It’s very disheartening to note that the sale of illegal abortion pills online is proliferating. Clearly, it reflects an increasingly desperate attempts by women and girls in resolving their crisis when faced with unplanned pregnancies.
The Ministry of Health has been clamping down on such sales, but we are concerned that it may be ineffective as these sales are conducted via various temporary e-channels like Facebook, WhatsApp, Twitter, WeChat etc that appears and disappears as fast as a flash of light.
In addition, many also sell fake pills or at times adulterated pills that either have no effects resulting in desperate women getting scammed or endangering their health and lives.
Even the genuine pills were often given with various medically inappropriate doses or regimes by sellers that further threaten women’s health.
So what are the root causes of such a rise in procuring illegal online abortion pills?
Low usage of modern contraceptive methods by women & girls at risk unplanned pregnancies, stigmatisation of single mothers and premarital sex.
Lack of childcare support for couples and single mothers.
Lack of access to legal safe abortion when indicated. This is exacerbated in many settings by stigma, poor knowledge about sexual and reproductive rights as well as persistent discrimination against women and girls.
Confidentially and secrecy that online procurement offer to women, girls and couples fuel the demand.
The unwillingness to address sexuality and sexual health care in an open and comprehensive manner is a continuous health threat, especially to vulnerable groups such as adolescents, women with disability, forced marriages, victims of violence or abuse, migrants (legal or trafficked) and sex workers to name a few.
Solutions:
A) Prevention
Behind every abortion is an unplanned pregnancy. The usage of contraceptives clearly prevents unplanned pregnancy and thus, abortion. Malaysia’s contraceptive usage of modern contraceptive is at a dismal 35 per cent for the past few decades.
Ministry of Health and all health care providers should redouble our efforts in increasing contraceptive uptake for women and girls who are at risk of unplanned pregnancy.
We need to continually debunk the myths and misperceptions regarding contraceptive and sexual health in the community. Health care workers must be continuously taught and sensitise to the reproductive needs of women and girls.
B) Support
Should unplanned pregnancy occur, there must be adequate support for women who are unprepared for any pregnancy.
Support can come in three critical areas of emotional, physical and financial. Increasing the number of counsellors, social workers, making available facilities for childcare, offering single mother allowances, offering tax incentives for employers providing childcare facilities etc will certainly adds towards decreasing the need for abortion.
The option of adoption should also be streamlined so that deserving couples can adopt in a less emotionally draining and roller coaster process. On the same token, mothers who opt to give up their child for adoption must be offered full support in all aspects.
C) Destigmatisation
Premarital sex and single motherhood are cultural taboos and frequently frowned upon or discriminated by society.
Conservative cultures look down on single motherhood and support is rarely forthcoming.
Society, authorities, communities and religious leaders have to engage comprehensively in trying to lead a paradigm shift in how we view single motherhood. We need to be more accepting with non-judgmental attitudes on how we can offer help rather then reject and ostracise.
D) Access to Safe Legal Abortion
When indicated and legally permissible, women or girls need to have access to safe abortion. The WHO had published updated comprehensive guidelines on medical abortion based on good evidence research globally.
The availability of medical abortion as a safe choice for women supervised by medical professionals will in turn decrease the need for women to resort to illegal unsafe methods.
Unsafe abortion is a public health crisis that threatens women’s lives and health globally, including in Malaysia.
The clamping down on illegal online abortion pills may hardly make a dent on its availability if we don’t address the root causes and institute a holistic approach towards women’s reproductive health care.
The democratising of health care and offering women and girls real reproductive choices is a universal health right.
Dr John Teo is a member of the Medical Committee of the Federation of Reproductive Health Association of Malaysia.
- This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.
