KUALA LUMPUR - Khin (not her real name) had abdominal pains so severe she couldn’t even walk properly. She had taken ‘Kathy Pan’, a Burmese traditional medicine, to make sure her menstruation starts, because she was worried. She had missed her period after her boyfriend got her drunk and persuaded her to have sex.
This is one of the everyday stories of women across Asia – it just so happened that Khin is from Burma. Women have different reasons for resorting to induced abortion, ranging from the stigma attached to pregnancy out of wedlock, socioeconomic problems or human right abuses.
Abortion is also a health issue, as discussions during the 3rd Asia-Pacific Conference on Reproductive and Sexual Health (APCRSH) on Nov. 17-21, show.
It is legal in some countries in the region, often under certain health grounds. China, Cambodia and Vietnam have legal abortion services, while Burma, Laos do not. In Thailand, abortion is illegal except when done by a physician and under two conditions -- when the pregnancy is a risk to the woman’s health or when the pregnancy is a result of rape.
But even where abortion is a legal option, there is limited access to and awareness of its use and availability in the community.
“There are enough provisions for abortion to be carried out legally throughout the region,” said Datuk Dr Raj Karim, director of the International Planned Parenthood Federation’s East Asia, South-east Asia and Oceania region. “But the problem is sometimes people don’t know that they can access that service because government don’t provide them and the private sector (ones) are too expensive.”
This means that regardless of whether abortion is legal or not, women’s access to reproductive health is vital.
Nearly 20 million out of 46 million women worldwide undergo abortions that are considered unsafe, according to the 2004 annual report of the IPPF.
This is also a major concern in a number of Mekong countries. According to the Fertility and Reproductive Health Survey conducted by the Department of Population and United Nations Population Fund in 2001, infection and unsafe abortion is one of the major reasons for maternal deaths in Burma.
Figures released by Burma’s health ministry show that there were 4,300 maternal deaths for every 100,000 live births in the country in 2000.
In Thailand, a hospital-based survey conducted in 1999 by the Department of Health, Ministry of Public Health revealed that a total of 45,990 women were admitted for treatment of complications from both spontaneous abortions and induced abortions.
Some groups of women are particularly susceptible to unsafe abortions, including migrant workers for whom pregnancy can mean termination of work or have no access to basic health services.
Indeed, in one session during the conference, a female Malaysian doctor asked about the lack of access to reproductive health care migrant domestic workers.
The chairperson of local organising committee, Dr Kamaruzaman Ali, said, “We are providing a venue for people to voice their concerns (at the conference)." Unfortunately, however, the voices of migrant women weren't quite everywhere in the conference due to the lack of legal documents.”
This issue resonates for people like Khin, who like many other women go to other countries in search of work.
According to Thai labour law, migrant women are required to take pregnancy tests before getting their registration as migrant workers can be approved. This is one of the main reasons behind the decision of some to end their pregnancies.
The paper ‘Working Our Way Back Home’ about fertility and pregnancy loss along the Thai-Burma border, done by Dr Cynthia Maung and Suzanne Belton, have documented different induced methods by community abortionists using sticks (from trees to cotton buds), traditional herbal medicines, Western medicines, physical massage, or taking hot and spicy foods.
According to the post-abortion care statistics at the Mae Tao Clinic in Thailand’s Tak province, founded by Dr Maung, at least 25 percent of abortion cases there are thought to be self-induced.
The Mae Tao clinic, based in Mae Sot town, is the only place to access health care for migrant and refugee women with abortion complications in Thailand. (END/IPSAP/MMM/JS/211105)