I saw this article a while back. It has a bit on the Thingyan silliness. And a lot of other things. I agree that it is time for new thinking on contraception but am unclear what exactly is being proposed by the author.
Jamie
++++++++++++++++++
Time for new thinking on contraception
Fiona Macgregor
Myanmar Times
24 April 2015
On the eve of the Thingyan holidays – a period increasingly renowned for drunken partying in Myanmar – it emerged that authorities had told stores to stop selling the morning-after pill during the festival. These strong-arm tactics led to many shops removing other forms of contraception, including in some cases condoms, from their shelves.
While it’s easy to dismiss this as simply another act of bureaucratic craziness, the consequences of this ill-considered act could be devastating and potentially life-threatening to a number of women, who are left to deal with disease, unwanted pregnancy and the risks of illicit abortion.
The last edition of this column looked at government attempts to control women’s reproductive rights through new legislation known as the population control bill. It could allow regional authorities to restrict women to leaving a three-year gap between each birth.
The lack of clarity, and difficulties and risks of enforcing such a law, support claims that the legislation is about restricting the reproductive rights of certain groups in society deemed to threaten Buddhist culture, and not aimed at genuinely addressing the problems of unwanted pregnancies.
The contraceptive ban – enforced by police as part of a “special project”, which also saw erectile dysfunction treatments barred – was of course clearly contradictory to effective birth control. Like the population control bill, it was apparently aimed at preserving certain cultural ideals – in this case, by attempting to prevent sexual licentiousness.
Uncomfortable about a perceived laxity in morals during Thingyan, authorities responded not with education or support but with sudden restrictions on access to contraception. This of course did little to dampen sexual desires, but did leave people at risk of sexually transmitted infections and unwanted pregnancies.
Contraception is legal in Myanmar, and many monks teach that it does not breach Buddhist beliefs. However, it remains subject to a number of cultural taboos, particularly for women. Health professionals have previously expressed concerns at reports that many women are using the morning-after pill – usually referred to by medical workers as emergency contraception – as a regular method of preventing pregnancy.
They point out that the medication, which contains high doses of hormones, can have significant and potentially harmful effects on a woman’s body if misused. It is certainly not designed to be taken frequently.
Until the recent clampdown, the pills could be seen for sale in corner shops as well as pharmacies, often without instructions or warnings of health risks. There is also a widespread misbelief that the morning-after pill can prevent the spread of STIs. This is a situation that health authorities need to tackle in an informed and effective way.
But in terms of harm reduction, restricting contraceptives during a period renowned for drunkenness and an increased likelihood of casual or irresponsible sex is the equivalent of saying, “We’re expecting a sudden rise in heroin use so we’ve ordered the banning of clean needles.”
The removal of condoms from shop shelves – whether that was part of the official project plan or not – is likely to have resulted in an increase in STI transmission. This is particularly worrying in a country that has a high prevalence of HIV.
The deliberate banning of emergency contraception also means there will almost certainly be a rise in unwanted pregnancies. Societal traditions mean many women, single and married, find it difficult to discuss contraception use with their partners. And the fact there is no law against marital rape means that married women do not have the legal right to prevent their husbands from having unprotected sex with them.
Since abortion is illegal in Myanmar, many women who find themselves pregnant when they do not want to be are left with two options, both dreadful: seek abortion from illicit sources; or go ahead with the emotional, physical, and financial demands of having a child they do not want. In the case of unmarried women, the latter choice will also likely mean condemnation and ostracism.
Buddhist culture in Myanmar does not support a right to abortion but, as evidence from across the world shows, when faced with the devastating and life-altering consequence of an unwanted pregnancy many women in countries where abortion is illegal seek a termination anyway.
That often means resorting to illicit drugs or surgery at the hands of unqualified practitioners, both of which can have damaging long-term health effects or even be fatal.
According to the World Health Organization, 21.6 million women experience an unsafe abortion worldwide each year – 18.5 million of whom are in developing countries – while 47,000 women die from complications of such terminations each year.
The organisation also reports that deaths due to unsafe abortions account for around 13 percent of all maternal deaths.
The issue is a highly emotive one, but whether society and individuals support the right of women to end unwanted pregnancies, or strongly object to it, all must agree that unsafe abortions are undesirable.
As Myanmar grapples with considerable social change, it is a good time to consider the benefits of revising discriminatory attitudes toward single mothers that leave many women resorting to illegal terminations out of desperation rather than a genuine desire not to have a baby.
However, most vitally, in countries where terminations are illegal but contraception is legal – as is the case in Myanmar – people must be given informed and easy access to safe and proper methods of pregnancy prevention. This is the best and simplest way to save women from resorting to illicit terminations.
It is important that women are not left to rely on the morning-after pill as a regular form of contraception, and other options made more easily available.
However, it is equally important that in situations where it is necessary to access emergency contraception women are able to do so.
Deliberately removing contraceptives and leaving woman at risk of the mental, emotional and physical consequences of unplanned pregnancy, particularly in a country where abortion is illegal, was irresponsible and unnecessary.
If authorities genuinely want people to have planned pregnancies and save them from difficult and painful moral decisions, they should be providing better, not worse, access to effective contraception.
Link: http://www.mmtimes.com/index.php/opinion/14098-time-for-new-thinking-on-contraception.html
