Teen pregnancy: Growing problem in Thailand

Births in Thailand falling but teen births rising fast (43% in last 10 years). Govt looking to follow successful UK teen birth reduction program.

The two-hour old daughter of a 17-year old girl is fed by a nurse at a hospital in Chiang Mai. (Reuters/Sukree Sukplan).

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Social Issues

Thailand struggles with teen pregnancy

8 Mar 2013
Reuters News agency
Thomson Reuters

When Mallika told her parents she was pregnant at 17, they pulled her out of school and ordered her to marry the baby's father. But the marriage didn't happen and the one-time aspiring singer now cares for her baby girl alone.

"I love her, but at the time I hid in shame," said Mallika, now 23 and a vendor of cheap, made-in-China clothing at a weekend market in Bangkok.

"The boy's family wanted to pay me to shut up and stay away from them. We were both children ourselves," she added, sitting in her dilapidated apartment overlooking a highway on the outskirts of the city.

Mallika's situation is, sadly, far from unusual. Thailand's teenage pregnancy rate is the highest in Southeast Asia after neighbouring Laos, according to the Bureau of Reproductive Health at the Public Health Ministry.

In fact, even though the overall birthrate is dropping, teen births are on the rise. Out of every 1,000 live births, 54 are from teen mothers aged 15-19 - higher than in the United States and 10 times higher than Singapore's teen pregnancy rate.

What's more, it's rising fast. The number of live births by Thai teenage mothers aged 15-18 increased 43% between 2000 and 2011, an annual public health report shows.

Though there are many factors responsible, health experts put weight on cultural mores that make frank discussion of the issue difficult, whether in an official context or a personal one. This is complicated by gender issues.

"Women are told to protect their virginity but Thai men who have multiple sexual encounters are seen as cool," said Visa Benjamano, a commissioner at the National Human Rights Council (NHRC).

If men sleep around, their image is not at stake whereas a woman's image is. Women are generally more afraid to discuss their sexual health needs in public. 

LACK OF DISCUSSION

Although sexual education is part of the national school curriculum, teaching is clearly insufficient. The Education Ministry limits instruction on the subject to eight hours a year despite changing attitudes towards sex among the young.

"Teachers are prudish and out of touch with Thai kids today and they approach the topic like a biology class rather than talking about the emotional issues involved," said Visa.

The consequences of unplanned pregnancy are often left out of classroom teaching too, despite a lack of legal options.

A 2011 report by the United Nations Population Fund (UNFPA) and Thailand's National and Economic and Social Development Board (NESDB) shows the number of women hospitalised in connection with abortions increased by over 16% between 1994 and 2009, hitting 60,000 in 2009.

Yet abortion is illegal in Thailand except in cases of rape or incest, to save a woman's life or preserve her physical or mental health, and if the woman is under 15 years of age. 

Under Thai law the penalty for performing illegal abortions is up to five years in prison or a fine of up to 10,000 baht. Despite this, illegal clinics and back street abortions abound. 

In 2010, Thai police found 2,000 foetuses on the grounds of a Bangkok Buddhist temple.They were believed to have been sent there from illegal abortion clinics.

The discovery left the public grappling with the reality of a highly charged religious and social issue. Abortion is recognised as a "sin" in the Theravada Buddhism practiced by up to 95% of the population.

Unlike the predominantly Catholic Philippines, Thailand offers easy access to contraception and birth control pills, with condoms and most other contraceptives readily available and sold over the counter.

But when it comes to teenage girls getting them, social stigma gets in the way.

Kanya Musiket was 15 when she started a physical relationship with a boy in her neighbourhood. But when she ventured to a local shop to buy condoms, shopkeepers would look at her "disapprovingly," making her feel ashamed.

OVERSEAS HELP

In a bid to find solutions, a Thai delegation visited Britain in November 2012, looking to emulate programmes there.

The number of babies born to teen mothers in England dropped by 27% between 2000 and 2010 and overall conception by teens fell by 25% between 1999 and 2010. Some areas, like Hackney in East London, showed reductions of over 40%.

This was due largely to a 1999 government plan aiming to halve England's under 18 conception rate by 2010. The plan used local grants and guidelines, government funds to improve access to contraceptives and media campaigns to raise awareness

By contrast, Thailand issued a population strategy plan in 2012 that focuses on reducing teen births but does not include either target reduction goals or concrete ways to do so.

There are university-led sexual health awareness programs, and the UNFPA is trying to raise awareness through both civil and private networks. Yet the most fundamental measure is the hardest to achieve: changing attitudes.

