Studying the Situation of Abortion Following the Enforcement of the Amendment to the Criminal Code (No. 28) B.E. 2564 (2021)

Abstract

Objective: To investigate the knowledge and attitudes towards Amendment (Act) No. 28 of the Criminal Code, as well as to explore the situation of policy execution and the operational aspects of abortion services following the enactment of this Amendment, B.E. 2564 (2021). Methods: This research was a descriptive study. The sample group included 29 executives and practitioners at the policy and local levels for qualitative data, and 521 individuals responsible for providing counseling and safe abortion services in public hospitals for quantitative data. Data were collected through interviews, questionnaires, and group discussions, and analyzed using content analysis for qualitative data and descriptive statistics for quantitative data. Results: The results revealed a deficiency in knowledge and understanding among practitioners regarding the substantive changes in the amended Act. A positive attitude towards the amendment facilitated a sense of comfort among practitioners in executing their duties lawfully and had a beneficial impact on service recipients, enabling access to legal abortion services for women with unplanned pregnancies. However, there were concerns about negative attitudes, fearing that the amendment might lead to decreased contraception use and promote premarital sexual activities. A qualitative analysis within an ecological framework highlighted several operational challenges in abortion services: 1) At the microsystems level, there was a lack of cooperation and personnel shortage among practitioners, as well as conflicts within families regarding the decision to abort; 2) At the mesosystems level, complexities in service procedures and inadequate service coverage across all locations were observed; 3) At the exosystems level, societal and community stigma towards abortion led to the concealment of such practices. These problems stemmed from personal beliefs viewing abortion as sinful; 4) At the macrosystems level, practitioners were found to be unaware of the guidelines for operating under the amended Act. Conclusion: There is a need to enhance knowledge and understanding of the Criminal Code Amendment (Act No. 28), B.E. 2564 among practitioners. Additionally, a change in societal mindset towards abortion, considering its socio-economic impacts, is crucial.