Abortion, Sin and the State in Thailand

Abortion is one of the most controversial issues of our age, yet most studies centre on the debate in Western countries. This book discusses abortion in Thailand, where, although abortion is illegal, between 200,000 and 300,000 abortions are performed each year by a variety of methods. Based on extensive original research in the field, the book analyses the abortion debate in Thailand, including stories of the real-life dilemmas facing women, situational ethics, popular representations of abortion in the media, the history and the politics of the debate. The work highlights women’s subjective experiences and perceptions of abortion, and places these ‘women’s stories’in an analysis of broader conflicts over gender, religion, nationalism and modernity, and the global politics of reproductive health.

Andrea Whittaker is a Joint Lecturer at the Key Centre for Women’s Health in Society and the Melbourne Institute of Asian Languages and Societies, University of Melbourne. She is a medical anthropologist whose primary research interests relate to reproductive health, gender and development in Thailand and Australia. Her previous books include Intimate Knowledge: Women and their health in North-East Thailand. Asian Studies Association of Australia Women in Asia Series Editor: Louise Edwards (Australian National University) Editorial Board: Susan Blackburn (Monash University) John Butcher (Griffith University) Vera Mackie (Curtin University) Anne McLaren (Melbourne University) Mina Roces (University of New South Wales) Andrea Whittaker (Melbourne University)

Mukkuvar Women: Gender, Hegemony and Capitalist Transformation in a South Indian Fishing Community Kalpana Ram 1991 A World of Difference: Islam and Gender Hierarchy in Turkey Julie Marcus 1992 Purity and Communal Boundaries: Women and Social Change in a Bangladeshi Village Santi Rozario 1992 Madonnas and Martyrs: Militarism and Violence in the Philippines Anne-Marie Hilsdon 1995 Masters and Managers: A Study of Gender Relations in Urban Java Norma Sullivan 1995 Matriliny and Modernity: Sexual Politics and Social Change in Rural Malaysia Maila Stivens 1995 Intimate Knowledge: Women and their health in North-East Thailand Andrea Whittaker 2000 Women in Asia: Tradition, Modernity and Globalisation Edited by Louise Edwards and Mina Roces 2000 Violence against Women in Asian Societies: Gender Inequality and Technologies of Violence Edited by Lenore Manderson and Linda Rae Bennett 2003 Women’s Employment in Japan: The Experience of Part-time Workers Kaye Broadbent 2003 Chinese Women – Living and Working Edited by Anne McLaren 2004 Abortion, Sin and the State in Thailand Andrea Whittaker 2004 Abortion, Sin and the State in Thailand

Andrea Whittaker First published 2004 by RoutledgeCurzon 2 Park Square, Milton Park, Abingdon, Oxfordshire OX14 4RN Simultaneously published in the USA and Canada by RoutledgeCurzon 29 West 35th Street, New York, NY 10001

This edition published in the Taylor & Francis e-Library, 2004. RoutledgeCurzon is an imprint of the Taylor & Francis Group © 2004 Andrea Whittaker All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging in Publication Data A catalog record for this book has been requested ISBN 0-203-42944-3 Master e-book ISBN

ISBN 0-203-68071-5 (Adobe eReader Format) ISBN 0–415–33652–X(Print Edition ) Contents

List of illustrations vii Series editor’s foreword ix Preface xi Acknowledgements xv Note on the transcription system xvii

1 Introduction: bearing politics 1

2 Abortion, sin and the state 11

3 A history of the abortion debate 29

4 Conceiving the nation: representations of abortion in Thailand 66

5 Corrupt girls, victims of men, desperate women: representations of women who abort 91

6 ‘A small sin’: everyday acts 109

7 ‘The truth of our day-by-day lives’: situational ethics 129

8 Global debates, local dilemmas 148

Appendix I 158 Appendix II 161 Glossary of Thai terms 163 Notes 165 Bibliography 176 Index 187

Illustrations

Plates 3.1 Cartoon showing Chamlong as a protective hard-working stork 49 3.2 Cartoon from The Nation newspaper in 1981 50 3.3 Cartoon published in Thai Rath newspaper 61 4.1 The backcover image from the 1981 booklet Tham thaeng...Khong sut thai haeng haiyanatham 71 4.2 An image from the booklet Tham thaeng...Khong sut thai haeng haiyanatham (Abortion: the last curve on the road to moral catastrophe) 72 4.3 Cartoon showing members of parliament voting in favour of the abortion bill 81 4.4 Cartoon from Ban Meuang newspaper 82 4.5 The ‘Democracy Hospital’ cartoon that appeared in Thai Rath 86 4.6 Image from Siam Rath 87 4.7 Cartoon depicting a series of word pictures linking abortion with political corruption and failures of democracy 87

Table A.1 Participants in focus group discussions on abortion 160

Boxes 2.1 Summary of the current Thai abortion law 13 3.1 The articles relating to abortion in the Royal Penal Code of Siam, 1 June 1908 34

