet

Traditional dal-bhat can be very nutritious during pregnancy with some adjustments:

  • Protein: Dal (lentils), beans, eggs, chicken, fish. Aim for protein at each meal.
  • Iron-rich foods: Dark leafy greens (spinach, mustard greens), meat, beans. Pair with vitamin C (lemon, tomato) for better absorption.
  • Calcium: Milk, yogurt, cheese, sesame seeds (til), green vegetables
  • Folate: Green vegetables, lentils, chickpeas, oranges
  • Whole grains: Brown rice (if tolerated), whole wheat roti, oats

Supplements

Most doctors in Nepal prescribe:

  • Iron and folic acid: Usually free from government health posts; Private: NPR 200-500/month
  • Calcium: Often added in 2nd/3rd trimester; Cost: NPR 150-400/month
  • Multivitamin: Prenatal vitamins available; Cost: NPR 400-1,200/month

Take iron tablets with orange juice or lemon water (not with tea/milk) for better absorption.

Foods to Limit or Avoid

  • Raw or undercooked meat/eggs: Risk of infection
  • Unpasteurized dairy: Avoid raw milk products
  • Certain fish: Limit large fish (tuna) due to mercury; local river fish generally safe in moderation
  • Excessive caffeine: Limit to 1-2 cups tea/coffee daily
  • Alcohol and tobacco: Avoid completely
  • Unwashed raw vegetables: Wash thoroughly to avoid toxoplasmosis

Common Pregnancy Concerns in Nepal

Anemia

Very common in pregnant Nepali women due to iron-deficient diets. Symptoms include fatigue, dizziness, pale skin. Solution: Iron supplements, iron-rich foods, vitamin C to aid absorption.

Gestational Diabetes

Increasing in Nepal, especially in urban areas. Management: Diet control, regular exercise, blood sugar monitoring. Some may need insulin.

High Blood Pressure/Preeclampsia

Potentially serious. Watch for: severe headache, vision changes, upper abdominal pain, sudden swelling. Requires: Close monitoring, possible early delivery.

Morning Sickness

Very common in first trimester. Tips: Small frequent meals, ginger tea, avoid spicy/oily foods, rest. If severe vomiting (can't keep water down), see a doctor.

Physical Activity and Work

  • Exercise: Walking, prenatal yoga (classes available in Kathmandu) are excellent. Avoid heavy lifting, contact sports.
  • Work: Most women can work throughout pregnancy. Nepali labor law allows maternity leave (60 days for government employees; varies in private sector).
  • Travel: Generally safe until 36 weeks. Avoid long bus journeys on rough roads in late pregnancy.

Preparing for Delivery

Delivery Options in Nepal

  • Normal vaginal delivery: Most common and safest if no complications
  • Cesarean section (C-section): If medically necessary or by choice at private hospitals
  • Water birth/natural birth centers: Limited availability; some private hospitals offer

Choosing Where to Deliver

Consider:

  • Distance from home (important during labor!)
  • 24/7 availability of OB/GYN and pediatrician
  • Neonatal ICU facilities (for premature or sick babies)
  • Blood bank on-site (for emergencies)
  • Cleanliness and infection control
  • Cost and insurance coverage

What to Pack for Hospital

Prepare by week 36:

For mother:

  • 2-3 comfortable nightgowns or kurta
  • Undergarments, maternity pads
  • Toiletries, towel
  • Slippers
  • Phone charger
  • Snacks (for after delivery)
  • Any medications you're taking

For baby:

  • 3-4 newborn outfits
  • Diapers (hospital may provide some)
  • Blanket or wrapper (nepali: khasto)
  • Cap and socks

Documents:

  • National ID/citizenship
  • All medical records, test results
  • Health insurance card (if applicable)

Cost of Pregnancy Care in Nepal

Government Hospital (Approximate)

  • ANC visits: Free to NPR 100 per visit
  • Basic tests: Free to minimal cost
  • Normal delivery: Free (Safe Motherhood Program)
  • C-section: Free to NPR 5,000
  • Total estimated cost: NPR 5,000-15,000

Private Hospital (Approximate)

  • ANC visits: NPR 800-2,000 per visit
  • Tests: NPR 10,000-25,000 (total for all 9 months)
  • Normal delivery package: NPR 30,000-80,000
  • C-section package: NPR 60,000-150,000
  • Total estimated cost: NPR 50,000-200,000+

Costs vary significantly between hospitals and cities. Packages often include hospital stay (1-2 days normal, 3-4 days C-section), basic tests, and doctor fees.

Government Support Programs

  • Aama Surakshya Karyakram (Safe Motherhood Program): Free institutional delivery at government facilities
  • Transportation incentive: NPR 400-1,000 for travel to health facility for delivery (varies by region)
  • Free iron/folic acid supplements: Available at health posts

Traditional Practices vs. Modern Medicine

Nepal has rich traditions around pregnancy and childbirth. While cultural practices can provide emotional support, balance them with medical evidence:

  • ✅ Helpful traditions: Family support during pregnancy; postnatal care (sutkeri care); nutritious traditional foods
  • ⚠️ Consult doctor before: Taking herbal remedies; restricting certain nutritious foods; following strict dietary taboos that may cause nutrient deficiencies
  • ❌ Avoid: Delaying emergency medical care for traditional remedies; home births without skilled attendant if high-risk

Warning Signs: When to Seek Immediate Care

🚨 Call your doctor or go to hospital immediately if you experience:

  • Heavy bleeding (soaking a pad in an hour)
  • Severe abdominal pain
  • Severe persistent headache with vision changes
  • Sudden swelling of face, hands, feet
  • Decreased or no fetal movement (after 28 weeks)
  • Leaking fluid (may be amniotic fluid)
  • Regular contractions before 37 weeks
  • Fever above 100.4°F (38°C)
  • Severe vomiting (can't keep anything down)

After Delivery: Postnatal Care

Care doesn't end at delivery. Follow-up is crucial:

  • 6-week checkup: For mother and baby
  • Breastfeeding support: Many hospitals offer lactation consultants
  • Immunizations for baby: Follow Nepal's immunization schedule (BCG at birth, others at health posts)
  • Birth registration: Register within 35 days at local ward office (free)
  • Family planning: Discuss contraception options with your doctor

Mental Health Matters

Pregnancy and postpartum can be emotionally challenging. It's normal to feel anxious or overwhelmed. Seek support if you experience:

  • Persistent sadness or crying
  • Extreme anxiety or panic
  • Inability to bond with baby
  • Thoughts of harming yourself or baby

Talk to your doctor—postpartum depression is common and treatable.

Your Pregnancy Journey Checklist

First Trimester:
✅ Confirm pregnancy with doctor
✅ Start prenatal vitamins
✅ Complete initial blood tests
✅ Choose healthcare provider
✅ Adjust diet and lifestyle

Second Trimester:
✅ 20-week anomaly scan
✅ Glucose tolerance test (24-28 weeks)
✅ Start preparing baby items
✅ Consider prenatal classes
✅ Decide on hospital for delivery

Third Trimester:
✅ Monthly then weekly checkups
✅ Pack hospital bag (by week 36)
✅ Arrange transport for labor
✅ Prepare home for baby
✅ Discuss birth plan with doctor
✅ Learn warning signs of labor

Pregnancy is a beautiful journey, and you don't have to navigate it alone. Whether you choose government or private care, the most important thing is that you and your baby receive safe, respectful, evidence-based care. Trust your instincts, ask questions, and embrace this incredible time in your life. Welcome to motherhood!