Birth Control, Pregnancy Termination, and Abortions in Thailand

Expert Advice on Birth Control

STD on the Rise

Sexually Transmitted Disease (STD) cases are on the rise in Thailand. In the past several years, the number of STD patients has almost doubled. According to the Public Health Ministry, in 2009 alone, nearly 25,000 cases have been recorded. The most prevalent STDs are gonorrhea with over 7,000 cases, followed by pseudo-gonorrhea and syphilis, and most patients are between 15 and 24.

There is no excuse for syphilis to be on the rise. It's a preventable disease, but a commitment from the government to stop it is required. Charitable groups like the Clinton Foundation and the Gates Foundation all required government cooperation as part of the grant process.


Tongue-In-Cheek Remarks

Another type of condom that struck scores of newcomers to Thailand is the ever-present receptacle called BeerGuard. Beer bars served it up so long as one ordered a bottle of beer to keep it cool.

Is your laptop cooking your testicles?   (Reuters Health)

Oral Contraceptives à±¼ "The Pill"

Many locally made over-the-counter (without a doctor's prescription) birth control pills are sold in widely accessible drugstores and pharmacy shops in Thailand. Virtually all pharmacists are English speakers. Many local and generic brands of contraceptive pills are broadly available throughout Thailand. They prevent sperm from fertilizing an egg and are reliable, effective, and inexpensive. Government hospitals provide contraceptive pills for free, or for a donation of five baht or so. These pills, however, usually contain a high dose of estrogen hormone and might have adverse side effects.

In fact, over 300 different brands of contraceptive pills are on the market. And all 300-plus brands contain the same active ingredients: estrogen (or oestrogen) and progestin. Pills marketed as premium brands, being able to reduce acne ("teen's pimples"), enlarge the breast's size and tenderness, increase libido, or not lead to weight gain, will cost more. When a particular pill is still under license, it is usually made abroad and thus is more expensive.

Air Travel During Pregnancy

Quite often we are asked if it is safe to fly during pregnancy. The answer is:
Air travel poses no special risks for a healthy pregnant woman or her baby. Mid-pregnancy period (14 to 28 weeks) is considered the best time to fly. It is recommended to drink plenty of fluids and take short walks every half-hour or so during the flight.

Information and Visa Application Inquiries

Abortions

According to Thai law (in effect since 1956), abortions are illegal in Thailand, except for girls under the age of 15 or with a serious illness, and when the pregnancy threatens the woman's health or results from rape, incest, or sex trafficking.

Women ending their pregnancies without satisfying one of these requirements face a prison term of three years and a 6,000 baht fine. Those performing the abortion can be jailed for five years and fined up to 14,000 baht. In cases resulting in serious injuries or death, the maximum penalty is increased twofold.

Yet de facto, the abortion law is rarely enforced, and illegal abortions remain common and an important public health issue for women in Thailand.

Thai women were denied access to safe abortions not only by the restrictive laws of the kingdom but also due to socially conservative attitudes of Thai society and a lack of understanding.

The latest data, however, indicates that the calls for the reform of abortion laws to widen the circumstances under which an abortion is legal are growing due to the support led by women's groups, and medical and legal professionals. As a result, the number of unsafe abortions, whether self-administered or by unqualified practitioners, is decreasing.

Ethical and Religious Concerns of Abortions in Thailand

Buddhism is the state religion in Thailand and Thais try to set up their legal system in line with Buddhist principles. Buddhism is generally depicted as extremely tolerant without attempting to impose its teachings on individuals. Although Buddhist morality is contextual and relative, it is not antinomian in general. Basically, the moral consequences of an act are determined by one's will or motivation. If the will behind an act is driven by greed, hatred, or delusion, which Buddhists regard as the three fundamental aspects of selfishness, then the act is deemed unskillful and be doomed.

The pro-life principle applies in the case of abortion simply because "there is no qualitative difference between an unborn fetus and a born individual" in Buddhism. And the extent of the offense is proportionate to the intensity of the wish to kill. The moral consequences of abortion concern not only the kinship between the pregnant woman and her fetus but also entail physical and mental trauma to the woman and all involved i.e. friends, family, advisors, and technicians.

It is important to note that the contraceptive method, if it does not harm the fetus or lovers, is reckoned to be skillful means. Obviously, from the Buddhist point of view, preventing unwanted pregnancies is far better than terminating them. Buddhism, however, advocates compassion for the individuals involved. According to the Buddhist precept, the state should not intervene in matters of conscience.

The Buddhist community in Thailand is deeply divided on the issue of abortions. Some political leaders like Major General Chamlong Srimunang are firmly opposed to any liberalization of the abortion law. Their position is based on the absolute sanctity of life in the Buddhist tradition. Others, including some monastic leaders, take a much more global view, pointing out that in Buddhist morality, the intent of the action has much to do with the karmic result of the act. Thus, in some cases, abortion could be a skillful act that should be morally permissible, especially when it serves against greed, hatred, and delusion.

