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Singapore

More women in Singapore seek referrals for abortion following unplanned pregnancy: SingHealth Polyclinics study

SHP is calling for better family planning services to prevent unplanned pregnancies that result in abortion, as the procedure comes with the risk of anaemia and may affect a woman's reproductive health. 

More women in Singapore seek referrals for abortion following unplanned pregnancy: SingHealth Polyclinics study
Abortion following unplanned pregnancy is on the rise in Singapore, going by a three-year study conducted by SingHealth Polyclinics. (Photo: iStock/graphixchon)
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SINGAPORE: More women are seeking referrals for abortion following unplanned pregnancy in Singapore, going by a three-year study conducted by SingHealth Polyclinics (SHP).

In 2020, 340 local women went to the eight polyclinics under the healthcare cluster to ask for a referral to a gynaecologist for an abortion, a 60 per cent increase from the 210 in 2018. 

Of them, more than 10 per cent had records of repeated referrals for abortions. 

The study, titled "Surveillance of Abortion and Family Planning in Primary Care”, is the first of its kind. It is aimed at identifying the profile of women who visited polyclinics for a referral on their unplanned pregnancy, and if there was an increasing trend.

Women seeking referrals were more likely single, aged below 20 or above 40 years of age, and from poorer households, it found.

Foreign women made up about 16 per cent of women referred for unplanned pregnancy, with an almost two-fold increase from 2017 to 2019, which the main author of the research paper, Ms Stephanie Quak described as a “growing concern”.

“Every year, about 100 foreign domestic workers are sent home because they are discovered to be pregnant, which breaches the legislation. This number could be under-reported, as an unknown fraction of them may have proceeded with the abortion quietly,” said Ms Quak, a student at Duke-NUS Medical School.

“The rise may be due to issues, such as language barriers, poor awareness and knowledge of health, and lack of healthcare accessibility.”

REASONS BEHIND UNPLANNED PREGNANCIES

SHP pointed to a lack of knowledge on contraceptives as one of the possible factors for such unplanned pregnancies. 

A survey by gender equality group AWARE and students from Ngee Ann Polytechnic’s Diploma in Psychology Studies in 2018 found that local youth had poor knowledge about contraceptives.

About 60 per cent of those aged 18 years and below who engaged in sexual activity did not take any precautions to avoid pregnancy or sexually transmitted diseases. The results showed that they tend to seek sexual health information from friends and partners.

“More initiatives may need to be implemented to coach parents to educate and initiate conversations on sexual matters at home. For older women with unplanned pregnancy, they may misperceive declined fertility after the age of 40 years, and hence stop using contraceptive,” said SHP.

BETTER FAMILY PLANNING SERVICES 

SHP is calling for better family planning services to prevent unplanned pregnancies that result in abortion, as the procedure comes with the risk of anaemia and may affect a woman's reproductive health. 

SHP is considering the use of telemedicine so that people have easier access to information.

Associate Professor Tan Ngiap Chuan, director of research at SHP, said that with the Healthier SG initiative encouraging adults to partner with regular family doctors, patients may be able to discuss their family planning plans with their physicians.

“With the establishment of a close relationship between the doctor and the couple, they can open up even sensitive topics for discussion, including family planning” he said. 

“This is one way to reduce the stigma and then of course, for the doctor to understand the issues around the couple and to find the best method or recommendation to advise them on family planning.”

There are plans to conduct interviews with individual women with unplanned pregnancies to gain fresh insight into their struggles and perception of the issue, Assoc Prof Tan added.

This will help SHP “develop and design person-centric measures and primary care services to potentially reduce unplanned pregnancy in the community, mitigate the gaps in family planning, and improve women’s health”, he said.

Source: CNA/ja(ca)
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