The morning of Jestha 21, 19, of Musikot Municipality-14, Rukum West, was the hardest day yet. The family was happy as they were expecting their first child, but as the labor pains increased, the family became fearful. Sushila, who became pregnant at a young age, became very complicated.

Even though Sushila was rushed to the district hospital, the doctor's words shocked the family even more. "Now give up hope for the baby, we can't save it if we don't bring it on time," says Sushila's sister-in-law Nandakala Roka, recalling the doctor's words. "After hearing that news, there was silence in the family." Sushila was carrying twins. We had taken her to the hospital wondering if she could be saved, but even though the doctor had said so, panic spread. However, after a long effort, one baby was delivered normally, but the second baby had to be delivered surgically. According to sister-in-law Nandakala, the risk was not over even after the baby was born. Sushila suffered from excessive bleeding. The doctor suggested taking her to the provincial hospital in Surkhet. As per the doctor's advice, the District Administration Office sent a rescue letter and after the girl was rescued by an army helicopter and taken to the provincial hospital, a glimmer of hope dawned on the Roka family.

Karuna Bista, 15, of Jagnath Rural Municipality-2 in Bajura, gave birth to a baby in a coma on November 21. She had become pregnant as a teenager and suddenly became unconscious without delivering the baby after suffering from labor pains. By the time she was taken to the district hospital, her condition had become critical.

The doctor referred her outside the district, saying that she could not be treated in the hospital due to excessive bleeding and obstetric complications. ‘Maybe because she was young, the daughter-in-law fainted while giving birth,’ said mother-in-law Amrita Bista, ‘the grandson was born in a state of unconsciousness.’ Even after the grandson was born, Karuna did not regain consciousness for two days. She was also rescued by helicopter and taken to the provincial hospital.

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Similarly, 15-year-old Nilima Sherpa of Makalu Rural Municipality-2 in Sankhuwasabha also became pregnant at the age of 15. On Chaitra 28, she was rescued by a Nepali Army helicopter after suffering from excessive bleeding and was taken to the Paropkar Maternity and Gynecology Hospital in Kathmandu. Nilima says that because she became pregnant at a young age, she had no idea about the delivery process, possible risks, and the necessary preparations for it. ‘I was more worried about how the baby would be born than about how I would survive,’ she said. ‘That experience of becoming a mother for the first time was the most terrifying moment I have ever had.’ She said that she got a new life after being rescued by a helicopter in coordination with relatives, local administration and concerned bodies on time.’ ‘I never imagined that a helicopter would come and rescue me like this and that all three of us would be saved,’ says Nandakala from Musikot, ‘The rescue was done at the right time to save the mother and the baby.’ Since the twins were born at a young age, both the babies are very underweight. Doctors say that they will have to be kept in the hospital for another month. Since Sushila’s health is still weak, it has not been possible to feed the baby directly with breast milk, and she has to express the milk and feed it through a needle,’ said Nandakala. Like Nandakala, Amrita from Bajura has a similar experience. ‘My daughter-in-law regained consciousness only two days after being taken to the hospital,’ says Amrita. She said that her daughter-in-law’s life was saved only because of the free rescue facility. Amrita says, ‘Since my son and daughter-in-law are young, I could not avail any of the facilities provided by the government.’

Dr. Sizan Rawal of Dolpa District Hospital said that even if the delivery was successful, the baby had to be referred to a well-equipped hospital to save it. ‘We do not have a pediatric specialist, essential equipment and other manpower,’ he said, ‘We are forced to refer even for the sake of saving it.’

Nilima from Sankhuwasabha also says that her life was saved due to the air rescue. ‘With everyone’s help, I received timely treatment, so both I and my baby were safe,’ she said. She shared her experience of becoming a mother at a young age, not only physically but also mentally. ‘My health is normal now, but if I see even a little blood, I am afraid that something will happen again.’ Even though my body has recovered, my mind is still not completely at peace,’ she said.

Locals say that since it is not easy to reach local health institutions from remote settlements in the hilly areas, they are forced to give birth at home. Doctors say that the risks remain the same due to the difficult geography and the hours it takes.

The ‘President’s Women Upliftment Program’ implemented by the Nepal government in 19 districts and some municipalities in 25 additional districts since the fiscal year 2075/76 has been effective in emergency rescue of pregnant women and those with complications in childbirth in areas where transportation is not available and taking them to the hospital on time.

Immediate rescue is being carried out in cases where there are complications in the delivery process, excessive bleeding, or when there is a delay in reaching the health institution. The Ministry of Women, Children, Gender and Sexual Minorities and Social Security has been deploying the army to rescue women based on the recommendations of the Chief District Officer of the concerned district and local health institutions. In this way, women in labor have been rescued from designated local levels in all seven provinces from the Central Air Base in Kathmandu and the West Air Base in Surkhet.

Army Spokesperson and Assistant Lieutenant Colonel Rajaram Basnet said that the emergency childbirth rescue program, which is being conducted on the recommendation of the local level, district hospital and district administration, has become a lifeline for women and babies. According to him, the free air rescue service is implemented in all 19 local levels including Taplejung, Sankhuwasabha, Bhojpur, Khotang Solukhumbu, Okhaldhunga, Manang Mustang Rukumpurba, Rukum, Paschim, Jajarkot, Dolpa, Kalikot, Mugu, Humla, Bajhang, Bajura, Achham and Darchula. It has been partially implemented in remote areas of 25 other districts, and pregnant women and newborns in danger of death are being air-rescued and taken to the designated hospital.

Under this program, about 950 pregnant women and newborns have been rescued by helicopter from all seven provinces so far. According to the data provided by the Nepal Army, 19 percent of those rescued are teenage mothers.

Dr. Lalit Jung Shahi, an obstetrician and gynecologist working at Karnali Provincial Hospital, says that young pregnant women are forced to undergo surgery for various reasons. ‘Young pregnant women are at risk of high blood pressure. That is why it is impossible to give birth without surgery,’ he says. ‘Young teenage girls who have been air-rescued have problems such as heavy bleeding as soon as labor pains begin, very low birth weight, high bleeding and anemia.’