Unplanned Pregnancy

SituationThailand is still lacking sufficient knowledge

on women's sexual and reproductive health. The

country's public health continues to aim at treating

illnesses rather than assisting patients in making theirown healthcare decisions. By social norms, medicalpersonnel are the decision-makers in treatment

selections. This is especially true with abortion where

the service is determined solely for medical reasons.

Women's needs are regularly ignored in such interest.

Abortion services do not include counseling and had

never been in the hands of women. When women want

to have an abortioil, it is taken away. When HIVpositive women want to keep their wanted pregnancy,

they are persuaded to terminate the pregnancy.

Research findings

There's no evidence of written record of the

experiences of women with unplanned pregnancies available

in Thailand. The women's valuable experiences were

never used in the design and implementation ofwomen's health policy, sex education curriculumdevelopment, of public education campaigns. Againstsuch backdrops, the Bangkok Office of the Population

Council carried out a research project entitled"Documenting Experiences of Women with Unplanned

Pregnancy." The following indicates some selected new

findings.

The discourse on "not being ready" Study

participants used the phrase "not being ready" in theiraccounts of unplanned pregnancies. The word"not-ready" functioned as a global frame of their feelings,

opinions, and reasoning of their unplanned pregnancies.

Each woman's state of not being ready differed and was

closely related to their life contexts at the time ofpregnancy. The discourse on "not being ready" has the

following signifi cance:

First, every woman has different definitions of "being

ready" and "not being ready" than other women. The

term can not be standardized for all women. One

woman cannot use another's definition to determine her

state of being ready.

Second, by legitimi zing the need for abortion as the

outcome of their "not being ready," interviewees have

redefined our former popular word of "unwanted

pregnancy." For the women, unplanned pregnancy

was not the outcome of inappropriate behaviors,

failures, or ignorance. Rather, it is symptomatic of a

larger patriarchal sociocultural structure of Thaisociety. Redefining their pregnancies, the women

have claimed their insiders' authority and attempted

to rescue women with unplanned pregnancies fromsocietal blames by pointing out to the accidental nature

of unplanned pregnancies and fate, both of which are

beyond their control.

Myth about abortion Understanding about abortion

in Thailand is seriously tainted with some uninformedbeliefs. It needs to be corrected urgently to pave ways

for appropriate policy. The followings are

counterpoints to the prevailing false beliefs:

f{r*{ #w#{y w{}rffi#pt vu{{fu wragsfwssrued pr{lryya{ipe{:V za*w{s

{88s sE&wer{f##&. Critics of "freedom to abortion" believe

that legal izing abortion will increase women's need

for abortion and that every woman with an unplanned

pregnancy will run to get an abortion anytime they

want. The belief is a false. There is no such thing as

"freedom to abortior," and legal izing abortion is not

granting a woman freedom to abortion. Rather, the legal

status of abortion will greatly create more choices forwomen to decide about their unplanned pregnancies.

Legal rzing abortion will provide safe abortionservices to women who will otherwise have it unsafe

anyway, and may possibly result in reproductivemorbidity, and even death.

Afersr{fupss {s rc#{ m{wrxys rs{ffit**f trp *rxrp{fser&a*wtf.

Pregnant women are not mothers. If a woman does

not think of herself as becoming a mother, the fetus

is not a child flookl. It can simply be a cluster of cells,

a fetus, a newborn, but not a child. Wording is critically

important. To name a fetus a child is to accord a

pregnant woman the mother status in spite of her

will. Motherhood must to be earned willingly. Itcannot be granted to a woman simply because she ispregnant. Likewise, fatherhood is not a result ofinsemination by a man. Motherhood and fatherhood

are achievable only when individuals are ready to

commit to care for a child with love and willinness to provide the child as best they could into a

complete adulthood.

The Policy Brief will serve as a tool in further policy advocacy work in an

effort to translate reproductive health research results and priorities into concrete

programmatic action. The dissemination of the Policy Briefs is hoped to initiate

concerns and discussions regarding these critical reproductive health issues among

groups of interested individuals within programs, as well as the general public.

