Birth Control, Pregnancy Termination and Abortions in Thailand

Expert Advice on Birth Control

Even if you use some other methods of birth control, condom is the king. Condoms not only prevent pregnancy, they are the only solution that protects against sexually transmitted diseases. Just in case of new romantic sexual encounters – you meet that "perfect" person, and... get caught in the heat of the moment. Condoms also protect you (and potentially your partner) from urinary and vaginal infections. Although, condoms are commonly available almost everywhere, keep in mind that selection and quality may be limited.

The most popular brand of condoms in Thailand is Durex. It can be found at most 7-eleven stores and many other convenient places. A relatively new condom that hit the Thai market in early 2000 is called BodyGuard. This larger size condom is foreigner-oriented and marketed mainly towards the tourists and ex-pat community. It is commonly found in vending machines in go-go bars and pickup joints in downtown Bangkok in Silom and Sukhumvit areas. It is also readily available in many bars and shorttime hotels in popular tourist spots throughout Thailand.

STD on the Rise

Sexually Transmitted Diseases (STD) cases are on the rise in Thailand. In the past five years, the number of STD patients has almost doubled. According to the Public Health Ministry, in 2009 alone, nearly 25,000 cases have been recorded. The most prevalent STDs are gonorrhea with over 7,000 cases, followed by pseudogonorrhoea and syphilis, and most patients are between 15 to 24.

There is no excuse for syphilis to be on the rise. It's a preventable disease, but a commitment from the government to stop it is required. Charitable groups like the Clinton Foundation and the Gates Foundation all required government cooperation as part of the grant process.


Tongue-In-Cheek Remarks
Another special type of 'condom' that struck scores of newcomers to Thailand is the ever present receptacle called BeerGuard provided by the bar when you order a bottle of beer to keep it cool.

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Is your laptop cooking your testicles?   (Reuters Health)

Whoever invented the 'laptop' probably didn't worry about male reproductive health. Turns out, unsurprisingly, that sitting with the PC on your lap will heat up your nether regions, which could affect sperm quality. And there is little you can do about it, according to the study published in the Fertility and Sterility journal, short of putting your laptop on a desk.
If you're still in the reproductive age range – beware!

Oral Contraceptives – "The Pill"

A large number of locally made over-the-counter (without a doctor’s prescription) birth control pills are sold in widely accessible drugstores and pharmacy shops in Thailand. Virtually all pharmacists are English speaking. Many local and generic brands of contraceptive pills are broadly available throughout Thailand. They obstruct sperm from fertilizing an egg and are reliable, effective and inexpensive. Government hospitals provide the contraceptive pill for free, or for a donation of five baht or so. These pills, however, usually contain high-dose of oestrogen hormone and might have adverse side effects.

In fact, over 300 different brands of the contraceptive pill are on the market. All 300-plus brands contain the same active ingredients: oestrogen and progestogen. Pills marketed as premium brands, being able to reduce acne ("teen's pimples"), enlarge the breast's size and tenderness, increase libido, or not lead to weight gain, will cost more. When a particular pill is still under the license, is usually made abroad, and thus is more expensive.

Air Travel During Pregnancy

Quite often we are asked if it is safe to fly during pregnancy. The answer is:
Air travel poses no special risks for a healthy pregnant woman or her baby. Mid-pregnancy period (14 to 28 weeks) is considered the best time to fly. It is recommended to drink plenty of fluids and take short walks every half-hour or so during the flight.

Abortions

According to the Thai law (in effect since 1956), abortions are illegal in Thailand, except for the girls under the age of 15 or with a serious illness, and when the pregnancy threatens the woman’s health or results from rape or incest. Yet de facto, the abortion law is rarely enforced, and illegal abortions remain common and an important public health issue for women in Thailand. There is evidence of wide public support led by women's groups, medical and legal professionals for the reform of abortion laws to widen the circumstances under which an abortion is legal.

Ethical and Religious Concerns of Abortions in Thailand

Buddhism is the state religion in Thailand and Thais try to setup their legal system in line with Buddhist principles. Buddhism is generally depicted as extremely tolerant without attempting to impose its teachings on individuals. Although Buddhist morality is contextual and relative, it is not generally antinomian. Basically, the moral consequences of an act are determined by one's will or motivation. If the will behind an act is driven by greed, hatred, or delusion, which Buddhists regard as the three fundamental aspects of selfishness, then the act is deemed unskillful and be doomed.

The pro-life principle applies in case of abortion simply because "there is no qualitative difference between an unborn fetus and a born individual" in Buddhism. And the extent of the offence is proportionate to the intensity of the wish to kill. The moral consequences of abortion concern not only the kinship between the pregnant woman and her fetus, but also entails physical and mental trauma to the woman and all involved i.e. friends, family, advisors and technicians.

