Abortion in Thailand

Abortion in Thailand is discouraged by law, but is not banned outright if specific criteria are met. Once strict laws have, over time, eased to take into account high rates of teen pregnancy, women who lack the means or will to raise children, and the consequences of illegal abortion. "Chapter 3: Offence Of Abortion" of the Thai Criminal Code addresses the crime of abortion and levies a penalties of up to three years imprisonment and up to 6,000 baht in fines for a woman found guilty of undergoing an illegal abortion. Exceptions are made in the case of rape or other extenuating circumstances. A court decision in early 2020, however, declared a portion of the abortion statutes unconstitutional and ordered that they be rewritten by 13 February 2021, a move that increased public debate on the topic.[1]

Legal status

The legal status of abortion in Thailand is governed by the Thai Criminal Code. Abortion is illegal except in certain in circumstances. By the letter, the law allows termination of a pregnancy by physicians only (1) when abortion is necessary due to the health of the pregnant woman, or (2) if the pregnancy was the result of rape. Abortions performed outside of these circumstances are punishable by up to three years in jail (as well as fines) for the woman and up to five years for the performer (up to seven years if it was performed against the will of the woman).[2]

In 1989, during the rise of the AIDS epidemic, the Medical Council issued a consultation to the Council of State on whether the law could be interpreted to allow abortion in HIV-positive cases in which the child, if born, could not be expected to enjoy an acceptable quality of life. The Council of State replied that this was impermissible, since the law allowed only consideration for the health of the mother, and not the child.[3] Later, the interpretation of health was debated, and the Medical Council issued a regulation in 2005 in which it explicitly interpreted both physical and mental health as possible factors necessitating abortion.[4] This has been widely interpreted to include women who are emotionally distressed at the prospect of having children they cannot raise. The regulation restricts clinics like those operated by the Planned Parenthood Association of Thailand to provide abortions to women only in their first trimester of pregnancy. Those seeking to end second-trimester pregnancies must do so at a hospital. Abortions are prohibited after 28 weeks.[5]

The Ministry of Public Health (MoPH) regulates medical abortions. Termination of a foetus that is fewer than nine weeks from gestation is permitted if some or all of the following criteria are met: (1) medical necessity, (2) legal necessity (e.g., rape), (3) female is under 15 years of age (and unmarried), (4) the foetus is at risk of severe abnormalities or genetic disorders.[6]^:17

In December 2014, two drugs that induce miscarriage—Mifepristone and Misoprostol—were approved for ending pregnancies in a hospital setting. The drugs must be prescribed by doctors at approved hospitals or clinics. Women who self-medicate to terminate pregnancies on their own are liable for punishment under the law.[5][7]

In a decision published on 19 February 2020, the Constitutional Court of Thailand ruled that Thailand's current abortion law is unconstitutional. Under Section 301 of the Criminal Code which deals with abortion, women who seek an abortion face up to three years imprisonment and a fine of up to 60,000 baht, or both. The Constitutional Court ruled that Section 301 violates Sections 27 and 28 of the 2017 Constitution of Thailand (also known as the "charter") which mandates equal rights for men and women, as well as the right and liberty to everyone to his or her life and person. The court ordered that Section 301 be nullified within 360 days of its ruling, i.e., no later than 13 February 2021.[1] Section 305 of the anti-abortion law, allowing for legal abortion when the pregnancy involves rape or endangers a mother's physical health, was judged to be not in violation of the charter. The Constitutional Court ordered the amendment of both Sections 301 and 305 to accord with Thailand's current realities. How the two sections will amended is unclear. By citing sections on equality between men and women, the court's ruling can be interpreted as meaning a man who causes a pregnancy should receive the same punishment the woman seeking to terminate that pregnancy.[1]

Abortion statistics

Teen pregnancies in Thailand account for as much as 15% of total pregnancies, well above the World Health Organization's 10% median. Data from the Thai Department of Health showed that 72,566 teens aged 10-19 years old gave birth in 2018, or 199 such babies being born per day. Of the total, 9% gave birth to their second child. In the 10–14 age group, 2,385 young girls, down from 2,559 in 2017, gave birth, seven cases a day.[8] According to the Thai National Health Security Office, over 300,000 women have sought medical treatment at state hospitals for incomplete abortions from 2009–2019. Nearly 100,000 of them suffered complications and infections. More than 20 of them died each year. The casualties mount even though safe, WHO-approved abortion pills, legal in more than 60 countries, have been available for over a decade.[7]