Series editor’s foreword

The contributions of women to the social, political and economic transformations occurring in the Asian region are legion. Women have served as leaders of nations, communities, workplaces, activist groups and families. Asian women have joined with others to participate in fomenting change at the micro and macro levels. They have been both agents and targets of national and international interventions in social policy at the level of the household and family. In the perform- ance of these myriad roles women have forged new and modern gendered identities that are recognisably global and local. Their life experiences are rich, diverse and instructive. The books in this series testify to the central role women play in creating the new Asia and re-creating Asian womanhood. Moreover, these books attest to the resilience and inventiveness of women around the Asian region in the face of entrenched and evolving patriarchal social norms. Scholars publishing in this series demonstrate a commitment to promoting the productive conversation between Women’s Studies and Asian Studies. The need to understand the diversity of experiences of femininity and womanhood around the world increases inexorably as globalisation proceeds apace. Lessons from the experiences of Asian women present us with fresh opportunities for building new possibilities for women’s progress the world over. The Asian Studies Association of Australia (ASAA) sponsors this publication series as part of its ongoing commitment to promoting knowledge about women in Asia. In particular, the ASAA women’s caucus provides the intellectual vigour and enthusiasm that maintains the Women in Asia Series (WIAS). The aim of the series, since its inception in 1992, is to promote knowledge about women in Asia to both the academic and general audiences. To this end, WIAS books draw on a wide range of disciplines including anthropology, sociology, political science, cultural studies and history. The Series could not function without the generous professional advice provided by many anonymous readers. WIAS, its authors and the ASAA are very grateful to these people for their expert work.

Louise Edwards Australian National University

Preface

A close friend of mine experienced an unplanned pregnancy in her early forties. It was her struggle to decide to have an abortion that has influenced me in writing about this topic for other women in other places and in another time. We rarely speak of her experience, what difficult negotiations must have occurred between her and her husband, what promises made, what desires and needs aban- doned, the relief and grief. The period surrounding her decision was one of tumul- tuous emotions and ambivalence. Although she recognises the need for her decision she remains ambivalent. She has difficulty reconciling the termination with her desires and identity as a loving mother, proud of her children. In periods of vulnerability, her unfulfillable desires find expression in nostalgia for a child that never was. This merges with her grief and guilt over an earlier miscarriage, a wanted pregnancy. Sometimes she speaks with relief at her decision, at other moments she speaks with anger and blame that she fell pregnant at all. Because of the ban on abortion at that time in Queensland, Australia, she flew to Sydney in the state of New South Wales and had a termination. She flew home the same day. Beforehand she warned her children not to tell their schoolmates of her pregnancy. It was several years before she entered a Catholic Church and undertook confession to a priest; not that she had been an active Catholic before her abortion, but the generational legacy of her mother’s faith demanded recon- ciliation. Although her confessor was sympathetic and absolved her, she has never returned. This book is written for her and for all women who have ever faced difficult choices. Her story is unique, her experience is not meant to highlight anything universal about the experience of women aborting, her ambivalence is not shared by all women who abort, many do so with much relief and no regret. Rather, it was sharing her emotional pain that has influenced my approach in this text. It reinforced the need to respect the women with whom and of whom I speak, to problematise any simplistic interpretation of motives or account of their experiences. My fum- bling questions forced their explication of previously secreted knowledges, demanding a level of introspection, self-objectification and narrative closure that many perhaps had not previously performed for other ears. Through me xii Preface and through this text their partial meanings became articulate, some perhaps felt confronted by the memories uncovered, no doubt many felt in their narratives the need to craft excuses, assert respectability to an outsider. For others though, their accounting seemed to provide an opportunity rarely accorded in their community – sympathetic ears and a lack of abrogation. Feminist scholarship demands a reflexive stance by researchers and a constant awareness as to the motives, responsibilities and politics of representation. There are many varieties of feminist practice. The definition of the term ‘feminist’ developed by the International Reproductive Rights Research Action Group (IRRRAG) succinctly summarises the orientation that I bring to this work.

A concern in theory and practice with the conditions of women, and a commitment to transform gender oppression along with and in relation to the systems of domination that divide women by class, race, ethnicity, region, nationality, religion, sexual orientation and age. This definition implies a questioning of all hierarchies and power relations, including those within the research process itself, and a general commitment to achieving social justice throughout the world. It also implies that women’s movements, geared toward ‘the political action of women’ on many issues, may not always be defined as feminist in this sense, and that the accepted meanings of feminism in our different national and cultural contexts may vary. (Petchesky 1998: 27)

