Migrant voices: Illegal abortion among women from Burma working in Thailand

August 7, 2012

WCRP: One month ago, Thai Labor Minister Padermchai Sasomsap proposed a plan to send pregnant migrant workers in Thailand back to their home countries to give birth[i]. The Minister introduced the initiative as an effort to curb child trafficking, but migrant and human rights organizations quickly came out in opposition to what they consider to be dangerous discrimination. In addition, the news touched on the long-standing issue of illegal abortions in Thailand, which, while not completely understood, are alleged to be prevalent among the migrant community. In Mahachai, Thailand, a booming industrial city with hundreds of factories and an estimated 400,000 Burmese migrants, the staff members at local medical clinics describe the frequency, motives, and dangers behind the hidden trade in illegal abortions.

Thailand’s abortion law [ii]has remained the same since 1956, when provisions of the Thai Penal Code stipulated that abortion is only legal in cases of incest, rape, or threats to the mother’s health, and only when performed by a physician. A woman causing her own abortion (or allowing someone else to do so) is subject to a fine and up to three years in prison. Laws also detail the sentences for non-medical practitioners who perform abortions, which are most severe if the woman is physically harmed or dies. Although these stern policies have existed for decades, there is evidence that the supply and demand for illegal abortions in Thailand remains high. The 2010 news story covering the discovery of more than 2,000 fetuses outside a Buddhist temple in Bangkok brought the magnitude of the issue to light, and prompted a woman’s health organization to estimate that between 300,000 to 400,000 [iii]illegal abortions are performed in Thailand each year.

For migrant women, abortion may represent the only conceivable alternative to losing their jobs, incomes or social standing. A doctor working in a clinic that serves migrants in Mahachai said, “Many migrant women from Burma come to my clinic and ask us to do abortions for them. I refuse, and explain the negative impacts to the women. I also encourage them to give birth to their babies. Some women do not know about contraception and get pregnant. Some take [birth control] medication, but forget to take it regularly. Some gain weight from the medication and stop taking it. Some women think that having sex with their husbands one time will not lead to pregnancy.” She added that clinics lose their licenses if they perform abortions, and that both doctors and mothers can be sent to jail.

Today, there are two to three million migrants from Burma living in Thailand, many of whom are women. The reasons women cite for travelling to Thailand vary, but often entail escape from hardships or the desire to better support their families. Some fled violence or threats in their communities, others were dissatisfied with low or absent wages at home, and many left due to armed conflict between ethnic and government soldiers in their villages.

The migrant’s journey from Burma to Thailand typically begins with a series of monetary challenges, and interviews with migrant women indicate heavy costs and subsequent debt. Women travelling without assistance pay roughly 1,500 Baht in transportation fees, while those who hire a broker to help them cross the border pay around 12,000 Baht. When they arrive, women are met with living expenses and documentation costs, the latter reported to be 3,800 Baht for a two-year work permit (5,000 if obtained through a broker), 6,000 Baht for a passport, and 5,500 Baht for a Burmese migrant card. Women often go into debt due to these initial burdens, increasing their vulnerability and escalating their urgency to earn money.

Women who are able to obtain worker cards or temporary passports are permitted to receive healthcare in Thailand at greatly reduced costs. Undocumented workers are, in theory, able to access healthcare if they cover the full cost of the services, but in practice, they fear deportation, cannot afford the prices, or encounter resistance by medical personnel to treat migrants. The combination of these factors, coupled with the cultural stigma attached to pregnant single women and the absence of a support system in Thailand to help with childcare, creates a situation in which women may feel that having a (or another) baby is simply not possible.

A women translator working at a clinic in Mahachai said, “At least 20 migrant women per month come to the clinic asking for an abortion. Sometimes, around six abortion patients come and ask in one day. That’s just for our clinic—there are around 30 clinics in Mahachai.”

Nai Aie Wee Mon of the Labor Promotion Network said, “We provide some education to [migrant] women, such as how to take care of themselves, how to use medicine to prevent pregnancy, how to combat infection, and how to take care of their children, but they seem uninterested because they are too busy with work and aren’t willing to give up wages to come learn about women’s health. Some also feel embarrassed to discuss these subjects.”

