SCMP Wednesday, November 15, 2000

Women's blood, sweat and tears
ELLA LEE
Ah Mei, a mainland woman married to a Hong Kong worker, has had three abortions in just three years. The last caused her immense pain, and she bled for a week. She has suffered health problems ever since.
But Ah Mei, who did not want her full name used for this article, may have to face the same ordeal yet again, because her husband refuses to use contraceptives and the family is too poor to have a fourth child.
Social workers say abortions are widespread among new arrivals from the mainland because of financial hardship and ignorance about contraception.
The ordeal of Ah Mei, who is in her 30s and until last year lived in Guangdong apart from her husband, is the tip of the iceberg. Of the 125 newly arrived women who sought help from a women's centre in Shamshuipo last year, 75 per cent had had abortions - many more than one - putting their health at risk and increasing the danger of a fatal infection.
Social worker Joyce Ho Mei-yee, who handled Ah Mei's case, says the recent economic downturn has driven more women to opt for abortions, and those who refuse to have them often have to pay a high price. Mrs Wong, for example, is still undergoing counselling after defying her husband's demands to abort their third child, now three months old.
"We have no bargaining power at all," complains Mrs Wong, who also declined to give her full name. "Men are selfish. They do not feel what we feel as a mother or as a woman. When there is an accident and you are pregnant, it is your problem not his."
Ms Ho, who is also the education officer at the Hong Kong Federation of Women's Centres, which runs the Shamshuipo centre, says it is frustrating to see how some women feel so powerless to control their own bodies, health and choice over whether to have children. She says the newly arrived women are always the most vulnerable. Most, like Ah Mei, are under-educated and unemployed and so wholly dependent on their husbands.
"The inferior position of the women within the family means they have no say over contraception, and their husbands regard abortions a trivial matter," Ms Ho says.
The latest figures from the Department of Health show the number of legal abortions in Hong Kong increased to 20,166 in 1996 from 18,357 in 1990. The figure then dropped to 16,073 in 1998.
But Ms Ho says the problem is worse than the official statistics suggest, since new arrivals from the mainland often choose to go back to Shenzhen to have abortions.
Ah Mei's husband is a part-time worker doing whatever jobs he can. The couple have three children, aged seven to 10, and the whole budget for the family of five is $5,000 to $6,000 a month.
Ah Mei had her first abortion in 1992 because the foetus was deformed. In 1994, while still living on the mainland, she had an unwanted pregnancy and decided to have another abortion.
"I had three children at that time, and we could not afford to have another child. I walked into a clinic near my village and had an abortion. Very simple. Abortion is not a big deal up there. Some friends had an abortion and went to work the very next day."
Ah Mei is the kind of women who does not know how to protect herself or make her voice heard. She sees herself as a servant of her husband and children, with the duty to make them happy.
"I once asked my husband to use condoms, but he refused. So I didn't dare talk about it any more. When I lived on the mainland, I didn't see him very often, and so whenever he made [sexual] demands, I tried to be accommodating."
With no formal information or proper medical counselling, Ah Mei could only use contraceptive products "recommended" by friends and neighbours, without knowing what they really were. She tried some unknown contraceptive pills, but they did not work. One year later, in 1995, she had another accident and became pregnant again. This time, her friends recommended abortion pills instead.
Unlike the practice elsewhere, where such pills are dispensed under strict medical supervision, on the mainland a doctor just gave Ah Mei the pills and told her to "go home for a sleep". She bled heavily that night and discharged the foetus, which she described as looking like "an egg with a soft shell".
"It was a nightmare. I bled for a week. I was so weak, and at last I was admitted to hospital to stop the bleeding." She then underwent surgery to clear the residue from her womb.
Since then, Ah Mei's health has deteriorated. She often feels weak, does not sleep well and sweats heavily.
Neither the abortions nor her poor health have persuaded her husband to use condoms. So even after moving to Hong Kong last year, Ah Mei made no effort to explore any form of family planning, and she fears having to undergo another abortion.
"I am so scared," she says. "I do not know when it will happen to me again. I really do not know what to do."
A 1998 Family Planning Association survey of 1,069 wives newly arrived from the mainland found they know far less about contraception than their Hong Kong counterparts.
Many had never heard of oral pills, injectables, diaphragms or spermicide - methods less commonly used on the mainland.
Among those from Guangdong, almost half regarded contraception as solely the woman's responsibility. The newly arrived women were also much more submissive, with only 46 per cent saying they had the right to reject their husbands' sexual demands.
The Department of Health provides cheap birth-control services. For $1 per consultation, women can get condoms and oral contraceptives from the department's maternity and child centres.
But Ms Ho says mainland wives such as Ah Mei were often unaware of this, and she called for more publicity for such services. Ms Ho says there should be more services tailor-made for such women and education for their husbands. Making them realise that contraception is a shared responsibility would also be very important.
She also says financial problems have driven more mothers to give up their babies. Some women say they have so little money to live on that they would rather spend it on food than contraceptives.
Mrs Wong, also a housewife, came to Hong Kong from Guangdong a few years ago to reunite with her husband and two oldest children, who are now studying in local primary schools. She almost lost her young son because of financial hardship but, unlike Ah Mei, stood firm against having an abortion.
Mrs Wong was hoping for a happy life, but her relationship soured when she discovered she was pregnant last year. Her husband did not want the extra financial burden of a third child. A construction worker, he is the only breadwinner in the family and makes anything from $6,000 a month to, sometimes, nothing at all.
"He pressed me to have an abortion at the Family Planning Association or in Shenzhen. He kept telling me that we had no money to keep the two elder children, so how could we possibly have another child?" she says.
Mrs Wong says she was on the verge of going for an abortion but gave up the idea at the last minute. "It is my baby, my flesh and blood. I did not want to kill him."
With blame from her husband and financial pressure depressing her, she has been undergoing counselling. She says women like her, uneducated and unemployed, are always abused.
Leung Tung-yeung, the director of Well Women Clinics of Tung Wah Group of Hospitals, says it is wrong for some women to use abortion as a method of contraception. "Some women just come for abortions repeatedly. We try to teach them different contraception methods. Some just think taking pills every day is troublesome, or their husbands are reluctant to use condoms."
Dr Leung says newly arrived women are likely to suffer more from depression, as they also have to cope with problems of adjusting to a new environment.
"Many of them have no friends, and many have financial pressure. They need more support. They will have to face a lot of pressure, whether they have the baby or not."
Mrs Wong certainly feels the pressure as she tries to bring up the child her husband never wanted. "I am so happy to be a mother. I love all my children. But I worry so much that I cannot give them any happiness. It is so hard to be a good mother, especially in a poor family."
Ella Lee ( ellalee@scmp.com ) is a staff writer for the Post's editorial pages.
Coming next: should Hong Kong license the new abortion pill?