Logo of Phnom Penh Post newspaper Phnom Penh Post - Abortions pose hidden risk for Cambodia's sex workers: study




Abortions pose hidden risk for Cambodia's sex workers: study

Sex workers wait for clients late at night near Wat Phnom in downtown Phnom Penh in 2009.
Sex workers wait for clients late at night near Wat Phnom in downtown Phnom Penh in 2009. Sovan Philong

Abortions pose hidden risk for Cambodia's sex workers: study

A shocking 40 percent of maternal deaths among Cambodian sex workers were the result of abortions, according to a recent study.

The research, published online last week in peer-reviewed journal BioMed Central Public Health, surveyed 271 female sex workers to ascertain the major causes of death for mothers in the industry and their children.

Study author and Global Health Promise director Brian Willis said his research found that of 194 reported deaths of female sex workers, nearly a quarter, 43, were maternal deaths, meaning women who died either during pregnancy, during childbirth or within six weeks of a termination or childbirth.

Willis said his team chose to focus on 32 of those 43 deaths because they occurred after the 2010 Cambodian Demographic Health Survey; his interviews took place in 2013, before the 2014 demographic survey was released.

A total of 13 women out of the 32 sex workers died from an abortion, while five (16 percent) died of complications related to HIV.

The report hinted that the high proportion of abortion-related deaths could indicate sex workers face barriers to reproductive health, safe abortions and post-abortion care.

“Based on the data we collected, it is unclear why so many of the reported deaths were due to abortion,” Willis said, adding the reasons warranted further research.

Dr Var Chivorn, executive director of the Reproductive Health Association of Cambodia, said despite abortions being a legal procedure in the Kingdom, stigma and shame were still major contributors to pregnant women seeking secret – and sometimes fatal – abortions.

“Because abortion is sensitive and the women don’t want to disclose their pregnancy, sex workers, as the most vulnerable group, tend to go somewhere where they can hide their identity, where it’s cheap. They often go to an unqualified provider,” he said.

He said abortions were the cause of 30 percent of maternal deaths in Cambodia overall, much lower than the study’s 40 percent figure for sex workers.

Chivorn said some women took abortion medication without proper advice, which could lead to complications, while others sought out traditional healers who used a deep massage on the womb.

Chivorn said this sometimes meant the foetus was not completely expelled and could lead to bleeding and infection, often resulting in the death of the woman due to septic shock.

“Abortion is actually very safe if performed by a trained provider,” Chivorn said.

The study found that obstructed labour and suicide each claimed three lives (9 percent each), while two women were killed in accidents and one was murdered.

One woman died of postpartum hemorrhage, and four deaths had unknown causes.

The participants reported a total of 58 children of sex workers had died, with HIV responsible for more than a third of deaths in children under 5.

Willis also pointed to a stark difference between his work and the official statistics from the 2010 CDHS.

That survey identified 40 maternal deaths among the general population through interviews conducted with more than 18,000 women, while his team identified 32 by interviewing “a much smaller sample” of 271 female sex workers in 2013. The 2014 demographic survey reported exactly 32 maternal deaths.

The disparity could suggest “there may be many unrecognized maternal deaths among [female sex workers] in Cambodia”, the report reads.

Sivann Botum, secretary of state with Ministry of Women’s Affairs, was unavailable for comment yesterday, while officials from the Ministry of Health could not be reached.

MOST VIEWED

  • Vietnam: Tougher sentences for child abusers

    Several National Assembly (NA) deputies in Vietnam are calling for tougher penalties to be handed down to child abusers. They hope stricter punishments will act as a strong deterrent to prevent offenders committing further offences in the future. Extreme measures such as chemical castration were

  • Central bank to shun small US banknotes

    The National Bank of Cambodia (NBC) is considering not accepting smaller denominated US dollar banknotes – $1, $2 and $5 – from banks and microfinance institutions (MFIs) which it said are flooding its stockpile as the demand for those notes is low. While some banking insiders welcomed the move as

  • PM lauded in Covid-19 fight

    World Health Organisation (WHO) director-general Tedros Adhanom Ghebreyesus sent a letter to Prime Minister Hun Sen thanking him for following the WHO’s guidance and commending Cambodia’s efforts in the fight against Covid-19. In his letter made public by the Ministry of Foreign Affairs

  • Workers return, hope for salaries

    More than 600 factory workers in the capital’s Chaom Chao commune in Por Sen Chey district returned to work after the factory’s owner promised to pay their salaries in instalments until the middle of next month. On Tuesday and Wednesday, more than 600 workers gathered

  • Women detained for forcing kids to beg

    Two women were sent to Phnom Penh Municipal Court on Thursday for forcing six children to beg for money for several months at the Chhouk Meas market in Krang Thnong commune in the capital’s Sen Sok district. Phnom Penh Department of Anti-human Trafficking and

  • Vietnamese tents baffle border guards

    Kandal and Takeo provincial authorities bordering Vietnam have expressed concern after witnessing irregularities by the Vietnamese authorities, including the deployment of soldiers to erect 114 camps just 30m from the border. Takeo provincial governor Ouch Phea told The Post on Thursday that Vietnamese soldiers had erected 83