Ignorance 'the main enemy in abortion debate'

A widespread belief in the illegality of the procedure and prejudices are leaving women to face back-street butchers and societal contempt

In Thailand, a woman can't just walk into a hospital and ask for an abortion, according to Nattaya Boonpakdee, coordinator at the Women's Health Advocacy Foundation. "You have to know somebody," she said, adding that this somebody may then lead you to a proper clinic, or to an abandoned house or shady back-street operation where the procedure will be performed, although not necessarily by a doctor.

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"There's always a high risk," said Ms Nattaya. "But when you're desperate, many are willing to take the risk."

One such woman was Pattira, who had an abortion when she was 19. Pattira is from a middle-class family and graduated from a local international school. She was preparing to further her education in the US when she was raped by someone she considered a friend. She became pregnant and for her abortion was the only viable option.

"It was a tough decision," she said. "But I had to think of my future."

Pattira's case may be understandable to many _ she was young and was raped. But another woman, Lara, had an abortion at the age of 25, and hers was a case of accidental pregnancy.

Lara is also from a middle-class background. Neither she nor her boyfriend were ready to get married, let alone become parents.

"It was a choice," said Lara. She explained that she had no one to turn to, no one to talk to and that she and her boyfriend kept the unwanted pregnancy a secret from their families.

"I feel guilty to this day," she said of her abortion five years ago. "But if I could turn back the clock I'd still have done it. I couldn't even take care of myself, how could I have taken care of a baby?"

Both women were lucky in that they knew somebody who led them to proper clinics with licensed doctors.

THE MAIN PLAYERS: Above, Pilawan Areerob, and right, Howard Wang. Above, right, Cabbages & Condoms, with owner Mechai Viravaidhaya, far right.

A 2002 Population Council survey found that out of every 100 Thai women who became pregnant, 45 said they were not ready to become mothers. Pattira and Lara were two such women.

The most recent abortion case to cause a media sensation broke last week and involved 29-year-old model Pilawan Areerob. Pilawan is known in entertainment circles as "Muay Maxim", famous for her modelling for the popular men's magazine, Maxim. She was also the live-in girlfriend of embattled Thai-Taiwanese singing star Howard Wang, who has been accused of drug trafficking and assaulting Pilawan.

As the public drama unfolded, Pilawan gave an interview alleging that she had an abortion at a clinic and that she was pressured into it by Wang. The story received wide public attention and she was condemned for having the abortion.

Later, reports stated that Pilawan became so distraught, feeling guilt and regret, that she attempted suicide. After the failed suicide attempt, she decided to inform the police that she had an abortion at a clinic inside the compound of the Cabbages & Condoms restaurant on Sukhumvit Soi 12.

According to Ms Nattaya, Pilawan's story is typical of unwanted pregnancies. Her guilt and regret are also not uncommon.

The women's rights activist explained that there are psychological issues both before and after an abortion that need to be addressed.

"This [Pilawan's] is a case highlighting that Thailand needs post-abortion care, which we don't have," she said.

Cabbages & Condoms is owned by former senator and well-known activist Mechai Viravaidhaya, also known as Mr Condom for his safe-sex activism. He has been promoting family-planning for more than 40 years.

Earlier reports alleged that the former senator also owns the clinic. With a link to another famous name, Pilawan's saga became even bigger news.

On Tuesday, police and the health department officials raided the clinic, which is on the second floor of the same building occupied by Cabbages & Condoms.

They found nothing irregular; no records, documents nor signs of any illegal abortions having been performed.

According to Pol Col Panin Watcharapraneekul, there were also no records of Pilawan as a patient. The clinic is not registered to Mr Mechai.

"We will question her [Pilawan] again, to get confirmation on the name that she used to obtain the abortion," said Pol Col Panin.

Pilawan told the media she would meet with police tomorrow.

Prasit Sakdanarong, an adviser to the health minister, told reporters that the clinic's records were not computerised. Everything had to be searched manually. However, if the clinic is found to have tampered with evidence by hiding or destroying records, the punishment is imprisonment of not more than one year and a fine of not more than 20,000 baht.

