On March 8, 2018, Dr. Wachira Pengchan, Director-General of the Department of Health, stated that the World Health Organization estimates that each year there are approximately 46 million abortions worldwide, of which about 20 million are unsafe abortions, and approximately 70,000 women die from unsafe abortions annually. 95% of these occur in developing countries, including Thailand. However, there is still no clear data on pregnancy termination because many unplanned pregnancies cannot access safe and legal services, leading them to seek illegal abortion services or purchase abortion drugs from the internet.
Dr. Wachira said that in the past, to reduce the harm from illness and death from unsafe abortions, the Department of Health collaborated with the Faculty of Medicine at Chulalongkorn University, Siriraj, Ramathibodi, Khon Kaen, and Songkhla Nakarin, under the support ofConcept Foundationand the World Health Organization, to research the system of providing medical abortion services. Subsequently, the drug was pushed for registration in 2014 and included in the national essential drug list in 2015 for use in legal abortion services and medical council regulations.
The abortion drugs are called Mifepristone and Misoprostol. Currently, there is a combined pill called Medtabol, which has been registered as an essential drug by the World Health Organization (WHO) and can be used safely for pregnancies less than 9 weeks.
In Thailand, this drug formula was registered as MeFi-Miso in December 2014, and most recently in June 2016, MeFi-Miso was included in theEssential Drug List J (1), meaning that the general public can access Mifepristone, Misoprostol, and Medtabol, but must be within special projects of ministries, departments, or government agencies that monitor and evaluate drug use. Currently, there is a network of 85 public and private hospitals and clinics across Thailand where women seeking to terminate a pregnancy can access services. Generally, these drugs are not sold in pharmacies or hospitals and clinics not participating in the project.
“For over 60 years, Thai law has allowed women to terminate pregnancies under the Penal Code, Section 305, where the abortion provider must be a licensed medical practitioner in cases where the pregnant woman has physical or mental health problems or becomes pregnant due to criminal acts as defined, such as rape, a child under 15 years old, consensual or non-consensual sex work, or indecent enticement. However, in the past, there have been very few health facilities providing safe abortion services due to societal attitudes and many healthcare providers still viewing abortion negatively and opposing the provision of abortion services in their facilities. Therefore, the Department of Health has pushed for the establishment of a volunteer network for safe abortion referrals (RSA: Referral System for Safe Abortion)to improve access to services for teenagers and women with unplanned pregnancies,” said Dr. Wachira.
Dr. Wachira said that those with problems can call the unplanned pregnancy consultation line 1663 to receive counseling and referral services, whether the choice is to continue the pregnancy or terminate it, as well as effective contraception services. Currently, theRSAnetwork has 110 officially appointed volunteer doctors from the Department of Health and 262 multidisciplinary volunteers to ensure Thai women have a good quality of life in celebration of International Women’s Day.
According to statistics from the National Health Security Office (NHSO) survey on the situation of pregnancy termination in Thailand in 2012, the mortality rate from unsafe abortions among Thai women is 25-30 per year, and approximately 30,000 women are injured due to complications from unsafe abortions.
Pregnancy termination (abortion) can be legally performed for two reasons
First reason: Legal reasons, when the pregnancy is a result of a criminal offense in cases of rape and cases related to the provision of sexual services with threats for the purchase of sexual services, doctors can legally terminate the pregnancy. Additionally, pregnant women under the age of 15 can terminate the pregnancy because there are laws protecting minors.
Second reason: Medical reasons, if the pregnancy affects the mother’s health, the pregnancy can be terminated.