As a feminist scholar and as a public health researcher I cannot hide my ideological support for women’s reproductive rights to terminate a pregnancy. This is despite my Roman Catholic upbringing. As an anthropologist, I hope I am able to demonstrate respect towards the views of those who do not support such a position and that I have been able to embrace the challenge to my own cultural pre- conceptions posed by this research and discussions with informants. This is a position most anthropologists confront in their research, the attempt to understand values and concepts they do not necessarily share. Particularly as a foreign researcher in Thailand, I will always be vulnerable to accusations of showing inadequate respect for Thai traditions and values, for an innate inability to understand Thai ways. This is especially the case when dealing with such a politically charged topic as abortion seen as a shameful topic that may bring discredit to the public face of Buddhist Thailand. This is a sobering challenge that can never be resolved. In writing this book, however, I am confident of the value of the insights that careful cross-cultural scholarship may bring and the importance of dialogue about abortion. I am also involved in research ‘at home’ in my own culture on reproductive decision making, work that has been informed by this project. My hope is that this work might be useful to further our understanding of the issues and debates not just in Thailand, but in other countries as well. At another level, this book also contributes to our understanding of what reproductive rights really mean in a given context. To paraphrase Petchesky from her Preface xiii introduction to the edited collection Negotiating reproductive rights, until we have a fuller understanding of the local contexts and manners of thinking in which women and men negotiate reproductive decisions and their sexual and family lives, we cannot assume that reproductive and sexual rights are a goal they seek and are therefore one with universal applicability (1998: 1).

Acknowledgements

Many people contributed to the realisation of this book. Foremost among them are the many Isan women whose stories informed this text. I thank them for their trust and generosity in sharing those stories. I also wish to thank the various activists and academics I interviewed to assist in building up a picture of the history of the abortion debate and its current incarnations. Parts of some chapters have appeared previously and I thank the journals for permission to reproduce parts of them here. Extracts have been used from my paper in Reproductive Health Matters (2002b), 10(19): 45–53, a shorter version of Chapter 4 appeared in Asian Studies Review (2001), 25(4): 423–45 published by Blackwell and a shorter version of Chapter 7 was published in Culture, Health and Sexuality (2002) (http://www.tandf.co.uk/journals/titles/136911058.html) 4(1): 1–20. A number of newspaper cartoons and images are used in this book (see the list of plates for details). In all cases every effort has been made to contact the rightsholders of copyright material included in this book. The author and publishers would be happy to include in any future edition an appropriate acknowledgement to any rightsholder not fully acknowledged in this edition. I also wish to acknowledge the National Thai Research Council who gave permission to conduct the research upon which this book is based. In Khon Kaen, I wish to thank my colleagues at the Faculty of Nursing, Khon Kaen University for their institutional support and the support of the Provinical Public Health office, Khon Kaen province, for permission to collect data and interview the most helpful staff at various District Hospitals. Mrs Nongluk Boonthai of the Ministry of Health is also thanked for her assistance in locating some of the material used in this book and for the stimulus to continue the work on this important topic. Thanks also to Ms Kanokwan Tarawan, and Ms Nataya Bunpakdi and Dr Simon Baker of the Population Council, Bangkok for their assistance. This research would not have been possible without the funding from the Commonwealth Government of Australia through an Australian Research Council Postdoctoral Fellowship to undertake the ethnographic research and a Large Australian Research Council Grant to undertake the historical research. Professor Margaret Jolly, my colleagues at the Gender Relations Project, and my colleagues at the National Centre for Epidemiology and Population Health, the Australian National University, are thanked for their support during my time there xvi Acknowledgements working on this project. Professor Lenore Manderson and Professor Merle Ricklefs, my colleagues at the Key Centre for Women’s Health in Society and at the Melbourne Institute for Asian Languages and Societies, The University of Melbourne, where I have finished this project, are thanked for their support and intellectual mentorship. Dr Louise Edwards is thanked for her editorial assistance and enthusiastic support. Dr Shelley Mallett and Dr Roger Averill and their children Grace and Lilly, Dr Roe Sybylla and Dr Richard Eves are thanked for their friendship amidst the traumas of changing towns and jobs while writing up this material. A number of research assistants worked with me on this project without whom this book would have been far slower in coming to fruition. My research assistant in rural Thailand, Ms Amornrat Sricamsuk, her mother and family are to be thanked for their friendship and generous hospitality. I also wish to thank Ms Saowalak Gafke who accompanied me for hot dusty hours in the National Library in Bangkok. Dr Scot Barme and Mr Peter Ross, of the Australian National University assisted with translations of a range of material. Ms Eloise Brown translated the bulk of newspaper and other material used in this book. Finally, I wish to thank my family for their support and my intellectual soul-mate, Dr Bruce Missingham for his thoughtful insights, clarifying conversations and for his support in parenting our daughter Claire as I finalised the manuscript. Note on the transcription system

Transcription of the Thai and Lao words used throughout this text follows the transcription system below. Under this system, tones and long vowels are not indicated. Exceptions to this system include place names, personal names and authors’ names where the transcription follows that customarily used. For consis- tency in the references list, Thai authors are listed alphabetically according to their last names, but their first names are indicated where available.

