The lived experiences of having a legal abortion among adolescent girls in Thailand

The purpose of this study was to explore the lived experiences of having a legal abortion among adolescent girls in Thailand. Hermeneutic phenomenology was the research design. The participants were 30 Thai adolescent girls who had a legal abortion. Purposive sampling and snowball sampling were used with the following criteria: adolescents aged 15 to 19 who had a legal abortion; pregnancy termination from the Referral System for Safe Abortion (RSA) network clinics in a province of Thailand; Thai language communication skills; and willingness to participate in taped interview session. In-depth interviews and non-participatory observation were used to collect data from December 2019 to July 2020. This study used thematic analysis and confirmed trustworthiness by data triangulation, member checking and debriefing. The findings revealed that four issues were involved in the lived experiences of having a legal abortion among the participants. The first was the meaning of legal abortion from the adolescent view point: safety withal sinfulness (safe and suffering relief, stigma in my life, and life learning). The second involved the effects of legal abortion on the adolescent girl’s life: Medical Abortion under GA ≤ 20 weeks’ safety all (twenty-seven healthy adolescents, a complication of a retained placenta, and couple of adolescent girls having drug side effects). The third involved the practices of legal abortion among adolescent girls: difficulties in accessing legal abortion services (hard to tell someone, what is the best choice?, and how to have an abortion?). The four and final issue involved the needs of adolescent girls for a legal abortion service: good care and confidentiality (good health care services, good nursing care, and keeping the secret). This new knowledge can help health care providers to gain better understanding about the lived experiences involved in having a legal abortion among adolescent girls in the Thai context and improve the quality of services to meet their needs. Such data can be used as baseline data for further research, such as the factors associated with safe and legal abortion care, the development of programs and policies to enhance the quality of safe and legal abortion services.

本研究旨在探讨泰国未成年女性合法堕胎的真实生活体验。本研究采用诠释现象学研究设计。研究对象为30名曾接受合法堕胎的泰国未成年女性。研究采用目的抽样与滚雪球抽样，抽样标准如下：年龄介于15至19岁、曾接受合法堕胎的未成年女性；在泰国某省份的安全堕胎转诊系统（Referral System for Safe Abortion, RSA）网络诊所完成终止妊娠；具备泰语沟通能力；愿意参与录音访谈。研究于2019年12月至2020年7月期间开展，采用深度访谈与非参与式观察收集数据。本研究采用主题分析法，并通过三角验证法、成员核查法与复盘法确保研究可信度。研究结果显示，参与者的合法堕胎真实生活体验涉及四大议题。其一为未成年视角下合法堕胎的意义：安全却背负罪恶感（即安全且缓解痛苦，但自身背负污名、亦从中获得人生体悟）。其二为合法堕胎对未成年女性生活的影响：妊娠龄（Gestational Age, GA）≤20周的药物流产整体安全性良好——27名未成年女性未出现健康问题，1例出现胎盘残留并发症，另有数名受试者出现药物不良反应。其三为未成年女性合法堕胎的实践困境：合法堕胎服务获取难度大（难以向他人倾诉自身困境、不知如何做出最优选择、不知如何实施堕胎）。其四，也是最后一项议题，为未成年女性对合法堕胎服务的需求：优质护理与隐私保护（即优质医疗服务、优质护理服务、严格保密）。本研究的新发现可帮助医疗服务提供者更好地理解泰国语境下未成年女性合法堕胎的真实生活体验，并优化服务质量以满足其需求。此类数据可作为基线数据，用于后续相关研究，例如与安全合法堕胎护理相关的影响因素研究、提升安全合法堕胎服务质量的项目与政策开发等。