About This Project
Decades of conflict and stalled economic development in Burma have led to mass population displacement. For displaced women along the Thailand-Burma border, access to health services is often limited, unwanted pregnancy is common, and unsafe abortion is a major contributor to maternal death and disability. Our project evaluates Burmese women's experiences using a referral system for obtaining safe and legal abortion care in Chiang Mai, Thailand with the aim of improving services in this region.
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What is the context of this research?
Over six decades of civil conflict and ongoing human rights violations in Burma have resulted in a lack of economic development and employment opportunities, a disruption in health and social services, and mass population displacement. This overarching political and economic context means that internally displaced people in Eastern Burma as well as Burmese refugees and undocumented migrants in Thailand face significant barriers to accessing health care. Burmese women on both sides of the border are at increased risk of rape and sexual exploitation, have unmet contraceptive needs, and lack ready access to safe and legal abortion care [1,2,3,4,5]. These factors have contributed to high rates of unintended pregnancy and unsafe abortion [4,5].
What is the significance of this project?
Burmese refugees and migrants with unwanted pregnancies face significant hurdles to accessing safe abortion care. These challenges arise from the cost of the procedure, linguistic and cultural differences between providers and patients, restrictions on travel, a lack of understanding of Thai medical and legal structures, and stigma. Thus women with unwanted pregnancies often resort to unsafe methods, practices that lead to significant reproductive health morbidities [4,5]. In April 2014 local organizations established a referral program for women from Burma seeking an abortion in Thailand to obtain safe and legal care in both public and private facilities in Chiang Mai [6,7]. By documenting women’s experiences we hope to improve the referral system and inform ongoing scale-up efforts.
What are the goals of the project?
The goal of the safe referral program is to reduce the socio-linguistic, economic, transportation, and documentation barriers that women from Burma face in accessing safe and legal abortion care in Thailand . Through this qualitative study, we will evaluate the experiences of women who were both referred for and denied referral for safe abortion care. Over a one-year period, we will conduct in-depth, in-person interviews with 30 women. By exploring the experiences of both groups of women we hope to identify avenues to improve the program and increase access to safe abortion care in the region.
This funding would cover the expenses associated with the local research staff (including interpreters and translators) and the participation of women who have been referred or denied a referral through the system. This funding would also allow us to produce a multi-lingual report (English, Karen, Burmese) to distribute to local stakeholders.
Meet the Team
Cambridge Reproductive Health Consultants (CRHC) is a non-profit organization dedicated to improving reproductive health and fostering reproductive justice worldwide. CRHC accomplishes its mission by conducting action- and intervention-oriented research, creating and incubating new and innovative programs, and developing and delivering evidence-based reproductive health information, resources, and trainings.
Angel M. Foster, DPhil, MD, AM
I hold the 2011-2016 Endowed Chair in Women's Health Research at the University of Ottawa, where I am an Associate Professor in the Faculty of Health Sciences. A 1996 Rhodes Scholar from Oregon, I received my DPhil in Middle Eastern studies from the University of Oxford. I received my MD from Harvard Medical School and my AM in International Policy Studies and BAS from Stanford University. My research focuses on emergency contraception, abortion, and health professions education and I currently leads projects in ten different countries. I have authored more than 70 publications on reproductive health and my co-edited book, Emergency contraception: The story of a global reproductive health technology, was published by Palgrave MacMillan. My second co-edited book, Abortion pills, test tube babies, and sex toys: Emerging sexual and reproductive health technologies in the Middle East and North Africa will be published by Vanderbilt University Press in 2016.
I currently serve on the Board of Directors of the National Abortion Federation and am the Immediate Past Chair of the Population, Reproductive, and Sexual Health (PRSH) Section of the American Public Health Association. In 2004 I was named one of Choice USA’s 30 Under-30 Activists for Reproductive Freedom and in 2009 I received the PRSH Section’s Outstanding Young Professional Award. In 2015 I was honored with a Femmy Award in recognition of my "outstanding contributions to women’s rights and equality in Canada’s National Capital Region."
I am a 2016-2017 research fellow with Cambridge Reproductive Health Consultants. After completing an Honours Bachelor of Health Sciences in French Immersion at the University of Ottawa in 2014, I was part of the inaugural team of the Ottawa Birth and Wellness Centre which provides pregnancy, birth, and postpartum options for women in Ottawa, Canada. My passion for women's health and my experience with under-served populations has led me to pursue projects documenting women's experiences accessing essential reproductive health care on the Thailand-Burma border.
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