Thai vowels

Phonetic Thai symbol Phonetic Thai symbol symbol symbol a inherent o inherent ao am oi ao o ao o inherent ai oi ai oe eoe e oei ew u ew u ae ua ae uay aew ui ieu ieu ia eua iaw euay iw ru lu xviii Note on the transcription system Thai consonants syllable-initial values

Phonetic Thai symbol Phonetic Thai symbol symbol symbol kph kh f ng m jy ch r dl tw th s nh b - (glottal stop) p

Thai consonants syllable-final values

Phonetic Thai symbol symbol k ng t n p m y or i w 1 Introduction Bearing politics

Patient 1. 40 yrs old. Pregnant 8 weeks. Presented with bleeding per vagina, fever, dizziness, complains of weakness and tiredness... Patient 2. 19 years old. Came by herself. Pregnant approximately 20 weeks. Stated that at 6.45 am she went to have an abortion at the Thawee clinic, presented to hospital 3.45 pm. Today had symptom of extreme abdominal pain, heavy blood loss. Upon presentation, temperature 37 degrees centigrade. BP 80/50mm/hg... Patient 3. 23 years old. Presented at 16.00 hours, patient came lying down. Pain in lower abdomen, had passed a large clot in last 30 minutes... Patient 4. 27 years old. Presented at 21.00 hours. Lower abdominal pain, bleeding per vagina, patient groggy. Had been bleeding heavily for one day before presenting to hospital. LMP 20 December 2539, Pregnant approx 18 weeks. BP 90/60mm/hg Temperature 40.5 degrees centigrade...(2days later patient had not improved, was referred to provin- cial hospital) Patient 5. 30 years old. Went for abortion 2 days before presenting, cold, weak, Temperature 39 degrees centigrade BP 120/70, UTI... (Selected medical records from one district hospital 1996/1997)

Every day, women like these present to hospital wards in Thailand with complications of illegal abortions. Despite restrictive abortion laws, it is estimated that between 80,000 and 300,000 abortions are performed each year, many using unsafe methods. Although many women experience no complications, others experience injury, infection, infertility and maternal death (Koetsawang et al. 1978, Narkavonnakit 1979, Chaturachinda et al. 1981, Narkavonnakit and Benett 1981, The Population Council 1981, Ladipo 1989). My interest in the issue began in 1991 when I first started fieldwork in Northeast Thailand, studying women’s reproductive health. Among the women I knew well in my field site of Ban Srisaket, abortion was a whispered subject that few women spoke of to me. The elderly woman whose house I shared claimed no knowledge of the practice of abortion in the community, yet I found out from her daughter that her Aunt had died from an abortion, after attempting to induce an abortion following the insertion of some twigs into her uterus. Other women I interviewed were more 2 Introduction forthcoming about their experiences of abortion. Some spoke in a matter of fact manner about their past abortions, others spoke of the fear and pain they experienced and the subsequent guilt over the Buddhist sin they had incurred. I met midwives who spoke of how they had helped women abort in the past through massage techniques ‘but not any more’. Whispered secrets among women stand in stark contrast to the very public horror stories of abortion paraded on the front pages of Thai daily newspapers. Raids of clinics and prosecutions of women procuring abortions and practitioners remain a regular feature of the Thai press complete with graphic photographs and sensational headlines. Along with this has been an ongoing debate about reform of the Thai legal codes regarding abortion. This book attempts to draw together the private and public face of abortion in Thailand. As an anthropologist, my work has always been concerned with drawing together the impact of the larger social and political context on the lives and bodies of women in local settings. In my earlier work Intimate Knowledge: Women and their health in North-East Thailand, I tried to combine the macro and micro view of women’s health; the political and the cultural economy, the ways in which state policies were played out on the ground and affected women’s access to health care, health practice and experiences of their bodies. My goal in this work is similar – to highlight the voices of women, their subjective experiences and perceptions of abortion, and to place these ‘women’s stories’ in a broader analysis of gender and the power relations that structure sexuality and women’s reproductive health decisions. As I argued in my previous work, while structural factors such as the distribution of economic, political and institutional resources, are fundamental to the degree of control women and men have over reproductive decision-making, cultural processes shape the contexts and meanings of their reproductive decisions, in particular gender ideologies, norms about morality and understandings of how women should behave (see also Browner and Sargent 1990). Similarly, this book looks not only at the political economy so crucial to women’s decisions about abortion, but also the wider social and cultural context, the political history, the popular representations and discourses about abortion, religious ideology and gender relations. But this book is not only about the issue of abortion; it simultaneously provides a new commentary on Thai society, gender relations and politics.

