J, who lives in Cambodia’s southern province of Takeo, wasn’t sure who to turn to for advice on her unplanned pregnancy. She couldn’t afford to have another child, and knew she wanted an abortion. “I felt afraid to discuss it with my family but I told my sister,” she told BuzzFeed News through an interpreter. “My husband supported my decision because our baby is one year and five months old, so we spend a lot of money already.” “My friend had an abortion at a Marie Stopes clinic two or three years ago and she told me they provided safe abortion. I searched M-A-R using my friend’s Facebook page and then sent them a private message asking about safe abortion.”
In doing so, J became one of thousands of Cambodian women who have messaged Marie Stopes International, a non-government family planning organisation, on Facebook asking for advice. She asked that her full name not be used in this article, to protect her privacy. “I didn’t want to call their number because I was worried someone would overhear me,” the 29-year-old said.“I felt comfortable because the counsellor said all my information would be private and wouldn’t be shared with anyone.” Over Facebook, the counsellor gave J more information on getting an early medical abortion, and two weeks ago she went into a Marie Stopes clinic where she was prescribed mifepristone to terminate the pregnancy.
In 2018 1,514 Cambodian women messaged Marie Stopes on Facebook for help. Last year that figure rose to 3,127, said contact centre coordinator Sreyneath Buth. “We often get messages from our clients asking about safe abortion and at how many weeks they can have an abortion, and whether in the future they’ll be able to have a baby or not [after an abortion],” Buth told BuzzFeed News. “They ask about contraception and sexually transmitted infections (STIs), and mostly young people just asking about the emergency contraception pill.” Buth says the messages often contain voice recordings “as it is faster and they don’t need to write”. Sometimes women who are concerned they have an STI send pictures of their discharge.
Facebook counsellors are trained in sexual and reproductive health and follow scripts “to make sure we are providing appropriate information”, Buth said. If women need to attend a clinic, the counsellor will help them make an appointment. Staff at Marie Stopes Cambodia say many women don’t know that abortion is legal up until 12 weeks gestation. After that, a public health facility will approve and provide a termination only if it is needed to save the woman's life or preserve her health, if the pregnancy is a result of rape, or if the foetus is diagnosed with an incurable disease.
Cambodia’s teen pregnancy rate has been steadily rising for more than a decade and a report by Save the Children found the number of Cambodian teenage girls who were pregnant had risen from 8% in 2010 to 12% in just four years. “We have this young 16-year-old girl and she is already 12 weeks pregnant and didn’t know where to go or who to ask, but she was randomly scrolling through her Facebook and found us,” the organisation’s integrated marketing director Camille Tijamo told BuzzFeed News. “Our clinic could not provide the termination so we referred her to a public health facility and her mother went with her.”
Some women want to remain anonymous, Tijamo said. “Some of them are creating a new account just to send us a message because you’ll see a random photo [as their profile picture] and then when we try to follow up it just says ‘Facebook user’,” she said. The one-on-one conversations in Facebook Messenger have been crucial in assisting women to discreetly access safe abortions, Tijamo said, adding that clients can use Facebook’s appointment feature to pick a time to come into a clinic. “Most of them are in a difficult position and really don't know who they can talk to or confide in,” she said. “If they have someone to discuss this kind of issue with they feel relieved.”