Thai-Myanmar border dying from unwanted pregnancies

A lack of access to healthcare is causing unwanted pregnancies, unsafe abortions and deaths among hundreds of thousands of displaced, migrant and refugee women along Myanmar's border with Thailand, a U.S-based NGO says. The region in eastern Myanmar is home to some 140,000 refugees and 446,000 internally displaced people who have fled conflict between government forces and armed ethnic groups fighting for political autonomy. Large numbers of economic migrants have also settled in the area. "The reproductive health situation (along the Thai-Myanmar border) is dire," said Dr. Angel M. Foster, who co-authored a report by non-governmental organisation Ibis Reproductive Health highlighting the health needs in the area. "The lack of access to contraception leads to a high rate of unintended pregnancy on both sides of the border," she told TrustLaw in an interview. "And because women on both sides of the border lack access to safe, legal abortion services, maternal morbidity and mortality are far greater than they would otherwise be." The maternal mortality ratio in Thailand is estimated at 48 per 100,000 live births, the report said. The number rose to 240 to 400 deaths per 100,000 live births in Myanmar and reached a staggering 721 deaths in eastern Myanmar. The report blamed the region's isolation and the risks in delivering medical care to conflict-torn areas for the much higher maternal mortality rates among displaced women in eastern Myanmar. But it said a general problem facing all women in the area was limited or non-existent access to family planning, safe abortion and general reproductive healthcare. A lack of funds, distrust of hospitals in Myanmar, a lack of trained healthcare workers, and common misperceptions about contraceptives and family planning methods were some of the other barriers, the report said. UNSAFE ABORTIONS Unsafe abortion using abdominal massage, consumption of malaria medications, "traditional" medicines or the insertion of a stick, fishing hook, or other instrument into the vagina lead to an unncessarily high number of deaths the group said. "Death from unsafe abortion is preventable. So it continued to be shocking to us during our interviews when we were told of community experiences of women, especially very young women, dying tragic deaths as a result of their attempts to end their pregnancies," Foster said. She added that the long-term consequences of a lack of reproductive healthcare for individual women, their children and their communities are significant. But it also affects women in less obvious ways. "Fundamentally, when women cannot control when or if to have children or how many children to have, they are unable to take full advantage of economic, educational and political opportunities," Foster said. "So reproductive health is directly tied to women's empowerment and autonomy."