As a matter of fact, legal abortions are very seldom in Thailand. Despite the fact that the abortion law is widely broken. Virginity is highly valued and there is a heavy social stigma against unmarried mothers, so fear and shame drive many single pregnant women to illegal abortions. They are unable to face the social consequences of their situation, and thus sacrifice their Buddhist principles against taking life. Contrary to the traditional Buddhist understanding, some rationalize that a very small fetus is not yet conscious and thus an abortion does not involve killing.

A horrific discovery (leaked in November 2010) of thousands of illegally aborted human fetuses wrapped in newspapers and plastic bags dumped at several Bangkok temples (wat in Thai) has brought the abortion issue back to the surface. Bear in mind, Buddhist temples in Thailand commonly perform cremation ceremonies and also store bodies in refrigerated storage areas. In the wake of gruesome revelations, the issue of unwanted pregnancies and abandoned babies have been put forth in the public eye again.

It has been mentioned by many pundits that some 200,000 women in Thailand annually undergo illicit abortions, although it's impossible to get accurate statistics. According to the National Institute for Child and Family Development, about 300,000 women and girls seek illegal abortions every year. The extent of dead fetuses, which is probably just the tip of Thailand's illicit abortion iceberg, stuns the nation's conscience.

Abortion Policy and Practices in Thailand

Some medical professionals discretely advertise the abortion business, but many abortionists are untrained, which commonly leads to dreadful consequences.

So, abortion in Thailand is de jure legal only when it is considered necessary to protect a woman's health or in case of rape. Under the recently revised (but yet published) abortion regulations issued by the Medical Council of Thailand, the term "health" includes mental, emotional, and physiological considerations as well as physical conditions. The determination that a woman qualifies for a legal abortion under that criteria can only be made by a medical doctor licensed in Thailand.

This determination (and, if positive, an abortion procedure) can be done at any hospital, private, or government. Though, some private hospitals with religious affiliations may choose not to provide that service. In early pregnancy, it can also be done at one of the many low-cost clinics operated by the Thai NGO Population & Community Development Association (PDA). For cost estimates, contact the hospital or clinic of your choice. Just remember that they will not tell you if they will be able to perform the procedure until the woman has met with a doctor.

Why do women have abortions?     (Worldwide Abortion Stats)
• 1% of all abortions occur because of rape or incest
• 6% of abortions occur because of potential health problems for the mother or child
• 93% of abortions occur for social reasons (i.e. a child is unwanted or inconvenient)

Mid-Pregnancy (20 weeks or so) Fetus in Mother's Womb

Important remarks!       (Are You Pregnant?)
Never consider getting an abortion anywhere other than a licensed clinic or hospital. Serious complications can arise from receiving an abortion from someone who lacks the necessary training or qualifications.
Abortion is an emotionally and hormonally upsetting procedure. Clinics and hospitals which are not usually frequented by foreigners may have a limited ability to provide appropriate counseling to farangs (westerners in Thai) due to the language barrier and cultural differences. Hence, women who do not speak Thai would be well advised to go to one of the larger international hospitals, or at the least, bring along a close friend who is a fluent Thai speaker.
If you become aware of the chance of an unwanted pregnancy within two weeks of possible conception, over-the-counter 'morning after' pills (popular brand names in Thailand are Madonna and Postinor) should be used. While these are to be used within 72 hours of possible conception, the latest research has shown that they are still worth taking for up to two weeks. Their effectiveness drops, but may still prevent pregnancy in 50% of cases. During the first 72 hours, they prevent the vast majority of pregnancies. These preclude a fertilized egg from implanting in the uterus, and so from a medical standpoint, prevent a pregnancy from taking place. Menstruation will occur as usual, and it will not be possible to tell if fertilization (conception) had taken place or not.

Teen Pregnancy in Thailand

According to records of the Department of Health, each year 10,000 students under the age of 15 become pregnant in Thailand. The subject of students' premature pregnancies and their legal right to compulsory education is attracting much controversy, particularly if it's related to early teen pregnancy.

As a rule, teenage girls don't intend to get pregnant. They just lack life's experience. By denying them education, it isn't just punishing them alone, which is wrong by itself, but a punishment for their children and families alike. They have already been punished by having to look after a child at such a young age, but to cut short their educational opportunity...

Thailand is a signatory to the convention on the rights of the child, so one can argue that a policy of expelling pregnant teenage students is against the law. The students' Pregnancy Bill proposed by the Thai government draws a hot debate. A draft bill intends to give pregnant students the legal right to take maternal leave and continue their studies after giving birth.

"A right is not something that somebody gives you.
It is something that nobody can take away."

Teenage sex has been going on since the get-go, but in Thai culture, it has largely been a thing that in the past wasn't spoken about whatsoever. Culturally, showing affection in public (such as holding hands, hugging, and kissing) is frowned upon in Thailand. And eventually, those taboos along with an attitude to sex are changing with the younger generation. Sex education and safe sex lessons in schools would help prevent teenagers' premature pregnancies and should be urged by all concerned.