H ORRIFIC instances of "back yard" abortions, including hitting pregnant women with a wooden plank, have been described by officials from the Ministry of Health.

And this year's publication of Cambodia's official abortion statistics indicate that abortions might have doubled over the past year to 5,139 - though unreported cases would boost that much higher.

Last year's "official" figures showed only 516 abortions, though many provinces went unreported.

The ministry's National Mother and Child Health Center (NMCHC) had figures available from 16 of Cambodia's 21 provinces. Doctor Koun Kanal, deputy director of the NMCHC, said they were double those of last year.

Serey Phal, deputy director of the NGO Family Health and Spacing project, said that unskilled workers in Svey Rieng province working as midwives practiced the kach kor or "break neck" abortion method.

Another NGO worker who would not be named explained the method.

It involved moving the fetus by manipulating the pregnant woman, locating the head and neck of the fetus, then violently twisting and breaking its neck.

She said other methods included unskilled "midwives" slapping the surface of a pregnant woman's stomach with a piece of wood or another hard object.

Others encouraged pregnant women to drink two liters of strong white wine with papaya resin daily. Still others used other herbs.

These methods were apparently used in the rural provinces.

The Post is also aware that private abortions can be arranged easily in Phnom Penh at a cost of between $30 and $250 - depending on the age of the fetus and the condition of the pregnant woman.

A doctor who had agreed to perform an abortion said: "I guarantee there will not be a problem if [the woman] follows my instructions."

"If the woman's fetus is more than four months old I have to collaborate with my colleagues."

Serey Phal said the increased number of abortions was caused by mothers having problems during pregnancy, not wanting their children, and an increase in teenage sexual intercourse.

Both Koun Kanal and Serey Phal indicated that women were dying or being harmed by such "traditional" abortion procedures.

The women could be harmed due to unsafe abortions and the use of unsterilized and unhygienic materials.

Phal said that in many remote areas pregnant women do not have access to health services. They bear their children at home.

She said neither did they have access to or knowledge of contraception and consequently went to unskilled "midwives".

Phal said the problem was not that abortions might be legal or illegal, the main concern was the preventable death or suffering of the mother.

Government policy states that abortion is only legal when the health of the mother is at risk.

Koun Kanal said however most private clinics considered money before considering the law and would give abortions on demand.

Cambodia's real maternal mortality rate is believed by health workers and NGOs to be 800 per 100,000, and suggests that only one in every 15 cases is reported.

Koun Kanal believes a quarter of all maternal mortalities occur during unsafe abortions.