Women’s bodies as contested sites Until relatively recently, the topic of abortion remained in the realm of demography, reduced to questions of its effects on fertility rates and maternal mortality, and the effectiveness of family planning programs. Recent work by anthropologists and feminists both within and outside of demography brought new perspectives to the study of all facets of reproduction, including abortion. In particular, they drew attention to the ‘political economy of fertility’ (Greenhalgh 1990), the ways in which the meanings, beliefs and practices surrounding reproduction are structured historically and culturally by local and global forces (Ginsburg and Rapp 1995, Greenhalgh 1995, Ram and Jolly 1998). They highlighted the nature Introduction 3 of state interventions into the reproductive lives of citizens (Anthias and Yuval-Davis 1989, Jolly and Ram 2001) and the ways in which reproductive experiences are structured by macro and micro relations of power, class and gender politics (Handwerker 1990, Rapp 1993, Lock and Kaufert 1998). For example, Ginsburg and Rapp’s (1991) notion of the ‘politics of reproduction’ and book Conceiving the new world order (1995) links global reproductive policies and practices with local cultural understandings and social relationships. They describe ‘stratified reproduction’, the power relations acting selectively to encourage and empower certain groups of people to reproduce. They observe that although women’s bodies are central to reproductive regimes, this centrality is displaced by religions, development agencies, scientists and states. During the same period the ferocious abortion debate raging in the United States inspired a number of studies. These analysed abortion as a practice and as a political and social construction subject to historical change, and embedded within the social and economic context, transformations in gender relations and changing sexual culture. Rosalind Petchesky (1990), whose work Abortion and woman’s choice: The State, sexuality and reproductive freedom was first published in 1984, provides a feminist analysis of abortion history, practice and politics within the United States. Her work, along with that of Kirsten Luker (1984) and Celeste Condit (1990) all begin with examinations of the history of the social and political configuration of abortion since the 1970s in the United States. They analyse how control over reproduction is a critical site of contest, reflecting broader economic, social and ideological concerns over women’s status and roles, and competing constructions of gender relations, sexuality and motherhood. Petchesky (1990: xi) writes: ‘Abortion is the fulcrum of a much broader ideological struggle in which the very meanings of the family, the state, motherhood, and young women’s sexuality are contested’. Condit added to the perspectives of Petchesky and Luker by adding a further perspective, a systematic examination of the ‘public repertoire of meanings’ surrounding abortion. She argues that emphasis upon economic and social change alone gives an incomplete explanation of the functioning of public argument in the revision of widely shared meanings. Her book, Decoding abortion rhetoric explores the changes to the practice and meanings of abortion in the United States through a study of ‘the vast flows of public discourse that spread across America to shift the meanings of abortion and of related terms, practices and laws’ (Condit 1990: 1). She traces the various events and rhetorical turning points within the abortion debate in the United States, the legal and public vocabulary, as well as a new visual vocabulary that emerged in the public culture. Anthropological work has also placed emphasis upon ‘women’s stories’ and their subjective experiences to balance the objectifying and generalised picture of abortion usually found in the demographic and epidemiological statistics. For example, Ginsburg’s (1998) work on the narratives of pro-life and pro-choice activists in North Dakota traces the reformulation and redefinition of gender oppositions articulated by proponents of both sides and their translations into a local community’s experience. Similarly, Luker’s (1984) study gave insight 4 Introduction into the worldviews and social circumstances of activists on both sides of the abortion debate. However, until very recently, studies of abortion have been dominated by works in Western countries. On the whole, there are few books which offer understandings of abortion within other religions (an exception is Keown’s (1999) volume on Abortion and Buddhism) and none which fully contextualise abortion in detail in a non-Western setting. Exceptions include studies on the mizuko kuyo rituals for aborted foetuses of Japan (LaFleur 1992, Hardacre 1997) and Taiwan (Moskowitz 2001), and a number of academic papers and edited volumes which offer smor- gasbord essays from a variety of countries, cultures and disciplinary perspectives (see, e.g. edited volumes by Githens and McBride 1996, Rylko-Bauer 1996, Mundigo and Indriso 1999). Whether in countries with restrictive abortion laws or not, the studies in these collections reinforce the relationship between the economic situation of women and the quality of abortion care they receive, a theme that also emerges in the stories of Thai women in this study. The depressing stories of women’s desperate attempts at self-induced abortion in Mexico, the presentation of Brazilian women to public hospitals following their use of misprostol (cytotec) and Chinese women’s fears about the effects of abortion upon their long-term reproductive health, all find their parallels in this book. The studies also emphasise the lack of information that women had about actual abortion procedures, even in countries where abortion was legal and carried out in medical facilities. A picture emerges of women in many countries submitting themselves for medical procedures surrounded by fear, misunderstandings and uncertainties.

