“I came by the bicycle so we can avoid the police”: factors shaping reproductive health decision-making on the Thailand-Burma border

Abstract

Abstract:For over half a century, political conflict combined with an overall lack of economic development has resulted in the displacement of millions of people both within Eastern Burma and to neighbouring Thailand. Given the overarching context, in conflict-affected regions of Burma, women face tremendous challenges in trying to obtain high quality, comprehensive reproductive health services. Drawing from interviews we conducted in Tak province, Thailand with 31 migrant and refugee women from Burma, this article explores women's lived experiences along the border and focuses on the ways that complex, overlapping barriers impact women's reproductive health decision-making at different points in their reproductive lives. Our results show that reproductive experiences are highly dependent on the woman's place of living mixed with her legal status and financial resources. Combined with socio-cultural taboos and externalized and internalized stigma, these dynamics blend to place constraints on women's autonomy and self-actualization. The way in which women's experiences are shaped by these barriers offers insights into priorities for education and programming to help improve reproductive health services in this protracted conflict setting. Keywords: abortion, ethnic minorities, family planning, migrants, Myanmar, refugees

To be, or not to be, referred: A qualitative study of women from Burma's access to legal abortion care in Thailand

“…However, unsafe abortion still accounts for 13% of all maternal deaths globally [ 25 ] and 60–65% of all abortions that take place in South East Asia are defined as unsafe [ 26 ]. Our findings are congruent with a body of research that consistently demonstrates that, irrespective of legal status, eligibility criteria, or availability of safe options, women will continue to seek to terminate unwanted pregnancies [ 11 , 14 – 17 , 25 , 27 ]. Liberalization of the abortion laws in both Burma and Thailand would serve as an important step in addressing women’s comprehensive reproductive health needs.…”

“…This exception is narrowly interpreted and procuring or providing an illegal abortion carries severe financial and criminal penalties for both the woman and the abortion provider. Unsafe abortion significantly contributes to maternal morbidity and mortality inside Burma [ 11 – 13 ] and it is well documented that women terminate pregnancies using unsafe practices including pummel massage and insertion of sharp objects on both sides of the border [ 7 , 11 , 14 – 17 ].…”

Access to community-based reproductive health services and incidence of low birthweight delivery among refugee and displaced mothers: a retrospective study in the Thailand-Myanmar border region

“… 22 23 More recent works have used focus group interviews with migrant mothers and lay maternal CHWs to illuminate ongoing barriers to care, and understand local perceptions of reproductive health. 24–27 To date, there has been no investigation of the relationship between access to community-delivered health services and individual delivery outcomes among the mothers in the region, leaving the direct impact of these community care models on obstetric outcomes largely unquantified at the population level.…”

Abortion Experiences and Perspectives Amongst Migrants and Refugees: A Systematic Review

“…Termination of pregnancy for genetic anomalies was the focus of three studies [ 20 , 30 , 31 ], and sex-selective abortion the focus of two [ 38 , 45 ]. While a few studies mentioned abortion-seekers’ SRH rights [ 24 , 29 , 41 ], only Deeb-Sossa and Billings included an extensive examination of rights, using a reproductive justice lens [ 26 ]. No studies explicitly used a rights framework to examine migrant and refugee abortion experiences, attitudes and/or perspectives.…”