While it is unclear how many migrant women seek illegal abortions, the reasons why are better understood. According to the Mahachai clinic doctor, “Mainly, migrant women are getting abortions because when they apply for jobs, the companies check their urine. If the company knows the woman is pregnant, she will not get the job.”

The doctor continued, “[Migrant] women are asking for abortions because some already have many children, others have to work to pay back debts from travelling costs, some are young and accidentally get pregnant by a boyfriend, and some do not have anyone to take care of them after the birth. Several women felt shy and would not let me explain contraception to them. Most women don’t want to lose their jobs or to stop working during pregnancy. It has primarily been women between the ages of 18 and 30 that come to me for abortions. They are so young, and sometimes girls are crying and tell me they don’t know what to do.”

The dangers of illegitimate abortion clinics and medicines are serious. A nurse from a government hospital in Mahachai explained, “Women are performing abortions [on themselves] by using pipes, sticks, pills, or with traditional medicine from Burma that, when mixed with alcohol, terminates the pregnancy. The outcome of [self-inflicted] abortions could be injury to the uterus that requires treatment. If the patients do not take medication or seek hospital treatment, they can develop serious problems such as lumbago or [interior] blisters. Later, if they want to get pregnant, they are at risk of miscarriage due to harmful blood still left in the uterus.”

Migrant women working in Thailand already confront an environment in which pregnancy, healthcare costs, and assistance with childcare present significant challenges.  Any policy that might decrease a woman’s likelihood of seeking legitimate medical treatment, or increase the pressure she feels to avoid pregnancy, does not meet the human rights afforded to migrant women.

The following case studies were collected at a migrant clinic in Mahachai, Thailand, and reveal the need for sincere improvements in access to healthcare, education about contraception, and safety nets for at-risk women. In each case, the clinic doctor refused to give an abortion, and the women’s subsequent choices are unknown.

Case 1

Name – Mi A

Age – 23

Ethnicity – Mon

Marital status – Single

Job in Thailand – Shrimp factory, Mahachai

By the time Mi A learned that she was one month pregnant, her boyfriend had already left to work in Malaysia. She did not know about contraception, or how to prevent pregnancy. She asked the clinic doctor to do an abortion, but the doctor refused and told her to keep the baby.

Mi A said, “I will go and buy medicine [illegally] for an abortion. I don’t want to have a baby because my boyfriend doesn’t know I am pregnant. Now, he is far away and if I tell him, he will not believe me. I have no husband and if I have a child, how could I live in the community? Also, I have a lot of debt and have to work to pay it back. I could not continue to work if I am pregnant, and how will I eat without a job? I live with a relative, but if I have a baby no one would take care of me.”

Case 2

Name – Ma KTS

Age – 32

Ethnicity – Burmese

Marital status – Married with four children

Job in Thailand – Shrimp factory, Mahachai

Ma KTS has four children that she left with her parents in Burma. She got pregnant two months ago, just one month after arriving in Thailand.

Ma KTS said, “I don’t want to give birth because I arrived here three months ago and I just got this job. I need money to pay my travelling costs. I already have four babies and don’t want anymore. I have to work and earn money to send to my children in Burma. I forgot to use contraception and got pregnant accidently. Now, my pregnancy is already two months.  I know if I have a baby I have to stop working to rest, and our bosses do not allow women who are pregnant to work. I don’t want them to know, so I came here.”

Case 3

Name – Mi Y

Age – 30

Ethnicity – Mon

Marital status – Married

Job in Thailand – Fish factory, Mahachai

Mi Y felt sick and visited the Mahachai clinic, where she was informed that she was one month pregnant. Mi Y said she does not want a baby because she has no money to spend on a child. She already has a young child at home in her village. “If I have a baby, I cannot continue to work. I just arrived in Thailand and got my job five months ago, and I don’t want to lose it.” When the doctor refused to give her an abortion, she said she would find abortion medicine somewhere else.