Teens rarely visit abortion clinics, possibly because parental consent is required, or possibly because they cannot afford the cost, between 4,000–5,000 baht. Clinics, like state hospitals, charge women for abortion services, except for rape victims or economically disadvantaged women.[5]

Health department data suggest that most women seek abortions for social and economic reasons. Quantifying the number of abortions performed is difficult as numbers are not made public. A 2012 report published by state hospitals does not differentiate between elective abortion, abortion for health reasons, or miscarriage. "...there has never been any official report on the ratio of induced abortions to the number of abortions overall in Thailand,..." the paper said. The director of Thailand's Bureau of Reproductive Health notes that there is no centralized database for abortion numbers in Thailand. Private clinics, citing confidentiality, do not provide data to his department. Illegal abortions are impossible to track. "No one in this country knows the overall number of abortions," he said.[5] The lack of national data means that his bureau resorts to conducting a yearly survey called the "Abortion Surveillance Report".[9] It compiles cases of abortion from a number of provinces to gauge the background and motivations of those who seek abortions.

Public opinion

Acceptance of abortion by the Thai public has lagged behind the gradual easing of abortion laws. Buddhism is the faith of 98% of the Thai populace, and nearly all the exclusively male Buddhist hierarchy view abortion as a transgression that will haunt the "sinner".[5] In a UNICEF study, those interviewed observe that abortion is not accepted culturally. Although medical abortion is available if specific criteria are met, social taboos stigmatize those seeking an abortion. Adolescents say their family members disapprove of abortion and that public health services staff frequently oppose abortion and denigrate women who inquire about it.[6]^:22

Patients under age 18 must have parental approval to access health care services. Adolescents emphasize the barrier that the requirement for parental consent creates. Most teens do not want their parents to know they are using reproductive health services. Parental consent is an obstacle to both general services such as birth control counseling as well as legal abortion services. Some of those interviewed describe a lack of privacy in hospitals as a barrier to accessing services. Youth responses also show that adolescents lack trust in service providers. They fear providers will not keep information confidential and are particularly anxious that providers will share information with family and other community members. This fear is heightened in smaller, close-knit rural communities.[6]^:21 Even in cases in which abortion is legal, interviewees reported that a large percentage of physicians are not willing to perform abortions or prescribe medication for medical abortion due to their beliefs or social pressures.[6]^:2

See also

• Childbirth in Thailand
• Health in Thailand

References

1. "Abortion laws to be amended by court ruling". Bangkok Post. 20 February 2020. Retrieved 25 February 2020.
2. "Thai Criminal Code; Chapter 3 Offence of Abortion (Sections 301-305)". Thailand Law Library. Siam Legal. Retrieved 25 February 2020.
3. อวิการัตน์ นิยมไทย (January–February 2011). "กฎหมายเกี่ยวกับการทำแท้ง: Abortion act" (PDF). Chunniti (in Thai): 167–176. ISSN 1686-3720. Retrieved 25 February 2020.
4. "ข้อบังคับแพทยสภา ว่าด้วยหลักเกณฑ์การปฏิบัติเกี่ยวกับการยุติการตั้งครรภ์ทางการแพทย์ ตามมาตรา 305 แห่งประมวลกฎหมายอาญา พ.ศ. 2548" [The Thai Medical Council’s Regulation On Criteria for Performing Therapeutic Termination of Pregnancy In accordance with Section 305 of the Criminal Code of Thailand, B.E. 2548] (PDF). Royal Thai Government Gazette. 122 (118D): 7–8. 15 December 2005. Retrieved 25 February 2020.
5. Charuvastra, Teeranai (3 March 2017). "Abortion in Thailand: More safe and legal than you may have thought". Khaosod English. Retrieved 25 February 2020.
6. "Situation Analysis of Adolescent Pregnancy in Thailand" (PDF). UNICEF. 2015. Retrieved 25 February 2020.
7. Ekachai, Sanitsuda (21 February 2020). "Historic ruling offers pro-choice hope" (Opinion). Bangkok Post. Retrieved 25 February 2020.
8. "World Contraception Day: Empowering young people to take family planning into their own hands" (Press release). Bayer Thai Co., Ltd. 26 September 2019. Retrieved 25 February 2020.
9. "Teenage Pregnancy Surveillance Report 2019". Bureau of Reproductive Health (in Thai). Ministry of Public Health. Retrieved 25 February 2020.