Abortions fall to 30-year low

Figure dips below 10,000 as more S'poreans use birth control, but rate for foreigners on the rise
By Theresa Tan, The Sunday Times, 27 Jul 2014

The number of abortions hit a historic low here last year, falling below the 10,000 mark for the first time in at least 30 years.

The Health Ministry told The Sunday Times that 9,282 abortions were performed last year, 13 per cent fewer than in 2012.

Last year's figure was also way below the peak of 23,512 in 1985. After pre-abortion counselling was made mandatory in 1987, the numbers fell steadily to an average of 12,000 a year for most of the past decade.

Gynaecologists and counsellors say the decline reflects the increasingly widespread use of contraception by Singaporeans.

The numbers would have been even lower, if not for a rising number of abortions on permanent residents and, especially, foreign women.

About six in 10 abortions last year were on Singaporeans, down from eight in 10 in 2003. Conversely, almost four in 10 abortions were on PRs and foreigners, up from two in 10 in 2003.

The foreign women who had abortions included maids, service industry workers, professionals, wives of foreign professionals and foreign wives of Singaporean men. They were from countries such as China, India, Indonesia, Myanmar and the Philippines.

There are practical reasons some choose to end their pregnancies.

Manpower laws bar female work permit holders, such as maids, from getting pregnant or giving birth here, unless they are wed to a Singaporean or PR with the Controller of Work Permit's approval. Those who become pregnant are not allowed to continue working here. Other foreigners have abortions as they are not married or do not want a baby to affect their job prospects here.

Dr Kenneth Wong, of Obgyn Centre, a private clinic, said: "Many of these foreigners have uprooted themselves to provide for their families back home and having a child is an inconceivable prospect to bear."

Ms Rose Boon, a volunteer with the Pregnancy Crisis Service which helps pregnant women in distress, said some wives of foreign professionals say they cannot cope with starting a family or having more children without family support.

Just over half of the abortions were on married women last year, while those on singles accounted for about 40 per cent.

Most of those who had abortions were in their 20s and 30s. Abortions on women under 20 fell by half in the past decade.

Last year, the most commonly cited reason for choosing an abortion was that the woman was unwed, divorced or widowed. That was followed by those who said they had enough children and those not ready to start a family.

There was also a sharp rise in tertiary-educated women who had abortions in the past decade. Some 43 per cent of the abortions were on graduates last year, almost triple the 16 per cent in 2003.

Graduates comprised the largest group by educational qualifications, overtaking those with secondary, vocational or O levels for the first time in the past decade.

Those interviewed said there are more women graduates now and many foreign professionals or their wives are also tertiary educated.

Ms Jennifer Heng, who counsels women with unplanned pregnancies, said: "Many of the women I see are highly educated and say they are not ready to be mothers.

"They feel it would not be fair to their babies if they were not settled in their careers. They want to focus on their careers and making money first and always feel they can have a child later."

Unlike lower-educated women who struggle to make ends meet and cannot afford another child, graduate women choose abortion as they do not want an unplanned pregnancy to derail their climb up the corporate ladder or lifestyle goals, counsellors say.

Ms Jennifer Chee, of Alife, a charity which counsels women facing unwanted pregnancies, said: "It's all about expectations. Instead of having five children, graduates feel it's better to have one or two children and focus all their time and energy to give their children the best."

HELPLINES

If you are distressed by an unplanned pregnancy, call the following helplines for assistance:

- Pregnancy Crisis Service: 6339-9770

- Alife: 6258-8816

- Babes: 8111-3535 (for pregnant teenagers)

Most aren't swayed by counselling
By Theresa Tan, The Sunday Times, 27 Jul 2014

Very few women seeking abortion change their mind after being counselled.

Health Ministry records for the past five years show that less than 5 per cent of those counselled decided to keep their babies.

Gynaecologists and counsellors say the reason is that most women would have made up their minds by the time they turned up at a clinic for an abortion. But those still struggling with the decision may be moved to keep their babies.

