Unplanned Pregnancy Hotline 1663 reveals that women with unplanned pregnancies cannot terminate their pregnancies under the law. It suggests that all health service facilities should provide pregnancy termination services to reduce harm to women.
August 8, 2018, the AIDS and Unplanned Pregnancy Consultation Hotline 1663 held a press conference on “Women with unplanned pregnancies being denied termination even under legal conditions” via Facebook Live on the 1663 AIDS and Unplanned Pregnancy Consultation Hotline fan page.
Nimit Tienudom, Director of the AIDS Access Foundation, stated that from the consultation services provided by the AIDS and Unplanned Pregnancy Consultation Hotline 1663 over the past year (August 1, 2017 – July 31, 2018), it was found that there were 28 service recipients who were eligible to terminate their pregnancies under legal and medical criteria but were denied services. This includes cases such as fetal abnormalities, pregnancies affecting the physical and mental health of the pregnant woman, service recipients under 15 years old, and pregnancies resulting from abuse. Being denied termination services leads these women to seek unsafe, non-standard services. Some even order medication from websites to terminate pregnancies themselves. According to the National Health Security Office (NHSO), in 2016, there were 11 deaths from unsafe pregnancy terminations, and the state incurred 112 million baht in expenses for treating those affected by unsafe terminations.
Nimit further stated that over the past year, the 1663 hotline found that 652 service recipients attempted to terminate their pregnancies themselves, such as ordering drugs from illegal websites or self-harming to induce miscarriage. This indicates that unplanned pregnancies, regardless of their cause, impact women’s mental health. Although termination is legally permissible, it is often denied due to negative attitudes of healthcare personnel towards pregnancy and abortion. This results in women being injured or dying from unsafe terminations every year. Therefore, it is urged that all health service units provide termination services for women with unplanned pregnancies to ensure quick and safe access to services. Currently, the Ministry of Public Health, through the Department of Health, has a policy to promote safe termination services for women with unplanned pregnancies, supported by medication and funding from the NHSO.
Achara Kaewpradit, Head of Operations for the 1663 Consultation Hotline, provided details on cases where service recipients were denied termination services despite being under legal conditions. One service recipient was pregnant, and the attending physician initially assessed that the fetus might have abnormal brain development, which could be confirmed in the fifth month of pregnancy. Additionally, a tumor was found on the cervix. However, the service recipient did not want to wait until then, as terminating a later-stage pregnancy would be emotionally difficult. She informed the hospital of her wish to terminate the pregnancy immediately, but the hospital under her rights did not provide the termination. When the service recipient consulted the 1663 hotline, she was able to terminate the pregnancy at a clinic within the RSA (Referral system for Safe Abortion) network. In another case, a service recipient was 19 weeks pregnant, and an ultrasound at a local clinic revealed 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 termination at the provincial hospital under the service recipient’s gold card rights. However, the provincial hospital refused, stating that they had no policy for pregnancy termination.
“We feel that the service recipients are very distressed because having to terminate a pregnancy due to fetal abnormalities is already painful enough, but being denied treatment by the hospital, even when eligible for termination, adds to their suffering. Not to mention the travel back and forth between their province and Bangkok, over 300 kilometers, only to be repeatedly denied,” Achara said.
Somwong Uraiwattana, responsible for the 1663 project, stated that from the consultation services provided by the 1663 hotline on unplanned pregnancies between October 1, 2015, and June 30, 2018, there were a total of 52,370 consultations. 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 1663 hotline referred 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 RSA doctors to help women with unplanned pregnancies receive safe termination services. However, if these services can be expanded within the normal public health service system, it would help women with unplanned pregnancies be safer and access services more conveniently without having to travel far. Since 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 termination services, while others choose to find ways to terminate on their own instead because they cannot afford travel expenses or cannot travel far due to family responsibilities,” Somwong said.
Source: https://prachatai.com/journal/2018/08/78195