MMA: Health White Paper must address issue of unintended pregnancies

Malaysian Medical Association (MMA) President Dr Koh Kar Chai has called on the government to recognise the issue of unintended pregnancies as an essential component that must be addressed in the Health White Paper expected to be tabled in November this year.

“This is one area we feel that has been largely neglected in the country. Now that a Health White Paper is being drawn up to set in motion various reforms needed in our healthcare system, it is time for the government to show more serious commitment to addressing this issue.

“MMA calls for increased engagement with experts and NGOs towards a holistic approach to address the complicated issue of unplanned pregnancies,” he said.

Koh cited that nearly half of all pregnancies are unintended, according to the State of the World Population 2022 report released by the United Nations Population Fund (UNFPA) in March this year.

“Malaysia is no exception, and the report warned that this human rights crisis has profound consequences for societies, women, girls and global health.

“Over 60 percent of unintended pregnancies end in abortion, and an estimated 45 percent of all abortions are unsafe, causing 5-13 percent of all maternal deaths impacting the world’s ability to reach sustainable development goals.

“Among the indicators which are used to gauge a health system are the stillbirth rate, perinatal mortality rate, neonatal mortality rate and also the maternal mortality ratio.

“While the aforementioned rates have been improving in recent years as stated in the Malaysian Health Facts 2021, there is the need to bring the rates down further,” he said.

Koh said that the Maternal Mortality Ratio (MMR) is 24.9 per 100,000 live births and has increased moderately in recent times.

“This ratio is important as it measures the level of human and social development of a country. It also shows a lack of fulfilment of the reproductive rights of women as well as a lack of responsiveness of the system to the needs of women.

“It is known that the two most important components that can bring the MMR down further are adequate antenatal care, safe delivery and use of contraceptives,” he said.

Koh pointed out that unplanned pregnancies impact stillbirth rates, perinatal mortality rates, neonatal mortality rates and maternal mortality ratio.

He said the causes of unplanned pregnancies include statutory rape in underaged girls, incest, premarital sex, sex illiteracy, poor economic status, premenopausal pregnancy and others.

“This ranges across the whole reproductive age group.

“We have also seen how unplanned pregnancies can lead to risky self-attempted abortion in the home and also the termination of pregnancies by unqualified healthcare personnel at unregistered healthcare facilities.

“Also heart-wrenching are the cases of newborns being abandoned in bushes, trash cans etc. and left to die or to be torn to pieces by wandering animals. Horrific as well are the cases of infanticide by young mothers with no social support,” he said.

Koh added that both the Ministry of Women Family and Community Development and the Ministry of Health have a shared responsibility to address the issue.

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