Case 4

Name – Mi O

Age -18

Ethnicity – Tavoyan

Marital status – Married

Job in Thailand – Shrimp factory, Mahachai

Mi O has worked in a shrimp factory for close to two years. The factory is large and employs many workers. Factory supervisors who learn of a pregnancy do not allow the woman to continue working.

Mi O said, “Even though I used contraception when I had sex, I got pregnant. I have no idea how this happened. I asked the doctor to give me an abortion, but the doctor wouldn’t do it. I will buy medicine [illegally] and I will take it. I don’t want to have a baby right now. I don’t want to lose my job and I have no extra money to spend on delivering a baby at the hospital.”

Case 5

Name – Mi T A

Age – 30

Ethnicity – Tavoyan

Marital status – Married

Job in Thailand – Shrimp factory, Mahachai

Mi T A has two children at home in her village. At the clinic, she told the doctor that she felt sick and hadn’t received her menstruation, and after the check-up the doctor informed her she was pregnant. Mi T A did not use contraception even though she said she did not want a pregnancy. The doctor attempted to talk to Mi T A about contraception and having sex, but she said she was too shy and didn’t want to listen. When the doctor refused to perform an abortion, she said she didn’t want to give birth because she has no money, no time to care for a baby, and has to keep working.

Case 6

Name – Mi P

Age – 18

Ethnicity – Mon

Marital status – Married

Job in Thailand – Shrimp factory, Mahachai

On July 24, Mi P’s mother took her to the Mahachai clinic to get her an abortion. According to the mother, Mi P just got married and is too young to have children.  If she keeps the child, she cannot continue her job and no one would take care of her. She has to work to get money first and then can have a baby later. Mi P said she does use contraception, but was busy with work and forgot to take the medicine.

Case 7

Name – Mi S

Age – 26

Ethnicity – Mon

Marital status – Married

Job in Thailand – Shrimp factory, Mahachai

Mi S arrived in Thailand one year ago and has not obtained a Migrant ID card yet. She does not want to visit a hospital for her pregnancy because she worries about the Thai police. She said that in order to give birth, she would have to go back Burma but has no money for the expensive travelling costs. Mi S came to the clinic to ask the doctor to show her where to get an illegal abortion.

Case 8

Name – Mi M

Age – 23

Ethnicity – Mon

Marital status – Married

Job in Thailand – Shrimp factory, Mahachai

Mi M and her husband work at a shrimp factory together. She uses contraception, but after a fight with her husband, she decided to stop taking the pills.

Mi M said, “I just got married and don’t want to be pregnant right now. I have no money and I have to work. If I have a baby, I will face difficulties with my job. I didn’t think that I could get pregnant if I stopped taking the [contraception], I was just angry with my husband and now I’m pregnant. I don’t want a baby now, but later when I am better off with my job, I want to have one.”

[i] http://www.bangkokpost.com/news/local/302196/minister-sticks-with-plan-to-deport-pregnant-migrants

[ii] Abortion law in Thailand is governed by the provisions of Sections 301-305 of the Thai Penal Code of 13 November 1956.  Under the Code, the performance of abortions is generally prohibited.  A woman who causes her own abortion or allows any other person to procure her abortion is subject to up to three years’ imprisonment and/or payment of a fine not exceeding 6,000 baht.  A person who procures an abortion for a woman with her consent is subject to up to five years’ imprisonment and/or payment of a fine not exceeding 10,000 baht.  If this act causes grievous bodily harm to the woman, the penalty is increased to up to seven years’ imprisonment and/or payment of a fine not exceeding 14,000 baht; and if the act causes the woman’s death, the penalty is increased to up to ten years’ imprisonment and payment of a fine not exceeding 20,000 baht. A person who procures an abortion for a woman without her consent is subject to up to seven years’ imprisonment and/or payment of a fine not exceeding 14,000 baht.  If the act causes grievous bodily harm, the penalty is increased to one to ten years’ imprisonment and payment of a fine of 2,000 to 20,000 baht.  If the act causes the death of the woman, the penalty is increased to five to twenty years’ imprisonment and payment of a fine of 10,000 to 40,000 baht.

[iii] http://www.time.com/time/world/article/0,8599,2032414,00.html


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