Overview of the book This book comprises of eight chapters that juxtapose competing narratives about abortion in Thai society – from the history of the abortion debate in Thailand and public representations of abortion in the media to stories of the real-life decisions facing women. It moves from the rhetoric to the realities of women and men’s lives, from the historical to the present, from the abstract to the specificities of people’s lives and decisions. In this way it is inspired by all the works mentioned above, seeking to combine various different dimensions of the ongoing debate and experience of abortion in Thai society. Writers are always faced with difficult decisions regarding the organisation of their material, and rarely will the solutions they find be adequate to represent lived experiences that are multivocal, dynamic, multidimensional and change across time. I am forced to impose a continuous narrative where one does not exist. Following this introduction, Chapter 2 comprises of an outline of the situation regarding illegal abortion in Thailand within the context of the widespread Thai family planning programme and reviews the current Thai studies of abortion. It describes Thai social attitudes towards abortion, including academic and Buddhist religious commentaries on abortion from both sides of the debate. It reinforces the fact that the issue of abortion remains crucial in terms of women’s health and women’s rights. In the following chapter, I begin my cultural analysis Introduction 5 of the history of the abortion debate in Thailand and the struggle for abortion law reform in Thailand. I detail the history of the abortion debate and practice in Thailand, from a private act performed alone or with the assistance of a village midwife or healer to an illegal practice commanding high prices and the subject of heated public controversy. As Chapter 3 demonstrates, abortion has always been practised in Thailand, and is not simply a new practice that has grown with the sexual revolution and advent of Westernisation in Thailand. The increased visibility of abortion in the 1970s and 1980s is a consequence of complex changes in Thai society – transition to an industrialising economy from a subsis- tence agriculture-based economy, social changes wrought by greater exposure to Western cultural forms and ideas, the advent of family planning, and a decrease in the size of families and the desirability of children, greater mobility through migration of young people and especially young women to participate in the cash economy, greater access to education for the population. While the works of Petchesky and others have looked at the politics of abortion, in this chapter I also use abortion as a means of talking about politics. I provide a new gendered perspective on Thai political history through the lens of this single issue. The issue of abortion in Thailand yields a further example of the ways in which women’s bodies are used to represent and constitute the territory upon which the imagined communities of nation-states debate contesting visions of the nation and affirm cultural values. In Chapter 4, I draw upon material from the public media, parliamentary debates and popular texts to explore how abortion is employed within narratives of Buddhist morality, nation, democracy and culture in Thailand. As I note in Chapters 4 and 5, the rhetoric presented in this debate is less about the realities of women’s actions than the consolidation of the Thai state, the ideological creation of a sense of Thai-ness, and ongoing anxieties regarding rapid social change. As I note, in anti-reform rhetoric, women who abort are presented as unnatural mothers, un-Thai and un-Buddhist. It has become an issue readily linked in public discourse with debates about threats to Thai culture and gendered narratives of the nation. Abortion draws attention to the politics of gender relations. In Chapter 5, I bring the discourses surrounding women, maternity and gender relations to the fore. The meaning of abortions will vary in different cultural systems where the social value of women depends upon their ability to bear children, or the number of children they bear or the sex of those children. The emphasis placed upon women as ‘good mothers’ in Thailand provides little recognition for women who do not fall into that category. Women are described through essentialist representations related to their reproductive roles as dutiful wives and mothers. Women who do not fit these roles, such as young pregnant unmarried students and prostitutes serve to highlight the dangers of deviation from these roles. I explore how three main tropes are used to depict ‘women who abort’ in Thailand – as corrupt girls, victims of men or desperate women. These tropes position ‘women’ and ‘men’ in certain ways and mandate how abortion is defined as a ‘social problem’ requiring management. Public depictions of gender relations in regard to the abortion issue tend to reinforce stereotypes of male sexual irresponsibility and female passivity and victim-hood. 6 Introduction These chapters give a sense of the powerful characterisations, ideographs and meanings evoked in discussions of abortion in Thailand, the uses of abortion as a metaphor for Thai political and social life, and point to some of the difficulties in substituting alternate views, a theme returned to in the concluding chapter. In the final part of the book, the narratives of women who have had abortions take centre stage. Here I answer questions about how women and men negotiate their experience of unplanned pregnancies and make the decisions about having an abortion. In Chapter 6, women speak of their lived experiences, the decision- making process, the relationship with their partners, and their feelings about the consequences of their abortions. I describe ethnophysiological understandings of conception and pregnancy, and factors affecting the accessibility of abortion. Men’s stories tell us about their roles in sexual responsibility, contraceptive use and decision-making. Paternity in village Isan society is very much described in terms of ‘responsibility’ and economic support, in contrast to women describing their role as mothers as one of ‘care’ and nurturance. As women and men struggle to find an idiom in which to speak of their experience, they also reveal broader social pressures impinging upon their lives. Chapter 7 looks at the decision-making process and the situational ethics of village women and men. Here I find that Petchesky’s (1990: 370–371) feminist humanist concept of ‘morality of praxis’ has its parallels in rural Thailand. Villagers may subscribe to a Buddhist morality, but one that cannot be separated from the social conditions and real situations in which pregnancies occur and careful considerations of the will and intention behind an act. It allows us to understand the apparent inconsistencies between morality, ideology and practice, and how people express notions of reproductive rights cross-culturally. The concluding chapter is less an end than a beginning of a comparative approach to some of the issues raised in the book. Although I am concerned with the specificities of the Thai experience, in this chapter I explore the global agendas influ- encing local abortion debates. In conclusion, I present some of the challenges facing abortion-reform advocates in Thailand.

Agency, choice and reproductive rights A crucial theme underlying this book is that of tensions between agency and structure and the notion of choice. As Jacobson (2000: 26) has observed, it is too easy to ‘fail to give women their due as autonomous agents and turn them into dupes and victims by suggesting that their choices are but mindless capitulations of social pressures’. Petchesky (1990: 11) suggests that the critical issue for feminists is not so much the content of women’s choices, but the social and material conditions under which choices are made:

To paraphrase Marx, women make their own reproductive choices, but they do not make them just as they please; they do not make them under conditions they create but under conditions and constraints they, as mere individuals, are powerless to change. Introduction 7 ‘Choice’ as it is usually conceptualised in pro-choice writings is bound up with Western notions of the autonomous individual subject who rationally selects between the available options (see Jolly and Ram 2001 for a discussion of this in relation to family planning). As studies of abortion in developing countries reveal, the ‘right to choose’ is not a mere question of the legality of abortion, but depends upon questions of culture, political economy, class and gender relations. How then do we define the notion of reproductive rights cross-culturally? The concept of reproductive rights stems from various international forums on human rights and reproductive issues, such as the International Conference on Population and Development (ICPD) at Cairo in 1994 and the Fourth World Conference on Women (FWCW) in Beijing in 1995 and Beijing 5 in Geneva. It seeks to replace the older conception of population and family planning discourse with a broader concept linking sexual and reproductive freedom to women’s human rights. Fundamental to the concept of reproductive rights is the principle that women’s human rights to self-determination and equality must prevail even in the most intimate realms of their family, procreation and sexual lives. The FWCW, Declaration and Platform for Action, paragraph 96 states,

The human rights of women include their right to have control over and decide freely and responsibly on matters related to their sexuality, including sexual and reproductive health, free of coercion, discrimination and violence. Equal relationships between women and men in matters of sexual relations and reproduction, including respect for the integrity of the person, require mutual respect, consent and shared responsibility for sexual behaviour and its consequences. (United Nations 1995)

Petchesky (1990: 2) notes that the philosophical bases of these principles of reproductive freedom rest in Western traditions, the liberal notion of ‘property in one’s own person’ which is not necessarily unproblematic in Asian societies. This has been the basis of critiques to the notion of reproductive rights from third world feminists. For example, Correa (1994: 77) argues that the emphasis on individual autonomy assumed in this discourse is founded on the Western bourgeois concept of a discrete ‘self’ which is culturally inappropriate for many cultural settings in Asia. She suggests that the notion of bodily integrity should be understood in the context of significant family, cultural, social and economic relationships and that rights discourse needs to take account of collective identities (Correa 1994: 79). However, Correa (1994: 82) also suggests an overarching principle such that ‘when cultural practices only consolidate women’s subordination and damage women’s physical integrity or their freedom to make decisions about their own lives, we must question them’. This question of the translation of reproductive rights across cultures has ram- ifications beyond the abortion debate. Anti-individualistic concerns may be taken up by nationalist and fundamentalist religious groups to object to any international guarantees of women’s reproductive rights as interference in the collective 8 Introduction rights of their nations to follow their own ‘culture and traditions’ (Anthias and Yuval-Davis 1989). As will be seen throughout this book this is a continued theme in the Thai anti-reform groups’ objections to legislative amendments.1 In response to these questions of how the concept of reproductive rights is translated across different cultures, the International Reproductive Rights Research Action Group (IRRAG) conducted a series of research projects on diverse women’s health issues in countries such as the Philippines, Nigeria, Mexico, Malaysia, Egypt and Brazil (Petchesky and Judd 1998). Grounded in women’s lived experiences, the group attempted to provide a culturally and situationally appropriate definition of what reproductive and sexual rights should entail. They adopted the term ‘sense of entitlement’ to capture their informants’ negotiated ‘subjective component of rights’, especially women’s needs and moral claims on partners, kin and caregivers (Petchesky 1998: 12–13). This concept of entitlement is more complex than a concept of rights grounded in conventional Western notions of individualism as they emerge from the social context and are negotiated relation- ally. It is based upon a notion of ‘the self both as individual and constructed through ongoing interaction and interdependency with others’. This can be seen in women’s narratives of their decision-making on abortion in Chapter 6 of this book, where they make reference not only to their desires not to bear more children, but their need for an abortion in order to fulfil their roles as mothers by ensuring a good life for their existing children. Thai women’s advocacy groups still grapple with these issues in their struggle for a language through which to express their arguments on abortion. ‘Feminist’ arguments about ‘choice’ and ‘rights’ smack of Western individualism and find little favour or legitimacy in Thailand. Similarly, arguments for abortion reform, based on what Correa (1994) terms the ‘health rationale’, place responsibility for abortion out of the hands of women and into the domain of the medical profession. Thai women’s advocacy groups have not yet succeeded in communicating the notion of ‘reproductive rights’ on this issue beyond a few seminars on legal reform. But the concept of ‘human rights’ is becoming an important framework within the context of the new Thai constitution guaranteeing a range of rights. ‘Rights’ discourse is thus being used in a number of contexts in Thailand at this time.2 With regards to abortion, recently Thawikiat Menakanit (2001) argued that in punishing only women for abortion the present law is against the Thai constitution which guarantees men and women equal rights. He states that while the constitution gives many rights and freedoms to Thais, such freedom is impossible if there are limitations placed over a woman’s right to decide what to do with her own body. He notes that those who would deny women this right are usually men, and that society should take more responsibility for this issue rather than solely punishing women. Chalidapon Songsampan, a political scientist from Thammasat University, has also described the abortion issue as one of rights: ‘All women’s issues in Thailand today are issues of rights. Human rights’. But reflecting the ongoing ambivalence she identifies rights discourses as a farang (foreign) discourse, an admission which undermines its authority (Population Council and Reproductive Health Advocacy Network 2000: 17). Introduction 9 Limitations of this study As with any study, this one has a number of limitations. First, my history and analysis of representations is largely based upon contemporary Thai and English media sources, such as newspapers, parliamentary records and some interviews with significant actors. I found it increasingly difficult to locate material prior to 1960, yet acknowledge that other archival sources may well identify more material. A study of legal sources, police and court records for reference to abortion cases remains to be done. Nevertheless, the form of analysis undertaken here holds potential for furthering our understanding of Thai history and politics. The ethnographic component of this book has its own limitations. It is based upon my fieldwork in Northeast Thailand, hence makes no claims to generalis- ability. My study was never designed to be a demographic study but an ethnography, with all the attendant subjective interpretations involved. I make no claims to provide any data on the incidence of abortion in rural areas of Thailand. The small survey I conducted as part of this study was conducted to give a sense of the incidence of abortion within a modest rural sample of women and as a means to identify women for the qualitative interviews but clearly is not large enough to make claims of statistical significance. Although randomly selected within a range of villages, the sample is clearly biased towards married women, missing the women who were away at the time migrating for work. However, as a study conducted in a range of rural villages that differed in their overall wealth, access to health services and distance from urban centres, it may be reasonable to expect that my findings do point to patterns occurring elsewhere in rural Thailand even if they differ on cultural detail. Due to the nature of this sample, therefore, there were few examples of adolescent women dealing with unplanned pregnancy among the women interviewed for this study. In part, this reflects the differing patterns of abortion use between rural and urban settings, as it appears that a growing percentage of women seeking abortion in urban settings are teenagers, while in rural settings it remains a decision made by older women to prevent further births rather than delay the birth of the first child. Adolescent issues thus only appear in the section on the moral panic over teenage sexuality in Chapter 5 on the public representations of abortion. It is clear that further research is required on this issue of adolescent pregnancy in Thailand and on the provision of better reproductive health services designed for them. Finally, of course, are all the attendant difficulties of interpretation and translation across languages and cultures. No doubt despite my best efforts, there are subtleties that have escaped me, questions asked poorly, answers misunderstood.

