Page 84 - IJPS-2-1

International Journal of Population Studies

RESEARCH ARTICLE

“I came by the bicycle so we can avoid the po-

lice”: factors shaping reproductive health deci-

sion-making on the Thailand-Burma border

3
1,2
Jillian Gedeon , Saw Nanda Hsue , and Angel M Foster 1,2*
1 Faculty of Health Sciences, University of Ottawa, 1 Stewart Street, Room 312-B, ON K1N 6N5, Canada
2 Cambridge Reproductive Health Consultants, Cambridge, MA, USA
3 Independent consultant, Mae Sot, Thailand

Abstract: For over half a century, political conflict combined with an overall lack of economic develop-
ment has resulted in the displacement of millions of people both within Eastern Burma and to neighbour-
ing Thailand. Given the overarching context, in conflict-affected regions of Burma, women face tremend-
ous challenges in trying to obtain high quality, comprehensive reproductive health services. Drawing
from interviews we conducted in Tak province, Thailand with 31 migrant and refugee women from
Burma, this article explores women’s lived experiences along the border and focuses on the ways
that complex, overlapping barriers impact women’s reproductive health decision-making at different
points in their reproductive lives. Our results show that reproductive experiences are highly dependent on
the woman’s place of living mixed with her legal status and financial resources. Combined with
socio-cultural taboos and externalized and internalized stigma, these dynamics blend to place constraints
on women’s autonomy and self-actualization. The way in which women’s experiences are shaped by
these barriers offers insights into priorities for education and programming to help improve reproductive
health services in this protracted conflict setting.
Keywords: abortion, ethnic minorities, family planning, migrants, Myanmar, refugees

*Correspondence to: Angel M Foster, Faculty of Health Sciences, University of Ottawa, 1 Stewart Street, Room 312-B,
Ottawa ON K1N 6N5, Canada; Email: angel.foster@uottawa.ca

Received: December 11, 2015; Accepted: January 19, 2016; Published Online: January 26, 2016
Citation: Gedeon J, Hsue S N and Foster A M. (2016). “I came by the bicycle so we can avoid the police”: factors
shaping reproductive health decision-making on the Thailand-Burma border. International Journal of Population
Studies, vol.2(1): 78–88. http://dx.doi.org/10.18063/IJPS.2016.01.002.
1. Introduction
Copyright: © 2016 Jillian
1
Eastern Burma represents one of the longest conflict-affected regions in the world. Infrastructure Gedeon, et al. This is an Open
Access article distributed un-
and services in Eastern Burma have been neglected, impeding movement, and creating enormous der the terms of the Creative
disparities in education, healthcare, and income generating opportunities (Sietstra, 2012; Mullany, Commons Attribution-Non-
Lee, Yone et al., 2008; Crawford, 2005). These overall dynamics combined with an overarching lack Commercial 4.0 International
License (http://creativecom-
mons. org/licenses/by-nc/4.0/),
1 In 1989, the military junta officially renamed the country of Burma as Myanmar. However, there continues to be significant permitting all non-commer-
debate as to the legitimacy of this name change. Our study team has chosen to use the name “Burma” as this respects the language used cial use, distribution, and rep-
by our study participants and the stakeholders that we work with on the Thailand side of the border. We will use Burma to refer to the roduction in any medium, pro-
country throughout this article. This is a decision made solely by the authors and does not reflect the views of the editors, the journal, vided the original work is pro-
or the publisher. perly cited.

78 International Journal of Population Studies | 2016, Volume 2, Issue 1