The state of reproductive healthcare for people from eastern Myanmar/Burma is terrible on every front. Forget education and resources for family planning. Decades of conflict and instability, which I probably don’t need to recap for you, have left contraception, abortion, and health conditions in dreadful circumstances. It’s worse again for ethnic minorities and those who have been displaced by the civil war, including those who have moved across the Thai border. Ibis Reproductive Health recently put out a needs assessment of reproductive health on the Thailand-Burma border called Separated By Borders that lays it out.
There’s just about no access to family planning. And sometimes there is, but it’s not enough. For instance, lots of people with IUDs can’t return across the border to have them removed properly, or distrust Burmese hospitals, and workers in the health clincs servicing displaced populations often don’t have the appropriate training. Emergency contraceptive pills? Barely available, and, where they are, their existence and how they work aren’t well known. It’s estimated that 80% of east Burmese women haven’t used birth control. Adolescents, of course, are far more unlikely to have access to reproductive services. See more on contraception at RH Reality Check.
Abortion is only legal in Burma under life-threatening circumstances. While the legality situation is slightly better in Thailand, the availability of safe abortions is another matter entirely. Maternal mortality rates are very high, and routinely the causes include post-partum hemorrhage and post-abortion complications. There are few sufficiently trained birth attendants in east Burma.
The Reproductive Health Response in Crises Consortium has some stark statistics. 55% of maternal deaths for Burmese women in Mae Sot, Thailand, were a result of post-abortion complications. Many of these women are engaged in factory work there, and pregnancy puts their families’ finances in a sire situation. Many Burmese refugees in Thailand have tried to induce their own abortions. Back in conflict-affected parts of east Burma, 21.8% of respondents to a 2010 study used modern contraceptives.
This is one of those consequences of war and displacement that are often not particularly emphasised. Reproductive healthcare needs serious emphasis in the case of Burma.