Contraception and Abortion:

Understanding What is behind Culture

Concepts
Women’s experiences and perception of
abortion,
abortion as reproductive health issue,
women’s right and choice,
health-seeking behavior, self-care
practices, health system as cultural
system
unmet need of family planning
youth-friendly RH service
male responsibility
 •SES Sexual Health
•EDU, OCCU •Free from
Male •Gender
Responsibility RTI/STD/AIDS
equality •Free from Violence
•Control their body
Women’s Sexual and sexuality
Sexuality M/F
Health Right •Sexual Satisfaction
status •INF. Sexuality

Women’s RH
Group/ORG. Women- •Safe Abortion
center •Safe F.P.
•Right to choose FP. and
HP &HS
Satisfaction
•Access inf. on FP
Determinants of •Safe Pregnancy
Reproductive •Access to infertile service
Health Problem •etc.
ABORTION: SOCIAL SCIENCE ‘S PERSPECTIVE

• Abortion is the human behavior since earlier

period
• Abortion is increasing nowaday
• Social value on abortion is different in each
historical periods and from culture to culture
• 3 Approaches
• Conservative--immoral, sinful
• Liberal, women’s right
• Neutral--depend on the reasons and context
Origins of Controversy issues:

• Religion
• Law

• Medical

• Human right

• Birth control method

 ETHICAL ISSUES: (conservative)

• It is a crime, i.e.in Thai case—on Headnews: “Mother

with Demon heart kill her baby by going to quack
doctor, both girl and doctor are put in jail.”
• Violation of fetus/baby’s right
• stoping the human being’s life
• It is immoral act

ETHICAL ISSUE: (LIBERAL)

• It is not a crime
• It is not against every religion
• Mother’s right over her own body
• It benefit the society
CRITERIA TO BE USED IN JUDGING
ETHIC OF ABORTION:

• PERIOD OF PREGNENCY

• REASONS OF PREGNANCY

• COST/EFFECT OF DECISION
FOR ABORTION
Ethical Approach to Unwanted
Pregnancy
Women have a natural Right (human right) to
reproductive freedom
Women have a social right to family planning
and abortion services
principle of liberty guarantees a right to
freedom of action
Utilitarian principle defines moral rightness by
greatest good for the greatest number
Justice-equitable access to necessary services
 Research area on Abortion:
Who are the women with
induced abortion?
• they are young and unmarried, forced to begin
sexual relation
• they are victim of rape or incest
• they are rich and poor, come from both rural
and urban
• they live in a wide variety of social, cultural,
religious, legal and political environment
• she has no knowledge about
how to practice safe sex
Who are the women with induced
abortion?
Many of them have more than one
abortion
Contraceptive use prior to abortion is
low, have contraceptive failure
Lack of information (counseling) on
efficacy, side effect, appropriate use of
contraceptive
use abortion as primary mean of
contraception
Who are the women with induced
abortion?
fear of side-effects of contraceptive
methods
unmet need for education on sexual
and reproductive health among young
people
Contraceptive use effectiveness
Lack of support from husband to
prevent unwanted pregnancy-
”it is women’s business”
 WHY DOES WOMEN HAS UNWANTED
PREGNANCY AND NEED TO TERMINATE?

• she wants to finish school

• she will get condemmed from
family and society
• she does not want to have a baby
because of economic reason
• she already has enough children she can
care for
• she got pregnant after being forced to have sex
 What is women’s experiences
on abortion (decision making
process, health seeking
behavior) and the context?
 Hierachy of resort
 Self-care practice: herbal medicine; material
insertion or vaginal manipulation; abdominal
massage, hitting, punching; self-medication:
mifepristone (antiprogestin), EP high
dose,misoprostal
 traditional healer, quack doctor
 methods of abortion women use depend
on their social network
 Popular Folk
sector sector
Professional
sector

Health system as cultural system: Klienman

 WHY DO THOUSANDS
OF WOMEN DIE, OR
SUFFER SERIOUS
CONSEQUENCES?
• Attitudes, law and regulations in many
countries are still very conservative
and deny women access to safe
abrtion services
WHAT CAN BE DONE?
• Improve the quality of contraceptive service

• provide safe abortion/service that treat

complication for all women who want or
need them

• Appoint more women to decision making

bodies

• More rational allocation of

resources to women’s health
overall and to neglected health
problems
What can be done?
High priority for youth-friendly education
and service for young people: education
on sexuality, physiology and
reproduction
Family planning service targeting male
partcipation, male contraceptive
prevalence rate is important indicator
Pre-post counceling on contraception,
sexuality and abortion