For more information please contact :

The Population CouncilP.O.Box 138 Pratunam Post Office

Bangkok 1 0409, THAILAND,

Ph. (66-2) 653-8586-7 Fax: (66-2) 255-5513

Email: jitttima@ popcouncil.th.com www.popcouncil.org

Recommendations ffiwffiT

seruice devefopment

Shelters for women withunplanned pregnancies

in every province

Many women need to keep their unplanned pregnancy confidential fromtheir families, friends, and colleagues. Most of approximately 12 shelters forwomen in Thailand are located in Bangkok. More shelters, if possible in all 76provinces of Thailand, will help increase women's choices.

Access to efficientand user-friendlycounseling service

Counselors must not impose their views, any laws, regulations, or policyto influence women's decision. They must provide client-centered service and be

respectful of the women's needs and human rights. Counseling clinics must have

easy public access. Referrals must be responsive to the women's desires whetherthey be to terminate the pregnancy or carry it to full term.

Rights to state benefitsfor children

of unmarried mothers

Private organizations cunently provide benefits to their employees' chil-dren regardless of the mother's marital status. Unfortunately, the practice is notthe same for children of mothers who work for government agencies. It isimportant that all children receive benefits regardless of their mother's maritalstatus and as to where their mothers work.

Family planning servicesfor

unmarried women

Study findings indicate that unmarried women practice no contraception

during their first sex while married women do so as they are firmly educated by the

Thailand Family Planning Policy. As quality prevention can prevent unplannedpregnancy to some extent, Thailand should extend their family planning services to allpeople including unmanied women of all ages to help reduce unplanned pregnancy

problem.

Keeppregnant students

in school

A ccording to traditional practice, once a student is found pregnant, she isexpelled from school. The practice pushes students with unplanned pregnancies

away and into deeper isolation. The Ministry of Education should make a mandatorypolicy for schools to take the responsibility in providing skills and knowledge forstudents to practice safe and responsible sex. Once discovered a pregnant studentand she decides to carry the pregnancy to full term, an ideal solution for thestudent should be to grant of temporary leave of absence, a chance to study at

home, and an opportunity for her to take final exams at the end of the year.

Urgent needfor gender-sensitive

training formedical professionals

T ney should receive compulsory gender-sensitive training as part of theirrespected professional trainings. As medical personnel play important roles inhealthcare for women with unplanned pregnancies, Gender-sensitive medical

personnel can help reduce the women's stress and possible psychologicaloutcomes dramatically.

Available, accessible,safe, and effectiveabortion services

D espite the legal status of abortion, women in Thailand reportedlydemand for safe and effective abortion services, care for both their physical and

psychological needs, and pre and post abortion counseling service.

Legal protectionfor women with

unplanned pregnancy

Z tre thai government should offer legal protection for women withunplanned pregnancies. Having had an unplanned pregnancy and desperately

seeking a way to take care of the situation does not make a woman a criminal.As suggested by many women in the study, state authorities should not viewwomen with unplanned pregnancies who seek abortion as outlaws.

National seminar on Choices for Womenwith Unplanned Pregnancy

I

The Population Council organi zed the nationalseminar on July 6, 2000 at Watergate Ballrooffi, AmariWatergate Hotel, Bangkok. The collaboratingorganizations were the Division of Family Planning and

Population (Ministry of Public Health), Institute forPopulation and Social Research (Mahidol University),Thailand Criminal Law Institute, Association for the

Promotion of the Status for Women, and Center for the

Protection of AIDS Rights. The one-day seminar was

attended by 700 multi-disciplinary participants fromprovinces throughout Thailand.

After an opening remark by the Minister of JusticeMr.Suthat Ngeun-meun, and a keynote speech by SenatorMeechai Veeravaidhaya, there's a session to review and

assess the choices of women with unplannedpregnancies. Dr.Suchada Rachukool from the Facultyof Nursing, Chulalongkorn University began by givinga brief history of abortion studies in Thailand.Ms.Nattaya Boonpakdee from the Population Councilpresented findings from the study on "Documenting the

Experiences of Women with Unplanned Pregnancies."Dr.Surasak Thaneepanichsakul from the Faculty ofMedicine, Chulalongkorn University talked about the

accounts of abortion in medical doctors' opinion. At last,

Dr.Suwanna Worakamin, the director of the Division ofFamily Planning and Population from the Ministry ofPublic Health stated her perspectives on "the state

policy for its people."