"This is about trusting the moral standards of those young people whom we have invested years of education and nurturing - our children," said Caspar Peek, UNFPA Representative for Thailand and Country Director for Malaysia.

We need everyone ... to see this as a challenge to development and not just something bad that happens to teenagers because they do 'bad' things.

(Source: Bangkok Post, Breakingnews, Thailand struggles with teen pregnancy, 8 Mar 2013, Reuters News agency, Thomson Reuters, link)


Teen Pregnancy Vocabulary

pregnancy - when a baby is growing inside a woman การตั้งท้อง
teen pregnancy - the social problem of teenage girls getting pregnant (at at time when they are not ready to be a mother) (See Wikipedia)
prevalence of teen pregnancy - (See Wikipedia)
unplanned pregnancy

pregnant (adjective) - having a baby developing inside the body ท้อง ตั้งครรภ์

conception - when a women becomes pregnant
conception by teens
overall conception by teens fell by 25%

struggles - experiences difficulty and makes a very great effort in order to do something ดิ้นรน
Thailand struggles with teen pregnancy

sexual education - sex education, teaching children about sex and where babies come from, for the first time (See Wikipedia)

birth control - devices and medicine to prevent pregnancy (See Wikipedia)
contraception - Same as "birth control"

birth control pills
contraceptives

curb - to control or limit something that is harmful ระงับ, ควบคุม ลดหรือยุติ
curb teen pregnancy

pull out - remove a person from a place (take out, take away from)
pull her out of school

When Mallika told her parents she was pregnant at 17, they pulled her out of school and ordered her to marry the baby's father.

one-time -
meaning: at one time in the past
aspiring -
wanting to do or be something in the future
one-time aspiring singer

But the marriage didn't happen and the one-time aspiring singer now cares for her baby girl alone.

vendor - seller of goods; a person who sells something พ่อค้า, แม่ค้า
a vendor of cheap clothing 

"I love her, but at the time I hid in shame," said Mallika, now 23 and a vendor of cheap, made-in-China clothing at a weekend market in Bangkok.

shut up - stop speaking (close or "shut" mouth)
stay away -
not go near (to a person or place)

The boy's family wanted to pay me to shut up and stay away from them.

outskirts - the areas at the edge of a city ชานเมือง
outskirts of the city

overlook -  to look over something มองลงไปเห็น
overlooking a highway

dilapidated - old and in bad condition ซึ่งชำรุดทรุดโทรม
dilapidated apartment

We were both children ourselves," she added, sitting in her dilapidated apartment overlooking a highway on the outskirts of the city.

rate - the level or speed at which something happens or changes, or the amount or number of times it happens or changes in a particular period อัตรา

far from unusual - happens often (not unusual)
Mallika's situation is, sadly, far from unusual

Mallika's situation is, sadly, far from unusual. Thailand's teenage pregnancy rate is the highest in Southeast Asia after neighbouring Laos, according to the Bureau of Reproductive Health at the Public Health Ministry.

birthrate - the number of babies born each year
the overall birthrate is dropping

In fact, even though the overall birthrate is dropping, teen births are on the rise. Out of every 1,000 live births, 54 are from teen mothers aged 15-19 - higher than in the United States and 10 times higher than Singapore's teen pregnancy rate.

annual - happening once a year ประจำปี
annual public health report

What's more, it's rising fast. The number of live births by Thai teenage mothers aged 15-18 increased 43% between 2000 and 2011, an annual public health report shows.

factors - the different things that affect the outcome of a situation, event, or decision ปัจจัย
there are many factors responsible

mores - the moral beliefs and practices of a group of people or society (part of the "tradition" they get from the past) ประเพณี
cultural mores

weight - importance ความสำคัญ
put weight on
put weight on cultural mores

issue - matter; a subject that people discuss or argue about ประเด็น
emotional issues

context -
the situation in which some event happens (that explain the event) เนื้อความ, เนื้อในเห็ด , บริบท

official - approved by the government or some authority ที่เป็นทางการ
an official context

personal  
- related only to one person ส่วนตัว,  ส่วนบุคคล, , เฉพาะตัว,  ด้วยตนเอง,  โดยตนเอง
a personal context


gender - the fact of being either male or female เพศ the differences between men and women (including biological and social) (See Wikipedia)
gender issues

complicated - has so many parts connected in different ways that it is difficult to understand (for example, a complicated machine or a city with a complicated system of streets) ที่ซับซ้อน
complicated by gender issues

Though there are many factors responsible, health experts put weight on cultural mores that make frank discussion of the issue difficult, whether in an official context or a personal one. This is complicated by gender issues.

