Public Network Reveals 52,370 Direct Consultation Requests, Urges Government to Stop Negative Attitudes
Mr. Nimit Tienudom, Director of the AIDS Access Foundation, stated that from the consultation services of the AIDS and Unplanned Pregnancy Hotline 1663 over the past year (August 1, 2017 – July 31, 2018), it was found that 28 service recipients were eligible to terminate pregnancies under legal and medical criteria but were denied services. This includes cases where the fetus is deformed, the pregnancy affects the physical and mental health of the pregnant woman, service recipients under 15 years old, and pregnancies resulting from abuse.
The denial of pregnancy termination services has led these women to seek non-standard, unsafe services. Some ordered medication from websites to terminate pregnancies themselves. According to the National Health Security Office (NHSO), in 2016, 11 people died from unsafe pregnancy terminations, and the state incurred 112 million baht in treatment costs for those affected by unsafe pregnancy terminations.
Mr. Nimit further stated that over the past year, Hotline 1663 found that 652 service recipients attempted to terminate pregnancies themselves, such as ordering drugs from illegal websites or self-harm to induce miscarriage. This indicates that unplanned pregnancies, regardless of the cause, impact women’s mental health. Although pregnancies can be legally terminated, they are denied due to negative attitudes of healthcare personnel towards pregnancy and abortion, resulting in women being injured and dying from unsafe pregnancy terminations every year.
Therefore, all health service units are urged to provide pregnancy termination services for women with unplanned pregnancies to access services quickly and safely. Currently, technology for pregnancy termination is very safe and uncomplicated. The Ministry of Public Health, through the Department of Health, has a policy to promote safe pregnancy termination services for women with unplanned pregnancies, supported by drugs and expenses from the NHSO.
Ms. Achara Kaewpradit, Head of Operations for Hotline 1663 Consultation Services, provided details on cases where service recipients were denied pregnancy termination services despite being under legal conditions. One service recipient was pregnant, and the obstetrician initially assessed that the fetus might have abnormal brain development, which could be confirmed in the fifth month of pregnancy, along with a cervical tumor. However, the service recipient did not want to wait because terminating the pregnancy at a later stage would be emotionally difficult. She informed the hospital that she wanted to terminate the pregnancy immediately, but the hospital under her rights did not terminate the pregnancy. When the service recipient called Hotline 1663, she was able to terminate the pregnancy at a clinic in the RSA (Referral system for Safe Abortion) network.
Another case involved a service recipient who was 19 weeks pregnant. An ultrasound at a local clinic found fetal abnormalities. The clinic doctor, who was also a provincial hospital doctor, referred the service recipient to a hospital in Bangkok for a confirmatory ultrasound. The Bangkok hospital confirmed the fetal abnormalities and issued a referral for the service recipient to terminate the pregnancy at the provincial hospital under her gold card rights. However, the hospital refused, informing the service recipient that it had no policy to terminate pregnancies.
“We feel that the service recipients are very distressed because having to terminate a pregnancy due to fetal abnormalities is already emotionally painful, but being denied treatment by the hospital, even when eligible for pregnancy termination, adds to the distress. Not to mention the travel between provinces and Bangkok, which is over 300 kilometers, and being repeatedly denied,” Ms. Achara said.
4-Year Review Finds 52,370 Unplanned Pregnancies: Mr. Somwong Uraiwattana, responsible for the 1663 project, stated that from the consultation services of Hotline 1663 on unplanned pregnancies between October 1, 2015 – June 30, 2018, there were a total of 52,370 consultations on unplanned pregnancies. It was found that the number of adolescent service recipients under 20 years old increased every year, accounting for 30.1% of all service recipients. Of these, 89.7% had clear options after consultation, with 6.2% choosing to continue the pregnancy, while 83.5% chose to terminate the pregnancy. Hotline 1663 referred pregnancy termination services to both public and private service units under the law and medical council regulations.
“In the past, 1663 has worked with the Department of Health and the RSA volunteer network to help women with unplanned pregnancies receive safe pregnancy termination services. However, if this service can be expanded in the regular system of public health service units, it will help women with unplanned pregnancies be safer and access services more conveniently without having to travel far, as RSA doctors are not available in every province. Service recipients and willing doctors are very sympathetic. Some have to travel across regions from the north to the northeast to receive pregnancy termination services, and some choose to find ways to terminate themselves instead because they cannot afford travel expenses or travel far due to family members needing care,” Mr. Somwong said.