Safer options for unwanted pregnancies

WE refer to Dr Nazeli Hamzah’s reminder on the worrying incidence of baby dumping and its causes, “Abandoned babies” (Sunday Star, June 28). This issue should be given urgent attention in the midst of the Covid-19 pandemic.The movement control order restrictions in Malaysia have resulted in an increasing number of unwanted pregnancies, as shown by the number of callers to the RRAAM’s (Reproductive Rights Advocacy Alliance Malaysia) abortion hotline for women.

Our normal calls average over 300 per month, but in May there was an almost 20% increase in callers. There was also an almost 10-fold increase in the number of callers with late pregnancies (over 20 weeks). Sadly, these may well have been planned pregnancies, but the impact of job losses and long-term economic uncertainty caused by Covid-19 may have forced them to consider such desperate measures.

The fact that the social disruption caused by the pandemic clearly affects women’s access to contraception and abortion and their decisions on termination has already been widely reported globally.

We support Dr Nazeli’s proposal to address this through sex and contraceptive education and services for youth. Although this has been raised many times, whenever problems of teen pregnancies or baby-dumping have been reported, very little has been done to implement them effectively.

Unfortunately, the inclusion of safe abortion services as an essential back-up to contraceptive failures cannot be avoided. It is surely far better than driving some desperate women into committing infanticide.

If unwanted pregnancies are detected early (within 10 weeks) and access to safe abortion is not delayed, there is virtually no medical risk to the women involved. We strongly urge the Health Ministry to adopt this as a rational policy to reduce baby-dumping and infanticide. Presently, access to safe abortion is uneven as most are covertly provided by the private sector and are thus not regulated.

With limited access to surgical abortion in clinics due to the lockdown, clients are relying on medical abortion (MA) with pills. MA has now been established as a very safe method for terminating early pregnancies (before 10 weeks) if proper guidance is given to the clients.

Increasingly, MA using telemedicine by phone and via the Internet has been shown to be successful even without a physical visit to a clinic. The lockdown instituted by the Covid-19 pandemic has resulted in increasing reliance on MA via telemedicine globally.

Over 75 countries (including Thailand, India and Vietnam in our region) have approved MA since 1988 and have been using it safely in their reproductive health programmes. Unfortunately, our Health Ministry has yet to recognise the recommendations made by the World Health Organisation to promote MA when there are no legal obstacles to abortion services, as is the case in Malaysia. The banning of these drugs has forced many to access them via online sites, many of which are scams.

Registering these drugs will provide women with an alternative treatment under local medical supervision when a clinic visit is not possible. It will also prevent serious medical complications due to incorrect advice.

Looking at the reports of baby-dumping, many will easily place the blame on the women and girls for their plight. Unfortunately, it is difficult for those of us who are better educated and have easy access to contraceptives (and even abortion) to imagine the situation faced by these women and girls who resort to dumping their babies.

These are poor and probably ignorant women and may possibly be victims of rape who are neither able to seek redress nor avoid a pregnancy. As a civilised society, we should do everything in our power to prevent tragedies from happening to women who are less privileged than most of us.


Founder member and hotline coordinator,

Reproductive Rights Advocacy Alliance Malaysia

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