We invite everyone to understand and prepare if the option is to terminate a pregnancy.
1) What to do when you suspect you might be pregnant?: The risk of pregnancy is having unprotected sex without effective contraception, such as counting days, withdrawal, or not using condoms. However, even with contraception, there is still a chance of pregnancy because no method is 100% effective.
How do we check if we are pregnant?: Check for pregnancy using a pregnancy test kit, available at pharmacies. Test 14 days after unprotected sex or after a missed period of at least one week. If unsure after the first test, wait another 7 days and test again.
2) If pregnant and not ready, what to do next?: Unplanned pregnancy is a situation that can happen, so life must always have choices. Review the situation, evaluate options that align with our lives, and listen to our own needs: whether to 1) continue the pregnancy or 2) not continue the pregnancy. We have the right to choose the path that aligns with our lives. Decide early when you start realizing you’re not ready because the longer the pregnancy, the harder it is to terminate.
3) Is choosing to have an abortion illegal?: If the pregnancy is less than 12 weeks, the pregnant person can decide on their own, and it is legal. If the pregnancy is more than 12 but less than 20 weeks, you can receive counseling services and legally terminate the pregnancy. At any stage of pregnancy, termination is possible in cases of physical or mental health issues, fetal abnormalities, pregnancy from rape or sexual abuse, or if the pregnant person is under 15 years old.
4) Where can you get counseling for unplanned pregnancy?:
Phone counseling: Call the unplanned pregnancy hotline 1663
Online counseling: Line@TamTang group or Facebook page Unplanned Pregnancy Hotline 1663
Automated system counseling: RSA Online
Counseling at state hospitals, adolescent clinics, or One Stop Crisis Centers with counseling services supported by the NHSO, where services are free for users.
Click here to see counseling channels: https://rsathai.org/qrcode/
5) Deciding to have an abortion, what you need to know is how far along is the pregnancy?: Knowing the gestational age will help determine where to receive services, as each place offers services at different gestational ages. Gestational age is measured in weeks, calculated from the first day of the last menstrual period to today (not from the date of intercourse, as many mistakenly believe). Click here to calculate gestational age
If you can’t remember your period, you can determine gestational age through an ultrasound: Since 2023, pregnant individuals with any health coverage can receive services free of charge at NHSO network facilities or use clinic services that offer them but must pay for the service themselves.
6) How to access abortion services?: Only some hospitals or clinics in Thailand offer abortion services. You can receive services at RSA volunteer network facilities that volunteer to refer abortion services (RSA volunteer network established by the Department of Health, Ministry of Public Health). Facilities include state hospitals, private hospitals, private clinics, and public benefit organization clinics distributed across all regions of the country, each accepting different gestational ages, indications, and referral areas.
Information on RSA network facilities is divided into 2 groups
1. Service users can coordinate or walk in to receive services themselves, which are private sector facilities with information on the website https://www.rsathai.org/networkservice
2. Facilities that require coordination through various counseling service units first to help coordinate referrals and schedule service appointments. Contact the unplanned pregnancy hotline 1663 for coordination assistance from 9:00 AM – 9:00 PM every day.
*According to adolescent pregnancy prevention guidelines, service users under 15 years old must have a guardian sign for service.
7) How much should you prepare for abortion costs?:
*The cost of abortion increases with gestational age.
**Currently, the NHSO supports ultrasound, abortion, and post-abortion contraception services for Thai service users with any health coverage. Services can be accessed at state hospitals under the Ministry of Public Health, using NHSO treatment rights.
Or receive services at private hospitals or clinics that are NHSO service units, which may incur additional costs depending on gestational age. If receiving services at private hospitals/clinics that are not NHSO service units, costs range from 5,000 – 20,000 baht, depending on gestational age.
8) There are two methods of abortion:
1) Use a vacuum aspirator or MVA to suction from the uterine cavity, applicable up to 12-14 weeks of gestation.
2) Use abortion pills, applicable at any gestational age, using two medications together (Mifepristone and Misoprostol). In Thailand, there are two registered brands. For gestational age under 12 weeks, doctors will prescribe the medication for home use, monitor during medication use, ensure complete abortion, and provide post-medication care.
Watch a video on modern and safe abortion methods: https://facebook.com/rsathai.org/videos/714192146304465
9) What to expect when visiting a medical facility?: The facility may be a clinic or hospital. After registering, you will receive counseling from a social worker or nurse. Then, you will meet a doctor for history taking, physical examination, and ultrasound to determine gestational age, and sign consent for treatment.
*Service users under 15 years old must have a guardian sign on their behalf.
Each gestational age has the following treatment guidelines:
Gestational age under 12 weeks
– Abortion can be performed with an MVA device, and after recovery, you can go home.
– Abortion with medication: The doctor will prescribe the medication, explain in detail how to use it at home, provide medication usage documents, contact channels during and after medication use, and schedule follow-up and contraception.
For gestational age over 12 weeks, abortion is only performed with medication, requiring inpatient stay at the hospital until complete abortion, and contraception before going home.
Watch videos
– Abortion with vacuum aspiration or MVA (Manual Vacuum Aspiration):
https://facebook.com/rsathai.org/videos/1558401454590176
– Abortion with medication:
https://facebook.com/rsathai.org/videos/729273161527261
10) Medication use, abortion, and post-abortion care at home: For gestational age under 12 weeks, the facility will prescribe abortion medication for home use: 1) Take the first type of medication at the facility or at home, and 2) 24-36 hours later, use the second type of medication, 4 tablets, by placing them under the tongue, in the cheek, or inserting them into the vagina. Side effects may include fever, chills, nausea, vomiting, abdominal pain, and diarrhea 1-2 times. During this medication use, have a friend present to assist.
After 4-6 hours of using the second medication, you will experience abdominal pain, increased bleeding, and the expulsion of the pregnancy sac, tissue, embryo, and placenta, indicating abortion. Symptoms will gradually decrease and disappear.
Seek medical attention at a nearby hospital immediately if you experience the following symptoms:
o Severe continuous bleeding
o Dizziness, fatigue, fainting, weakness
o Fever lasting more than 24 hours or fever with chills
o Foul-smelling vaginal discharge, abdominal pain, pelvic pain
After abortion, there may be more bleeding than a normal period for 1-2 days, which will gradually decrease. During this time, avoid exercise or heavy work. Menstruation will return in 4-8 weeks. Ovulation can occur quickly, and unprotected sex may lead to pregnancy. *Don’t forget to use contraception/condoms every time you have sex. Attend follow-up appointments or self-test urine 3-4 weeks after abortion.
11) Mental care after abortion: After abortion, it is normal to feel depressed due to hormonal changes, similar to postpartum depression, and it will disappear within a month. Family, friends, surrounding people, and societal attitudes can affect whether this feeling improves or worsens.
Continue living with understanding, use contraception or condoms to prevent pregnancy. Life experiences, both positive and negative, create learning and strengthen life.
How to take care of yourself after abortion, watch the video: https://facebook.com/rsathai.org/videos/1034024740812433