Breaking the cycle

Breaking the cycle

Debate continues on whether Thailand's abortion laws should be overhauled

SOCIAL & LIFESTYLE
Breaking the cycle
Dr Rebecca Gomperts.

An illegal abortion facility was uncovered by police in Sakon Nakhon earlier this year. Syringes, needles, gloves and vinegar were found inside the seemingly abandoned house, which opens for service only upon request.

The uncovered bottle of vinegar serves as a corrosive agent that, upon being injected into the vagina, can induce miscarriage. This is, according to the authorities, a very dangerous method that can cause infection, reproductive problems and even death.

Forced miscarriage is laced with heavy moral criticism in many countries including Thailand. Unplanned pregnancy is rarely well-received — especially in the young and unmarried.

Add abortion to the whole ordeal and society is more than ready to throw stones. From a Buddhist perspective, many believe there’s no greater sin than intentionally killing an innocent baby. News headlines regarding women seeking abortion often paint them with an evil-mother image.

For superstitious minds, fear of baby ghosts, or even that such women can never conceive again, are used to convince pregnant women to embrace motherhood, no matter how unprepared they are.

Most people are under the false assumption that unplanned pregnancy only occurs in the young, who are reckless with contraceptive use. But the truth is, contraception doesn't always work, and rape is frequently the cause of unplanned pregnancy. And this can happen to women regardless of age, social status, financial situation or education.

While it is legal — to a certain extent — to get an abortion in Thailand, the practice comes with various conditions. Section 305 of the Thai Criminal Code states that abortion is only allowed for the following cases — women with physical or mental problems; pregnancies in which the baby risks being born with disability or genetic disease; or pregnancies that are the result of sexual assault.

Abortions can be performed only by certified doctors at suitable healthcare facilities, and for pregnancies that are still in their first trimester (ie, fewer than 12 weeks old). The pregnant woman must also consent to terminating her pregnancy.

Even when it’s legal to do so, many healthcare providers will refuse to perform abortions based on personal or religious reasons. Some who are otherwise willing may refuse for fear of being stigmatised by peers and colleagues.

Recently in Thailand to address the issue of a woman's right to a safe abortion was Dr Rebecca Gomperts, a Dutch physician who leads a pro-choice, non-profit organisation called Women on Waves (WoW), which aims to help women who live in societies with restrictive policies to seek safer means of abortion.

The story on WoW’s effort is told in Vessel, a 2004 documentary that follows Dr Gomperts and her team as they sail around the globe providing abortions at sea. The team meets opposition from pro-life and religious communities wherever they sail. Eventually, an underground network is formed in many countries to bypass the law and put the decision-making power back into women’s hands. WoW’s website, as well as its online network, Women on Web, provides information on the use of mifepristone and misoprostol — two types of medicine that can help terminate pregnancy. The use of these medicines is a method for medical abortion recommended by the World Health Organization.

Through their campaigns, the team has influenced a change in abortion policy in Portugal and Spain. Credit, said Dr Gomperts, must go to the local women's organisations in each country who pursue the cause.

“I always have more respect for the local women's organisations because they’re the ones that are left behind. I go back to my comfortable Netherlands and they’re the ones who have to do the ongoing work,” said Dr Gomperts during the discussion period following a recent screening of Vessel in Bangkok.

It was estimated by the World Health Organization in 2012 that unsafe abortion occurs with around 22 million women. This has resulted in 47,000 deaths and 5 million injuries a year. It’s also startling to find that half of those unsafe abortions happen in Asia.

In Thailand, a network of willing doctors is now being formed to connect women to a referral system so they can get a safe abortion.

“It’s difficult to change people’s minds if they don’t share your beliefs,” said Dr Bunyarit Sukrat, a representative from the Department of Health. “It’s better than leaving women to their own devices. They could end up at illegal abortion clinics, or buying pills without knowing if they are real or fake. All these could result in serious health complications.”

Terminology, as Thai activists opined, can be problematic when campaigning for women’s right to an abortion. As the word tum taeng — literally, "forced miscarriage" — carries a strong negative connotation in the country, some activists have been replacing the word with “termination of pregnancy” and others. Still, Dr Gomperts suggested there’s no way around it — the taboo must be broken.

“If we’re afraid to use the word, then it adds to the stigma,” she said. The terminology issue also covers how we identify the concept of unborn baby. Some now opt for words like foetus or embryo to avoid the emotions linked to the word "baby".

“They’re all biologically correct nevertheless,” she said.

Information on how to perform a safe medical abortion is now available in 20 languages — Thai included — on WoW’s website. Within the country, those with an unplanned pregnancy can seek advice from 1663, the hotline of the Aids Access Foundation, which also works with unplanned pregnancy.

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