In the afternoon the participants had the opportunity toselect a group of their interest to participate. The fivegroups are;

l) Cultural Contexts: Thailand's Diverse Values, Ethics,and Religious Beliefs towards Abortion. The discussionfocused on beliefs and attitudes of Thai people towardsabortion. Some viewed abortion as a religious sin.

Some took a practical stance and thus view abortion as

the better of the two evils. Many used human rightsapproach which opened up for a debate on whose rightsshould be respected between a woman's rights to end

her pregnancy and a fetus's rights to life. The group

analyzed how cultural diversity in Thailand shaped the

life quality of women during and after an unplannedpregnancy.

2) Alternative Unplanned Pregnancy Bill. The Thai State

criminalizes abortion and stigmatizes women withunplanned pregnancy, who, in fact, need help.

In search for legal alternatives to protect and guarantee

women's rights to safe life, the discussion took a justice

approach to evaluate articles 301-305 of the CriminalCode.

3) Institutional Regulations, Social Services, and ServiceDelivery in Response to Unplanned Pregnancies. Many

women were pregnant as a result of failed birth controlpractices. They did not have knowledge and access to

effective birth control methods. For these and manyother women, although abortion was not a desirablesolution, they had to seek one in order to survive.Many unmarried women choose to terminate theirpregnancy over their employment. Many unmarriedwomen reasoned it as they would not have sufficienteconomic resources to raise their so-called"illegitimate" children since they could not claimchildc are benefits. For many poor women alreadyburdened with providing for their families single-handedly, another mouth to feed would endanger the

survivability of their whole families. By using the

real-life experiences of women with unplannedpregnancies, the group demystified "unplanned

pregnancy" and brainstormed to find effectiveprevention measures and appropriate responses to the

diverse causes of unplanned pregnancies in order tobetter serve women's needs.

4) Options for Women with Unplanned Pregnancies.Many people think that abortion is the only solution tounplanned pregnancy. Many also define "freedom toabortion" as women's access to unregulated abortionservices. These opinions are unfortunate over-simplifications, which have hindered attempts to set upa system that provides a range of services for womenfacing unplanned pregnancy. The group learned about

different experiences of women with unplannedpregnancies, identified these women's diverse needs and

interests, and discussed the potential design of a service

system for diverse groups of women with unplanned

pregnancies.

5) Public Education: Critical Mass Media for Womenwith Unplanned Pregnancies. The Thai mass media can

have a decisive role in shaping public opinion aboutabortion and women who have sought abortionservices. In recent years, radio, television, and printmedia personnel have sometimes not been objective in

their news coverage. Reports on abortion-relatedincidents have been tainted with personal prejudices,

which, unfortunately, further the stigmatization ofwomen facing unplanned pregnancies. The groupdeliberated on effective mass media for women and

people's democratization process.

At last, Dr.Kritaya Archavanitkul from Institutefor Population and Social Research, MahidolUniversity moderated a plenary discussion on"Creating Options for Women with UnplannedPregnancies: Achieving a Holistic Approach toWomen's Health."

All seminar discussions are included in the

seminar proceedings.

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fl uridln:0.:?nirYruroof unr The Population Council!t

nl,in?i'rru ETtllrrir.:'ru.lrurfoleiu: n'r:io-urio.rilreunr:niro.r#udldei"rr{orrdohivrial. flnlrj::mn:. 2943.le

The Alan Guftmacher lnstitute. Sharing Responsibility: Women, Society and Abortion Worldwide. New York: AGl, 1999.

Supom Koetsawang. 'lllegally lnduced Abortion in Thailand," Paper Fresanterl in IPPF SEAO Regional Programme Arlvisory Panel Meeting on

Ahortion. Bali, 29-30 October 1993.

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