Pre-abortion counselling is compulsory only for Singaporeans and permanent residents who have passed the Primary School Leaving Examination, "have at least some secondary school education" and have fewer than three children. It is also mandatory to refer unwed girls under 16 for pre-abortion counselling at the Health Promotion Board.

Last year, the Health Ministry said it was reviewing the guidelines and proposing that all women seeking an abortion be counselled. It will consult the public on its plans later this year.

Ms Jennifer Heng, who had two abortions and now counsels women with unplanned pregnancies, hopes pre-abortion counselling will be extended to all.

"No matter what your background is, you will suffer the psychological and emotional effects of abortion, such as guilt," she said.

Among other things, those who are counselled watch a video about the abortion procedure and its implications. They must also wait at least 48 hours after the counselling before proceeding with the abortion.

Women interviewed said they received little or no counselling at private clinics. All they had to do was to watch the video and wait at least 48 hours.

Brenda, a 33-year-old childless divorcee who is self-employed, had a relationship with a foreigner, but he left her after she told him she was pregnant. She always wanted to become a mother, but her family told her it was best to abort.

"My heart said to keep the baby, but my head said no. The baby would be a burden, I was financially strapped and the child would remind me of his father," she said. She became depressed, had suicidal thoughts, and felt lost. "I didn't tell my friends as I didn't want them to judge me," she said.

When she told a doctor she wanted to have an abortion, he just advised her to consider it carefully. It was only when she called the Pregnancy Crisis Service that she found support. "The counselling helped me emotionally to come to a decision," said Brenda, who chose to keep her baby. She gave birth to a boy earlier this month.

"I'm very happy to be a mum although it's a lifetime commitment. Now my parents say, 'The baby is so cute, lucky you never aborted'."

Dealing with guilt after three abortions
By Theresa Tan, The Sunday Times, 27 Jul 2014

Felicia, a 35-year-old unmarried consultant, has had three abortions and each time, guilt and shame sent her into a deep funk.

She is among those who have had multiple abortions.

Last year, one in three women who terminated their pregnancies had previous abortions. Some 22 per cent had their second abortion, 7 per cent their third, and 4 per cent, their fourth or more.

The proportion of repeat abortions has remained stable in the past decade.

Felicia (not her real name), a polytechnic diploma holder, had her first abortion when she was 17. She was then a student, could not afford to have a baby and felt that her father would kill her if he found out she was pregnant.

"I felt very lost and hopeless then, and I had no one to talk to," she said. "I thought if I had an abortion, my life could go back to normal."

Afterwards, however, she became depressed but felt too ashamed to confide in anyone.

Two years later, at 19, she found herself pregnant again by another boyfriend.

"I didn't have to struggle as much as I did the first time, to decide on an abortion," she said. "I felt it was the only option for me. So I suppressed my feelings."

But guilt and depression came back to haunt her.

She said her boyfriends did not want to use condoms during sex and she was not comfortable with taking birth control pills.

Besides, she did not think she would be so unlucky as to get pregnant again. This is a common refrain of women who have had multiple abortions, said Ms Jennifer Chee of Alife, a charity which counsels women facing unwanted pregnancies.

More than a decade after her second abortion, Felicia got pregnant again. This time, it happened while she was having an affair with a married colleague. She dreaded the thought of a third abortion, but her lover told her to do it.

As she did not feel confident that she could raise a child alone, she did as he said.

"I hardened my heart," she recalled.

This time, though, the abortion almost sent her over the edge. She suffered from insomnia and depression and had suicidal thoughts.

All her abortions were done at private clinics. She said she received no counselling, but was made to sit through a video about abortion each time.

She said: "There's a great sense of regret. If someone could have told me there were other options, I might have gone through with my last pregnancy. Women don't realise the impact of abortion - no one talks about all the pain, shame and regret."