On Wednesday, April 5, 2017, in Khon Kaen province, doctors, nurses, pharmacists, and public health officials gathered to discuss “Assisting in Referring Unplanned Pregnancies for the Safety of Adolescents.” Uncle Doctor also attended the meeting and shared experiences on both medical and instrumental pregnancy termination.
Uncle Doctor told the attendees that there is currently a network of doctors, nurses, and multidisciplinary professionals volunteering to receive and refer safe pregnancy terminations, referred from the unplanned pregnancy consultation line 1663. This network is called “RSA Volunteers.” This meeting established guidelines for referring unplanned pregnancies in Khon Kaen province, with pharmacies in the province willing to refer women with unplanned pregnancy issues to meet with RSA volunteers for safety.
The issue of illegal abortion drug sales on the internet is still widespread. Recently, it was found that a nurse’s photo from a hospital in Nakhon Sawan province was stolen and falsely claimed as their own to advertise abortion pills, insertion pills, and blood-expelling pills on Facebook, with the accompanying text stating, “100% real delivery, interested in ordering, add the doctor’s Line.” The real nurse, the owner of the photo, has now filed a police report.
Another case example that Uncle Doctor encountered involved a 30-year-old woman with two children, the eldest being 5 years old and the youngest just 1 year and 3 months. She breastfed her child for 6 months and then continued with birth control pills. Normally, she works as a vendor at markets, working more than 10 hours a day, which often led her to forget to take her pills, sometimes taking them late or doubling up. She found that her last period started on January 25, 2017, and she missed her period in February. By March 13, she took a home pregnancy test and found out she was pregnant. Counting from January 25, she was 47 days or nearly 7 weeks pregnant. She searched the internet for abortion drug websites and found a shop called “Y_PA Clinic,” and ordered the pills.
“At first, they asked for 4,000 baht, claiming it was a special abortion pill that would definitely work, with all steps provided, asserting that their pills were genuine and not from a fake website. They instructed to transfer the money to an account, and the pills would be sent via EMS in 2-3 days,” she said. She was told to take all the pills and insert one pill every 4 hours, not to move after insertion, and to observe symptoms for one night and one day, including buying insertion equipment.
She decided to transfer the money, but after 3-4 days, she still hadn’t received the pills, so she called to follow up. He angrily said, “I don’t have time to answer questions 24/7, and I’m not in debt to anyone,” then sent a real EMS number. She noted that Y_PA Clinic’s delivery was complicated, initially sent from Bang Bua, Chachoengsao, then rerouted to Sriracha, Chonburi, and finally to Khon Kaen, with the account number she transferred to seemingly not belonging to the same person.
A week later, she received the pills (she checked with the post office and found the package was registered, not EMS). She found the pill name was Cytotec, with instructions to insert 2 pills vaginally, along with 12 capsule pills to be taken 4 times before insertion. However, nothing happened except for some mucus and slight bleeding, with no abdominal pain. She called the original website to report that the abortion didn’t occur, and the pills didn’t work, but no one answered, so she messaged via Line. They blamed her for not inserting deeply enough according to the steps. When she argued that she followed all the steps and bought the insertion equipment, which was for antifungal vaginal suppositories costing 190 baht, they said she needed to buy another set of pills. She realized that continuing with the pills might be dangerous. After consulting a younger friend, she was advised that she might have been scammed and was recommended to see an RSA doctor.
On March 20, 2017
She met with a volunteer doctor to discuss the issue and had an ultrasound, revealing an 8-week 4-day pregnancy with an embryo measuring 1.76 cm. She told the doctor, “If I keep it, I’m afraid it will be affected by the pills, afraid of side effects… if I’m pregnant, I can’t do anything.” She said she had to take care of her children herself, losing income because she had to stop to care for them.
During her first pregnancy, she had to stay in the hospital for 2-4 months due to morning sickness and needed constant IV fluids. The second pregnancy was just as severe, but she stayed at home. She received care and problem-solving from real doctors, ensuring safety with pregnancy termination drugs used in the RSA network.
On March 29, 2017
A woman with an unplanned pregnancy received a termination from a community hospital in the central region, referred by the unplanned pregnancy consultation line 1663.
She said, “I admire the work of the medical team and hospital staff, especially the doctor. Before receiving the service, I felt scared and imagined the termination to be quite frightening, but in reality, it wasn’t as scary as I thought. Moreover, I received friendly and close care, making me feel like a VIP guest of the hospital.”
On the same day, another client at an RSA network clinic sent a message saying,
“Everyone is kind and compassionate, helping me through my troubles. I came with insufficient money, and they helped, even providing money for the ride home. At first, I was very scared, but after experiencing this, it wasn’t as scary as I thought.”
Uncle Doctor understands that women facing unplanned pregnancies need safety, confidence, friendliness, confidentiality, and someone to listen and encourage them. There are still women with unplanned pregnancies who are unaware of the available services nationwide. Therefore, it is encouraged to choose a safe path by calling the unplanned pregnancy line 1663 for consultation and assistance in being referred for effective pregnancy termination services.
With love and care
Uncle Doctor Ruangkit Sirikanchanakul