Nepali women face grueling work every day with very little rest. Their responsibilities consist of domestic chores, child care, work in the fields, and looking after livestock. Tasks include chopping and hauling wood, carrying water, planting and weeding rice, and lifting heavy loads.

Women in Nepal work an average of 16 hours per day in the non-formal, unpaid work sector—a rate much higher than the global average (UNDP 2004). The strain that this kind of work places on the pelvic muscles is a probable cause of the unusually high rate of UP in Nepal, especially because women maintain high levels of physical exertion during pregnancy and immediately after delivery.

In a clinic-based study in Bhaktapur, Kathmandu Valley, 87% of prolapse patients reported having worked heavily during pregnancy and in the postpartum period; 26.73% of women started working in the fields 2-3 weeks after delivery (Bodner-Adler et al. 2007). In the post-partum period, this kind of heavy labor is often the immediate cause of a prolapse. In a study of women from two plains districts in Nepal, 76% of respondents with UP reported that they were carrying heavy loads, collecting water, chopping wood, or husking and pounding rice when they felt their uterus “fall” (CAED 2006).

	Agar Devi Shah
	Birma Prayar
	Sajani Devi Chaudhary