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Friday, May 06, 2011
Thai women 'mistreated' by physicians
It is safe. It is fast. It is cheap. It is the
standard treatment for miscarriage and incomplete abortion in most
countries. Yet the medical profession in Thailand shuns this simple
medical technique which could save the lives of countless women.
Why is that? Simple answer: "It's because physicians here do not
care about women's feelings and problems," says Prof Dr Kamhaeng
Chaturachinda, a prominent obstetrician.
He should know. According to Dr Kamhaeng, former president of the
Royal Thai College of Obstetricians and Gynaecologists, scraping and
scooping the lining of the womb with a hard metal spoon or a curette is
still the standard treatment for miscarriage and incomplete abortion
here, although there is a much easier and less painful way to do the
Mention sharp curettage or khood mod look in Thai, and most women
will cringe at the much-dreaded image of crude scraping and scooping of
the womb. The technique was first introduced in the medical field more
than a century ago. And this now-archaic method is still routinely used
with Thai women as if time had stood still and not moved on.
Suction of the uterus with a simple medical tool called manual
vacuum aspirator or MVA, is now the main method worldwide to remove
uterine contents from miscarriage and incomplete abortion. Research has
shown that this technique to prevent bleeding and infection is safer,
with less side effects than sharp curettage. The procedure is easy and
fast. The tool is also cheap, making it easily accessible to the
masses. Yet, MVA is not taught in Thai medical schools. Consequently,
few hospitals use this less painful method to handle miscarriage and
It is estimated that Thailand has one million pregnancies a year. By
nature, about 10-25% of pregnancies will end in miscarriage. Imagine
how many women must go through womb scraping when it is completely
Worse, the scraping and scooping of the uterus is often done "raw",
without anaesthetics, on women and young girls with complications from
incomplete abortion, to "give them a lesson".
This medical punishment for "bad women" reveals the deep-rooted
prejudice and sexual double standard that sustains our draconian
abortion law, forces women to seek unsafe services and risk their
lives, costing the healthcare system a fortune while killing 900 women
each year in dismissive silence.
Let's face it. Unplanned pregnancy is a big problem here. According
to the Health Department, three in every 10 women opt to end their
pregnancies. It is estimated that about 300,000 women each year seek
abortions. At 300:100,000, the death rate from abortion in Thailand is
among the highest in the world!
Isn't it ironic? Thailand is a medical hub attracting patients from
around the world with its advanced medical technology and expertise.
Yet it still subjects its women to rudimentary womb scraping and
untimely death from unsafe abortions.
Isn't it maddening? Medical technology has long made it easy and
safe to end early pregnancy with pills or suction of the womb. With
some training, nurses and midwives could easily handle the procedures,
which would help save women's lives in remote areas where there are no
doctors. Still, when the pills are outlawed and womb suction is shunned
by physicians, women suffering natural miscarriage must undergo painful
treatment, while those who want to end their pregnancy must turn to
quacks, risking injury, long-term health problems, and even death.
This is why Dr Kamhaeng has made it his mission to train health
personnel to quit scraping the womb and to use the manual vacuum
aspirator instead. An ardent advocate of safe abortion, he insists that
the Medical Council regulations already allow safe abortion on grounds
of health concerns and rape.
For example, the criminal law regards sex with girls under 15 as
rape. This means that doctors can legally end early pregnancies for
underage girls. Resistance within medical circles itself forces the
girls to turn to quacks.
Dr Kamhaeng was being kind when he said physicians here did not care
much about women's feelings and problems. These physicians simply don't
care about women, full stop.