cool - clever; impressive ดีเลิศ (คำสแลง)
commissioner - a member of a commission, a group of people who have been formally chosen to discover information about a problem or examine the reasons why the problem exists

"Women are told to protect their virginity but Thai men who have multiple sexual encounters are seen as cool," said Visa Benjamano, a commissioner at the National Human Rights Council (NHRC).

image - an opinion; the picture of something that people have in their mind, what people think about something ภาพลักษณ์
at stake - might lose something
their image is not at stake - people might have bad opinion of you, might lose face  

sleep around - have sex with many women or men

If men sleep around, their image is not at stake whereas a woman's image is. Women are generally more afraid to discuss their sexual health needs in public.
lack - does not have ขาดแคลน
lack of discussion

national - a citizen of a particular country ประชาชน
curriculum - the group of subjects studied in a school, college, etc หลักสูตร
the national school curriculum

insufficient - not sufficient, not enough ไม่พอ
teaching is clearly insufficient

Although sexual education is part of the national school curriculum, teaching is clearly insufficient.

instruction - การสอน
subject -  วิชา
instruction on the subject

the Education Ministry limits instruction on the subject to eight hours a year

attitudes - ทัศนคติ,  เจตคติ
changing attitudes  
changing attitudes towards  
changing attitudes towards sex among the young

The Education Ministry limits instruction on the subject to eight hours a year despite changing attitudes towards sex among the young.

prudish - ซึ่งเคร่งครัด,  ซึ่งเจ้าระเบียบเกินไป
out of touch -
don't know what is happening 
Teachers are prudish and out of touch with Thai kids today

approach - a way of doing or dealing with something การจัดการกับปัญหา วิธีการทำให้ถึงจุดหมาย
approach the topic of sex education like a biology class rather than talking about the emotional issues involved.

consequences - the things that happen as a result of some action
the consequences of unplanned pregnancy

options - choices ทางเลือก
The consequences of unplanned pregnancy are often left out of classroom teaching too, despite a lack of legal options.

abortion - when the baby is removed from the mother before she gives birth to it (ending the pregnancy)

A 2011 report by the United Nations Population Fund (UNFPA) and Thailand's National and Economic and Social Development Board (NESDB) shows the number of women hospitalised in connection with abortions increased by over 16% between 1994 and 2009, hitting 60,000 in 2009.

illegal - against the law ผิดกฎหมาย, นอกกฎหมาย
abortion is illegal in Thailand

rape - the crime of forcefully having sex with someone against their wish การข่มขืน
incest - the crime of sleeping with your father or mother (or some other close family member)
abortion is illegal in Thailand except in cases of rape or incest

preserve - to keep something as it is, especially in order to prevent it from being damaged or destroyed ทำให้คงอยู่, สงวน
preserve her physical or mental health

Yet abortion is illegal in Thailand except in cases of rape or incest, to save a woman's life or preserve her physical or mental health, and if the woman is under 15 years of age. 

penalty - a punishment, or the usual punishment, for doing something that is against a law โทษ
the penalty for performing illegal abortions is up to five years in prison

fine - an amount of money that you have to pay because you have broken the law ค่าปรับ
the penalty is up to five years in prison or a fine of up to 10,000 baht

clinics - places where people go to receive medical treatment
illegal clinics

back street abortions - an abortion done in some secret place (not a doctor's office)
abound
- there are many of them
back street abortions abound

Under Thai law the penalty for performing illegal abortions is up to five years in prison or a fine of up to 10,000 baht. Despite this, illegal clinics and back street abortions abound.

grounds - the area around a place, around the buildings, enclosed in a fence
the grounds of a Bangkok Buddhist temple

foetus - ทารกในครรภ์
Thai police found 2,000 foetuses on the grounds of a Bangkok Buddhist temple

In 2010, Thai police found 2,000 foetuses on the grounds of a Bangkok Buddhist temple.They were believed to have been sent there from illegal abortion clinics.

highly charged - very emotional
a highly charged religious and social issue

reality - that is actually happening ความเป็นจริง
the reality of a highly charged religious and social issue

grappling with - try to deal with and solve a big problem
grappling with the reality of a highly charged religious and social issue

sin - an action, thought, or way of behaving that is wrong according to religious laws บาป
Abortion is recognised as a "sin" in Theravada Buddhism

population - all the people who live in one country, area or place กลุ่มที่อาศัยอยู่ในบริเวณหนึ่ง
Theravada Buddhism  by up to 95% of the population.