Conclusions To study the issue of abortion in Thailand is to view Thai society in ways which challenges the Kingdom’s most cherished images and stereotypes about itself, especially those that present Thailand as a Buddhist state, a country proud of the maintenance of its cultural heritage and ‘Asian values’, a state where women 10 Introduction enjoy a high status and equality. The public admission of abortion’s continued existence is felt as a national loss of face. A similar defensive denial can be seen in the approach of successive Thai governments on other difficult legislative issues, such as prostitution, gambling and official corruption. To focus upon this issue exposes some of the contradictions in this image and offers an alternate vision of Thai society and political life. In writing this text, I hope that it may have an impact upon the continuing debate over abortion law reform in Thailand. It is likely that this work will be dis- missed by conservative elements in Thailand as that of a farang Western feminist. As will be discussed later in Chapter 3, feminism is still considered somewhat illegitimate in Thailand, stereotyped as the ideology of man-hating lesbians. However, at another level such a criticism does point to my positioning as a first- world feminist writing about women in the developing world and the replication of a colonialist mentality inherent in such an enterprise. There is an inevitable challenge in any such research project in reproducing women’s realities particularly through a language that is not their own, and the risks of selection, distor- tion and misinterpretation. In the chapters on women’s lived experiences, I have tried to remain true to women’s own logic and expressions, but the challenge to reproduce ‘women’s voices’ is fraught and will always be mediated by my own analysis and interpretation. It is also important to recognise that this book itself is an intervention, an attempt to present another view of the issue in Thailand, to lend its perspective to the ongoing debate. As such I make no claims to neutral- ity. Rather, I would argue that it is impossible to provide scholarship that is not political in some sense on an issue as important as this one for women’s health and rights, nor should we. Experience throughout the world has demonstrated that when restrictions on abortion are lessened, the numbers of abortion-related deaths decrease, owing to the greater availability of safe procedures by trained health practitioners. The legalisation of abortion does not result in increased abortion rates, but it does change the conditions under which abortions are performed. However, presently only 22 per cent of countries allow abortion upon request and in most parts of the developing world safe abortions are not an option for women. Of course mere legality does not guarantee access for women, particularly for women who are poor, or rural, or disabled or young. Even in some countries where abortion is legal, such as Cambodia, there remains an urgent need to make safe abortion services accessible (Mundigo and Indriso 1999: 24–25). There is no question that effective contraception is a better alternative to abortion. But in the absence of failsafe contraception, the reality is that there will always be failures and unplanned pregnancies, for a range of reasons. Women who experience unplanned pregnancies should not be coerced into continuing a pregnancy or motherhood and they should not have to risk death or morbidity for the sake of access to trained medical personnel providing a safe uncomplicated procedure. Bibliography

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Thai language newspapers cited Ban Meuang Daily Mirror Daily News Daily Times Dokpia Sapda Khao Sot Krungthep Thurakhit Matichon Matichon rai sapda Matuphum Naew Na Phu Jat Kan Rai Sapda Prachathipatai Siam Rath Siam Rath Sapda Wijan Tawan Siam Thai Post Thai Rath Thai Sot Thai Thurakhit

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