Mr Mechai meanwhile denied any involvement with the clinic.

"I'm not involved in its operation, nor am I connected in any way legally with any medical facility," he said.

According to the former senator, the clinic operates with licensed physicians and with operating permits from the Public Health Ministry.

"I don't believe the clinic performs any illegal medical procedures, including illegal abortions," he said.

Where the law is concerned, Section 305 of the Criminal Code allows abortion in cases of rape, foetal defects or when the mother's life or physical or mental health are at risk.

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"The law is quite broad," said Ms Nattaya. She explained that a case can be made from family pressure or economic hardship for a woman to obtain a legal abortion, at the discretion of the doctor, but she added that the Thai Medical Council has outlined strict guidelines so that this process is not abused.

However Ms Nattaya said there are two ongoing issues regarding abortion in Thailand.

The first is that many people do not know the law and believe that abortion is still illegal. This view is echoed by Mr Mechai, who said that even some members of the police and the media still believe that abortion is illegal.

The second issue is that very few doctors are willing to perform abortions.

"They [doctors] may have varying personal reasons," said Ms Nattaya, "but the main reason is that most believe it's sinful. They don't want to take a human life."

For this reason, women seeking an abortion have very few places to turn to, and often turn to places that perform illegal abortions for cash, but with substandard procedures.

In 1999, 45,000 women suffered from botched abortions, according to the Women's Health Advocacy Foundation. Ms Nataya said that this was the last time data was collected, however the number of women who had successful abortions in that year was in the hundreds of thousands. The numbers from 1999 alone are testament to the widespread practice of abortion in Thailand, legal or otherwise.

According to Ms Nattaya, there are instances in which a doctor is willing to perform the operation, but the hospital's director may refuse to allow the practice to take place at the hospital.

"To deny a patient who seeks [legal] medical treatment is unethical by international standards," said Ms Nataya. "But for many [directors] it's a matter of personal beliefs."

She explained that pregnancy may lead to an act of desperation, where a woman with an unwanted pregnancy may find themselves in a back-street "clinic", under the knife of someone who may not even be a doctor. This is because most clinics and hospitals simply close their eyes, ears and doors to the plight of such women.

"What Thailand needs right now is cooperation from all sectors of society to fully understand the legality of pregnancy termination," said Mr Mechai. However, he cautioned that the current sensationalism exhibited by the Thai media clearly prohibits any move for reform at this stage.

"Society must now provide the opportunity for women to come out and express their views on this issue," he said. "I'm saddened by the current obvious ignorance of the facts, which exacerbates the problems women face with their dire predicaments."

THE THAI CRIMINAL CODE ON ABORTION

Section 301: Any woman who causes an abortion herself or allows any other person to procure an abortion for her, shall be punished with imprisonment not exceeding three years or fined not more than 6,000 baht, or both.

Section 302: Whoever procures an abortion for a woman with her consent, shall be punished with imprisonment not exceeding five years or a fine not exceeding 10,000 baht, or both.

Section 303: Whoever procures an abortion for a woman without her consent shall be punished with imprisonment not exceeding seven years or fined not more than 20,000 baht, or both. If such act causes other grievous bodily harm to the woman, the offender shall be punished with imprisonment of one to 10 years and fined 2,000 to 20,000 baht. If such act causes the death of the woman, the offender shall be punished with imprisonment of five to 20 years and fined 10,000 to 40,000 baht.

Section 304: Whoever only attempts to commit the offences in Section 301 or Section 302 shall not be punished.

Section 305: If the offences in Section 301 and 302 are performed by a medical doctor and are necessary for the mental or physical health of the woman or if the woman became pregnant due to the breaking of Section 276, 277, 282, 283 or 284 of the Criminal Code [covering sexual assaults and rape], the person will not be held accountable.

ENFORCING THE LAW: Above, government adviser Prasit Sakdanarong, and top, Pol Col Panin Watcharapraneekul.

CENTRE OF STORM: Top, the clinic that shares a building with Cabbages & Condoms where Pilawan Areerob said she had an abortion.

About the author

columnist
Writer: Voranai Vanijaka
Position: Bangkok Post columnist