no reproductive rights for burma's poor

December 17,2008 The Irrawaddy
Desperate Decisions – Kyi Wai

Rangoon — In a dark room in a dormitory for workers at a steel factory, a
58-year-old woman is fanning her daughter, who is moaning in agony and
covered in sweat.
“It hurts, it hurts,” the young woman groans. “Mother, it hurts.”

The woman’s voice and the sound of her mother’s fan fill the room. As she
watches her daughter suffer, the older woman’s despair deepens. Seeing no
way to end her child’s excruciating pain, she moves the fan faster,
knowing that it is all she can do to help.

Normally, it would be possible to turn to others for assistance. But this
was no normal medical emergency. If she asked for help, the mother knew
that she would have to explain what was wrong with her daughter, and that
would mean revealing her crime: having an abortion.

Abortion is a crime in Burma, but when the young woman became pregnant
with her third child, she knew that she had no other choice. Three months
into the pregnancy, she went to a back-alley abortionist.

The mother knew about her daughter’s decision, and did not object.
“My daughter already has two children, and she also has a lot of debt. I
know it’s a crime, but I had to agree when she told me what she wanted to
do,” the mother said.

“It’s all my fault,” she added, breaking into sobs.

The woman’s daughter and son-in-law were low-paid employees of the steel
factory who struggled to make ends meet. Two days after the abortion, the
daughter went to a hospital for women and was diagnosed with blood
poisoning. No longer able to work, she was threatened with dismissal from
her job. On top of that, she faced three years in prison if anybody
learned the cause of her condition.

The woman’s plight was not uncommon.
“Most women in Burma are poor and have little knowledge about birth
control. When they have an unplanned pregnancy, they worry about their
future and try to induce an abortion. Many of them end up with blood
poisoning because of this,” said a gynecologist in Rangoon.

“There are more and more abortion patients every year,” the doctor added.
“Seven out of 10 patients who come to this clinic want abortions. The
number has tripled since 2004, and is eight times higher than it was a
decade ago.”

Most of the women seeking abortions are poor and already have more
children than they can support. Although Buddhism proscribes the practice,
and the law treats it as a major crime, many feel it is the only way they
can deal with an unwanted pregnancy.

Poor women who want to end a pregnancy usually turn to abortionists who
use traditional methods. These include administering tonics known as
saypugyi (“hot medicines”), which consist of common herbal medications
mixed with alcohol, boiled ginger water or hot water and black pepper. If
these fail to have the desired effect, more invasive means are applied.

“Local abortionists usually try to damage the embryo in the uterus by
putting strong pressure on the supra-pubic region or pounding on the
abdomen. They also insert sticks into the uterus,” said a doctor.

These methods carry a high risk that pieces of the embryo will remain in
the uterus, resulting in bleeding and infection. In extreme cases, blood
poisoning or hemorrhaging can lead to death.

Despite such risks, however, many women see no alternative.

“For rich families, children are treasures,” said the gynecologist. “But
for the poor, they are often a burden they can afford to bear.”

“I have a son and this is my second pregnancy,” said a woman lying in a
bed and fighting against her pain. “If I have this child, I will be fired
from my job. So I had to have an abortion.”

The woman recalled being told by her boss on her first day of work at a
water-purifying plant that he wouldn’t let her stay on the job if she
became pregnant. “He knew I was married, so he told me not to expect any
time off if I was planning to have another child.”

Such warnings are common in Burma, where employers are obliged by law to
give married women 45 days of paid maternity leave when they become
pregnant—something that almost never happens in practice.

Poverty doesn’t only force many women to resort to abortions—it also
increases the likelihood a woman will become pregnant in the first place.

“Money is needed for birth control. If a couple can’t spare about 700 kyat
(US $0.60) per month for birth control, there will be an unplanned
pregnancy in the family. Half of the poor families I meet simply cannot
afford family planning,” said the gynecologist.

Birth control pills are available in Burma, and are the cheapest means of
preventing pregnancy. But at 700 kyat per month, they are still beyond the
means of most low- income families.

Other methods, such as progesterone hormone injections, are even more
prohibitively expensive. An injection that provides three months of
protection costs 1,500 kyat ($1.30), while a one-month shot is 3,000 kyat.

Even condoms, the most widely promoted form of birth control, are beyond
the means of many ordinary Burmese. Although they cost just 200 kyat (less
than 18 cents), this is far more than the average worker earning 1,500
kyat a day can afford.

Sterilization is also not an option for most, since it is illegal for
women under 35 years of age (most who seek abortions are between 25 and 40
years old).

Abortions by properly qualified medical professionals are also out of the
question for most women in Burma. If a nurse or health assistant performs
the procedure, it costs around 50-100,000 kyat ($44-88)—a small fortune
for Burma’s poor.

This leaves only back-alley abortions, which cost a mere 5-20,000 kyat
($4.40-17.80). For those who experience life-threatening complications or
find themselves facing criminal prosecution, however, there is a far
higher price to pay.