Most women facing unplanned pregnancies are overwhelmed with sorrow, regret, shame, worthlessness, loss of confidence, and morale. In such situations, using intelligence and concentration to reflect on the problem and consider solutions is very difficult.
On December 26, 2016, there was news from the RSA volunteer network in the Northeast that a patient spent 6,000 baht on an illegal abortion by injecting a solution into the vagina, but it was unsuccessful. There was slight bleeding for 3 days. She waited another 3 weeks but did not miscarry. When she returned to the same person, they said she had to pay another 6,000 baht. She went to see a doctor and had an ultrasound showing a pregnancy of 18 weeks. Many women have failed with this method. This case is concerning, as it wastes money, doesn’t solve the problem, and involves deception.
RSA doctors in the North also found two women who had unsafe abortions by injecting saline into the vagina during the same period. The AIDS and unplanned pregnancy hotline 1663 provided counseling and referred many women to doctors for safe abortions. They helped a 32-year-old woman who bought abortion pills from an online drug-selling website, but the pills were ineffective.
Knowing that these two methods are risky and ineffective, women should not choose them.
On December 14, on Koh Chang, Trat Province, villagers found the body of a fetus about 5-6 months old discarded in a trash can. The body had bruises and was covered with ants. It is assumed that the mother could not care for it.
On December 26, on Koh Samui, Surat Thani Province, a fetus was found in a garbage pile, red in color, with the umbilical cord still attached. It is believed that the mother was not ready to take responsibility and performed a self-abortion upon discovering the pregnancy.
In both news cases, the police said they would continue to pursue the matter. Both cases involved abortions that were too late, with a high risk of hemorrhage, considered dangerous and not advisable at such an advanced stage of pregnancy.
Academic information indicates that the danger of abortion increases with the gestational age. Pregnancies over 3 months are 10 times more dangerous than those under 3 months. Abortions should be performed early, within the first 2 months, for maximum safety by a doctor.
Uncle Doctor asked the opinions of relatives and women with unplanned pregnancies about why they bought abortion pills from websites. The answers were:
(1) Afraid to see a doctor, fearing the doctor would not perform the abortion, make them continue the pregnancy, and view them as bad women.
(2) It matches their solution and needs.
(3) Fear of legal and moral issues.
(4) Want to keep it a secret.
(5) Convenient, not complicated.
(6) Lack of awareness.
(7) Fear of parents finding out if they see a doctor.
Those who did not buy pills from websites had reasons such as:
(1) Unsafe.
(2) Fear of being deceived.
(3) No one to consult when problems arise.
They concluded that websites might be more accessible and convenient, but Uncle Doctor wants women to choose to believe that “seeing a doctor is more reassuring, confident, and safer.” Most importantly, they can consult at any time.
Additionally, the 1663 hotline revealed service results in 2016, showing that
555 women with pregnancies between 17-29 weeks wanted abortions, which is considered late consultation and very dangerous. 197 patients admitted to buying abortion pills, 130 tried self-abortion, and 75 went for unsafe abortions. None of these three methods should be chosen as they may not result in abortion and pose risks of bleeding and infection.
93 people bought pills from the internet, with poor results: only 3 successfully terminated the pregnancy, 1 had health impacts, 74 failed to terminate, and 60 experienced adverse health effects. 5 did not use the pills due to safety concerns, and 2 were deceived as they did not receive the ordered pills.
The results are certainly not good, are they?
Research in 2007 on “What Causes Women to Delay Abortions” by Illy Lee and team from the University of Southampton, England, found delays in the “path to abortion” at one of five stages:
(1) Suspecting pregnancy.
(2) Between suspicion and pregnancy testing.
(3) Knowing the result and decision-making.
(4) Decision-making and requesting an abortion.
(5) Between requesting an abortion and the abortion process. Delays were caused by the women themselves or the services. For women, reasons included not testing for pregnancy, letting time pass, delaying seeing a doctor for months, uncertainty about abortion, worrying about abortion, waiting to ask a partner or others, thinking the pregnancy was still small.
Service-related cases included long waits for doctors, delayed appointments, unfamiliarity or confusion about the location, changing doctors. Delays in each stage could range from a few days to several weeks. Thai women face similar issues, with common mistakes being not thinking they could be pregnant due to frequent missed periods, leading to complacency and not testing to confirm pregnancy.
An example is a 26-year-old woman who saw a doctor on December 15. She thought she missed her period for 2 months because she had her period for 4 days on October 10. She had a history of receiving contraceptive injections in Khon Kaen, but when it was time for the next injection, she was in Bangkok. The doctor there did not give the injection because she was not menstruating and advised her to come on the second day of her period. She was advised to take birth control pills, but she forgot and had bleeding on October 10. An ultrasound showed a pregnancy of 17 weeks, not just over 2 months as she thought. The delay was due to misunderstanding and not noticing pregnancy symptoms.
Consulting about pregnancy, “Time and decision-making are the most important.” Knowing about the pregnancy and seeing a doctor as soon as possible is best. Methods that are ineffective and unsafe should not be chosen by women.
With love and concern,
Dr. Rueangkit Sirikanchanakul, RSA Network Coordinator