Limited Birth Choices in Thailand

According to a clinical study by Penny Haora and Streerut Thadakant from 2006 there is virtually no model of midwife-led care practised in Thailand.

There are no midwifes in Thailand, only obstetric nurses working in hospitals. A birth at home with a midwife is not an option. There are no birth centers in Phuket. Birth in a hospital or a birth at home without a professional birth attendant (unassisted birth) are the only options available.

A reply to my 2008 enquiry from the Thai Nursing Council:

Kindly refer to your e-mail dated April 10. request homebirth service from a midwife. According to information provided by representative of Thailand Nursing Council in Phuket, there is no service provide there. Several hospitals are available at Phuket.

C-sections in Thailand

In Thailand, Dr. Stephen Atwood of the maternal and child-health section of UNICEF’s regional office, says, “I’ve seen statistics from Bangkok General Hospital that suggest the national rate is as high as 65% of all births.” (The actual figure is unknown — the Thai Ministry of Public Health told TIME that it does not keep statistics.)

In Thailand, the pleas of natural-birth advocates do not find a large audience. “It’s like pushing a stone uphill,” says veteran campaigner Dr. Tanit Habanananda of the Childbirth and Breastfeeding Foundation of Thailand. “We’re frustrated. It’s very easy to get a C-section in Thailand. We have some colleagues at hospitals trying to change things but it’s very hard.” His spouse, Dr. Melanie Habanananda, adds: “If you use the term ‘natural birth’ here, people think it means you have to go sit in a paddy field to have your baby.” Cesareans, she says, “have become very fashionable, especially among middle-class women” A third of the babies at Bangkok’s private Samitivej Hospital, for instance, are delivered by C-sections, even though its birth unit was set up by Dr. Tanit Habanananda specifically to promote natural childbirth. (Those babies are also almost entirely born to Thai mothers. The foreign women who make up a large portion of Samitivej’s admissions prefer to try for natural birth, says Dr Boonsaeng Wuttihpan, head of Samitivej’s birth unit, who adds that the hospital remains very committed to promoting nonsurgical delivery.)