It is important to note that contraception, if it do no harm to the fetus or lovers, is reckoned to be skilful means. Obviously, from the Buddhist point of view, preventing unwanted pregnancies is far better than terminating them. Buddhism, however, advocates compassion for the individuals involved. According to Buddhist's precept, the state should not intervene in matters of conscience.

Buddhist community in Thailand is deeply divided on abortion issue. Some political leaders like Major General Chamlong Srimunang are firmly opposed to any liberalisation of the abortion law. Their position is based on the absolute sanctity of life in Buddhist tradition. Others, including some monastic leaders, take a much more global view, pointing out that in Buddhist morality, the intent of the action has much to do with the karmic result of the act. Thus, in some cases, abortion could be a skilful act that should be morally permissible, especially when it serves against greed, hatred, and delusion.

As the matter of fact, legal abortions are very seldom in Thailand. Even though, the abortion law is widely broken. Virginity is highly valued and there is a heavy social stigma against unmarried mothers, so that fear and shame drive many single pregnant women to illegal abortions. They are unable to face the social consequences of their situation and thus sacrifice their Buddhist principles against taking life. Contrary to the traditional Buddhist understanding, some rationalize that a very small fetus is not yet conscious and thus an abortion does not involve killing.

A latest horrific discovery (spotlit in November 2010) of thousands illegally aborted human foetuses wrapped in newspapers and plastic bags dumped at several Bangkok temples (wat in Thai) has brought the abortion issue back to surface. Keep in mind, Buddhist temples in Thailand commonly perform cremation ceremonies, and also store bodies in refrigerated storage areas. In the wake of gruesome revelations, the issue of unwanted pregnancies and abandoned babies has been put forth in the public eye once again.

Aborted human foetuses in plastic bags exposed at Bangkok's temple.

It has been mentioned by many experts that some 400,000 women in Thailand annually undergo illicit abortions, although it's impossible to get accurate statistics. Dr Suriyadeo Tripathi, director of National Institute for Child and Family Development, said that about 300,000 women and girls sought illegal abortions every year. The extend of dead foetuses, which is probably just a tip of Thailand's illicit abortion iceberg, stun the nation's conscience.

Abortion Policy and Practices in Thailand

Some medical professionals more or less discretely advertise for abortion business, but many abortionists are untrained, which commonly leads to the dreadful consequences.

So, abortion in Thailand is de jure legal only when it is considered necessary to protect a woman's health or in case of rape. Under the recently revised (but yet published) abortion regulations issued by the Medical Council of Thailand, the term "health" includes mental, emotional and physiological considerations as well as physical conditions. The determination that a woman qualifies for a legal abortion under that criteria can only be made by a medical doctor licensed in Thailand.

This determination (and, if positive, the abortion procedure) can be done at any hospital, private or government. Though, private hospitals with religious affiliations may chose not provide that service. In early pregnancy, it can also be done at one of the many low cost clinics operated by the Thai NGO Population & Community Development Association (PDA). For cost estimates, contact the hospital or clinic of your choice. Just remember that they will not tell you if they will be able to perform the procedure until the woman has met with a doctor.

Why women have abortions?     (Worldwide Abortion Stats)
• 1% of all abortions occur because of rape or incest
• 6% of abortions occur because of potential health problems regarding the mother or child
• 93% of all abortions occur for social reasons (i.e. a child is unwanted or inconvenient)

Mid Pregnancy (~ 20-week) Fetus in Mother's Womb

Important remarks!       (Are You Pregnant?)
Do NOT seek abortion at other than a licensed clinic or hospital, as serious complications can occur when abortion is performed by an untrained or unqualified person.
Abortion is an emotionally and hormonally upsetting procedure. Clinics and hospitals which are not usually frequented by foreigners may have a limited ability to provide appropriate counseling to farangs (foreigners) due to language barrier and cultural differences. Hence women who do not speak Thai would be well advised to go to one of the larger international hospitals, or at the least, bring along a close friend who is a fluent Thai speaker.
If became aware of the possibility of an unwanted pregnancy within two weeks of possible conception, over-the-counter 'morning after' pills (popular brand names in Thailand are Madonna and Postinor) should be used. While these to be used within 72 hours of possible conception, the latest research has shown that they are still worth taking for up to two weeks. Their effectiveness drops, but may still prevent a pregnancy in 50% of cases. During the first 72 hours they prevent the vast majority of pregnancies. These precluding a fertilized egg from implanting in the uterus, and so from a medical standpoint, prevent a pregnancy from taking place at all. Menstruation will occur as usual and it will not be possible to tell if the fertilization (conception) had taken place or not.