The discovery left the public grappling with the reality of a highly charged religious and social issue. Abortion is recognised as a "sin" in the Theravada Buddhism practiced by up to 95% of the population.

predominantly - mostly or mainly ส่วนมาก มีอิทธิพลเหนือ, มีมากกว่า
the predominantly Catholic Philippines

access - the ability to get something สิทธิหรือโอกาสในการใช้
offer easy access - can get easy
Thailand offers easy access to contraception and birth control pills

sold over the counter - can buy a drug at the drug store or pharmacy (do nto need special permission from a doctor or a "prescription")
condoms and most other contraceptives are readily available and sold over the counter

Unlike the predominantly Catholic Philippines, Thailand offers easy access to contraception and birth control pills, with condoms and most other contraceptives readily available and sold over the counter.

stigma - something that embarasses you, makes you ashamed
social stigma  - something that makes people look down on you, think you are bad

gets in the way -
that stops you from doing something; is an obstacle or barrier

But when it comes to teenage girls getting them, social stigma gets in the way.

physical relationship - meaning: having sex (probably more than "holding hands" though this would be "physical" too)

Kanya Musiket was 15 when she started a physical relationship with a boy in her neighbourhood.

ventured to - went to, traveled to
look at her
 disapprovingly
feel ashamed

But when she ventured to a local shop to buy condoms, shopkeepers would look at her "disapprovingly," making her feel ashamed.

overseas - from or in a foreign country
overseas help

bid - an attempt to do something ความพยายาม
In a bid to ...  - trying to do something, attempting to do something
delegation - a group of people chosen or elected by a group to represent them คณะผู้แทน, คณะบุคคลที่เป็นตัวแทนของคนกลุ่มใหญ่

looking to - planning to do
emulate -
trying to do something good, by following another's example
looking to emulate programmes there

In a bid to find solutions, a Thai delegation visited Britain in November 2012, looking to emulate programmes there.

The number of babies born to teen mothers in England dropped by 27% between 2000 and 2010 and overall conception by teens fell by 25% between 1999 and 2010. Some areas, like Hackney in East London, showed reductions of over 40%.

grants - giving money for some activity (rather than lending money) เงินทุน หมายถึงเงินที่ให้ช่วยเหลือ โดยไม่ต้องใช้คืน
local grants

guidelines - rules to help guide action แนวทาง นโยบาย

funds - money needed or available to spend on something เงินทุน
government funds

improve - to make better ทำให้ดีขึ้น
improve access to contraceptives

local grants and guidelines, government funds to improve access to contraceptives

awareness - the state of knowing about something การรับรู้, การทราบ
raise awareness

media - radio, television, newspaper, the Internet, considered as a group สื่อ
campaigns - a long series of events staged to achieve a goal or to promote something (for example, an "anti-smoking campaign")
media campaigns to raise awareness

This was due largely to a 1999 government plan aiming to halve England's under 18 conception rate by 2010. The plan used local grants and guidelines, government funds to improve access to contraceptives and media campaigns to raise awareness

strategy - a plan to achieve long term goals ('strategy' gives the big picture, 'tactics' the details)
population strategy plan

issued - made available ออกใหม่
Thailand issued a population strategy plan in 2012

target - a goal; something you are planning to achieve เป้าหมาย
target reduction goals

concrete - based on facts, not on ideas or guesses
concrete ways to do something

contrast - a difference between two things when you compare them ความแตกต่าง
By contrast, ... - ... different from what we just discusssed ....

By contrast, Thailand issued a population strategy plan in 2012 that focuses on reducing teen births but does not include either target reduction goals or concrete ways to do so.

fundamental - very important and essential พื้นฐาน รากฐานที่สำคัญ
measure - an action taken to solve a particular problem มาตรการ
fundamental measure

the most fundamental measure
the most fundamental measure is the hardest to achieve

There are university-led sexual health awareness programs, and the UNFPA is trying to raise awareness through both civil and private networks. Yet the most fundamental measure is the hardest to achieve: changing attitudes.

moral - about what is right and wrong, about how people should behave
standards - a rule for behaving which should be obeyed มาตรฐาน, บรรทัดฐาน, กฎเกณฑ์, กรอบ acceptable levels of quality or achievement มาตรฐาน

moral standards
moral standards of young people

This is about trusting the moral standards of those young people whom we have invested years of education and nurturing - our children.

challenge - something that needs a lot of skill, energy, and determination to deal with or achieve สิ่งที่ท้าทาย, การท้าทาย
development - the gradual growth and formation of the economy and government of a country
a challenge to development 

We need everyone ... to see this as a challenge to development and not just something bad that happens to teenagers because they do 'bad' things.

About the author

columnist
Writer: Jon Fernquest
Position: Online Writer