Also see Anna Clark’s article about the lack of contraception access in Eastern Burma.
After decades of conflict and human rights abuses, reproductive health care in eastern Burma is among the worst in the world. Millions of women still inside Burma as well as those who have fled to neighboring Thailand face a perfect storm of devastating health consequences from lack of access to family planning and safe, legal abortion.
In Burma, abortion is only legal to save the life of a pregnant woman. And although abortion is legal in Thailand in some circumstances, women from Burma living in Thailand as refugees or migrants are generally unable to access safe abortion care. As a result, unsafe abortion is a major contributor to maternal mortality and morbidity on both sides of the Thailand-Burma border.
Reproductive health efforts have been undertaken by non-governmental organizations and community-based organizations in this region for decades. However, these efforts are often fragmented and lack coordination. In addition, few organizations address the issue of unsafe abortion beyond advocating for more family planning. In 2010-2011, a team of researchers from Ibis Reproductive Health and the Global Health Access Program conducted a comprehensive health assessment in order to understand abortion practices, harm to women, and ways to reduce the impact of unsafe abortion in this longstanding conflict setting.
Last week we formally released the report, Separated by borders, united in need. Our findings show a severe lack of access to family planning and considerable harm from unsafe abortion. Lack of health education and information contribute to high rates of unintended pregnancy, particularly among adolescents. Women have difficulty accessing family planning services and organizations report lack of contraceptive supplies. There is widespread misinformation among health workers about the legal status of abortion and referrals for legal and safe services within Thailand are rare. A lack of trained providers and restrictions on travel also prevent women from accessing safe, legal treatment.
As the world directs its attention to Burma and the possibilities for political change, it is important that we not forget women and women’s health. The sixty-year civil conflict in Burma has had a significant impact on reproductive health. As Burma embarks on its journey toward political reform, donor funds are likely to flood into the country. We must remember to target some of those resources to women’s health so that women can fully participate in political and economic opportunities to come.