Unsafe Abortion : A Major Cause of Maternal Mortality in Thailand

()

()

Problem and Situations ;

(Unsafe Abortion)

20 7-8
95
(15-49 ) 16 1 4
2542 40

( 12.4, 12.0, 11.8 7.4 ) 14
300 100,000
2551 3



2,684
( 20,500 ) 21,024







2,000

Sharp Curettage (D&C)



(International Conference on
Population and Development-ICPD) .. 2537 4 2538
(Millennium Development Goals-MDGs)
MDG5
3 4 2558

(Convention on the Elimination of All Form of Discrimination Against Women-CEDAW)

ICPD
Plus 5 ( 2542)



in circumstances where abortion is not against the law, health systems should train and
equip health-service providers and should take other measures to ensure that such abortion is safe and
accessible. Additional measures should be taken to safeguard womens health
(Maternal Mortality and Morbidity-MMR)

( 2544 MMR 24 : 100,000 ) MMR
110 : 100,000 ( 2542 300 :
100,000 )

Laws do not stop abortion, they simply make it unsafe ;

305 305
.. 2500 2

,,,, ( )

Gold Standard Technology ; 2 Medical Surgical Abortion

1. Medical Abortion : As Early As Possible, As Late As Necessary
Medical Abortion
Mifepristone (RU486) Misoprostol (Cytotec)
( 63 ) 95-100%
(Federation International of Obstetricians and
Gynecologists-FIGO) Medical Abortion
20
.. Mifepristone 2545 .
Misoprostol
500-5,000 ( 17 )

2. Surgical Abortion : From D&C To MVA ;

Surgical Abortion Invasive Procedure Medical Abortion
WHO FIGO Vacuum Aspiration Surgical Abortion
Intra-Uterine Evacuation Sharp Curettage (D&C)
D&C MVA D&C
Surgical Abortion (
)
MVA


Sharp Curettage (D&C) MVA
Endometrial
Biopsy DUB, Blighted Ovum, incomplete abortion

Program for Prevention of Maternal Morbidity& Mortality from Unsafe Abortion (1999-2009;

()
/ 2541
.. 2542

305
.. 2548 15 2548
305








Safe Abortion : Technical and Policy Guidance for Health System

(Post Abortion Care and Counseling-PAC) Incomplete Abortion
Surgical Abortion Medical Abortion MVA D&C

WHO FIGO

;




1.

2.1
2.1.1 (In-service Training)
2 ( 1 1 )
MVA
2.1.2 MVA
2.1.3

( )
2.2 Safe Abortion MVA
(Pre-service Training)
3.
3.1
MVA D&C .
3.2 Public Advocacy
3.3 .. Mifepristone (RU486)

(95-97%)
3.4 .. Misoprostol (Cytotec)
(
. .. )
4.

5.