People buy abortion pills online as they are an easier and less stigmatised route.
People buy abortion pills online as they are an easier and less stigmatised route.

KUALA LUMPUR: Experts are calling for abortion pills to be made available at public health clinics and pharmacies to prevent cases of overdose and serious health complications.

Reproductive Rights Advocacy Alliance Malaysia (RRAAM) hotline coordinator Dr Sim Poey Choong said while the dangers cited by the Health Ministry regarding the overdose of abortion pills were correct, it hardly seemed to be a good reason to prevent the pills from being prescribed and supervised by doctors to provide safe abortions in early pregnancies.

On Dec 27, Health director-general Datuk Dr Noor Hisham Abdullah said there had been a rise in the online sale of banned abortion pills, misoprostol and mifepristone, which could lead to serious health risks.

He said unsupervised use of abortion pills could result in complications, such as uterine rupture, abnormal bleeding and fatal infections if left untreated.

He said misoprostol was a registered medical product often used without the supervision of registered medical practitioners.

In November 2016, the product’s registration was cancelled and its sale prohibited.

“This problem has been highlighted for years in the media and RRAAM has brought this problem to the Health Ministry’s attention before.

“Any young person facing an unwanted pregnancy with access to the Internet will know about abortion pills. You can search for abortion pills online to confirm this.

Dr Sim Poey Choong
Dr Sim Poey Choong

“These pills are safe when taken under advice and have been approved by established medical authorities, such as the World Health Organisation, the International Federation of Gynecology and Obstetrics, as well as the International Planned Parenthood Federation. The guidelines issued by the Health Ministry have been acknowledged in 2012,” said Dr Sim.

However, he said, the ministry had not taken the logical step of registering the pills to make them available to doctors locally, which lead to users finding help from online sources.

Dr Sim said having CyberSecurity Malaysia track down and block online sellers, as well as the Customs Department identifying and confiscating individual packets of abortion pills, was difficult and impractical.

“If abortion pills are made available to doctors to treat patients, Internet sales will dry up.

“I don’t see any other strategy than this to reduce online sales.

“The safety of abortion pills has been proven beyond doubt. Obstacles are due to political sensitivities. Our position is that the policies should reflect the Penal Code, not religious moral attitudes.

“Abortion pills are officially unattainable (at public clinics or pharmacies). But some medical officers and pharmacies may have contraband supplies.”

Dr Wan Julia Sham Ariffin
Dr Wan Julia Sham Ariffin

On social repercussions of the availability of abortion pills online, Universiti Putra Malaysia Social and Development Sciences Department head Associate Professor Dr Nobaya Ahmad said they might encourage couples practising unprotected sex to find a quick fix to unwanted pregnancies.

“It will encourage couples in a sexual relationship and getting pregnant to easily abort the foetus as with current knowledge and technological access, there is no way of knowing who might buy the pills and whether the person buying it may have knowledge on the impact of taking the pills.

“Morally, it is not accepted in many societies. It is also against many religions to abort unwanted pregnancies.

“Abortions should be done by medical personnel because there may be a negative impact on a woman’s health.

“The government shouldn't allow abortion pills to be sold online. Abortion should be done only by medical professionals. There should be no compromise on aspects that have moral and religious implications.”

All Women’s Action Society programme and operations manager Nisha Sabanayagam said most people resorted to pills sold online as they were an easier and less stigmatised route due to the negative perception of abortion.

Despite abortion being legal in Malaysia based on conditions, Nisha said negative perception of the termination of pregnancies had led people to believe that it was illegal.

“The high purchase of abortion pills over the Internet without medical advice is indicative of social realities in the country.”

However, Nisha said, even if the abortion pills sold online were the prescribed choices of doctors, people must be aware that it was unwise to take the pills without medical supervision as it could lead to more health risks.

“Make the pills available to doctors, who can prescribe them with the qualified knowledge and who can perform safe abortions for early-stage pregnancies, if necessary.

“Abortion should not be stigmatised, especially when it puts women’s lives at risk.

“Women should also be allowed to express their rights over their bodies freely and this includes saying no to unwanted sexual activities, including sex without the usage of contraceptives and being allowed the option of safe and medically supervised termination of pregnancy, especially if the continuation of the pregnancy causes them undue mental and physical stress.”

She added that encouraging people to go doctors to discuss the possibilities of abortion also provided the government with an option to collect more medical data on pregnancies and abortions, especially unwanted teenage pregnancies.

“Campaigns on safe sex and reproductive rights should be carried out extensively in all languages and it should be carried out especially on the Internet since we now know that this is the channel often used to obtain information about sex and related topics.

“Men and women need to be educated as reproductive rights involve society.

“If we want to tackle the issue of unwanted pregnancies, especially among minors, then sex education is the route to follow.

“Contrary to popular belief, sex education is not about encouraging minors to have sex, but rather to teach them about what sex entails, including its possible consequences.”

Muslim Doctors Association vice-president Dr Wan Julia Sham Ariffin said women would often think that buying abortion pills online was the best option to terminate their unwanted pregnancy.

“Without supervision from health officers, women would buy the pills whenever an unwanted pregnancy happens, she said.

“The pills should not be readily made available for purchase over the counter. Prevention should be the option instead of the cure.”

Dr Wan Julia added that due to the online availability of the abortion pills, men feel that they were released from their responsibility if they refused to acknowledge the unwanted pregnancy.

“This would only lead to more serious mental health problems among women, and the mental health percentage in Malaysia is worrying.”