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What’s With The “Stigma” Against Women Seeking Reproductive Healthcare In Malaysia?

What’s With The “Stigma” Against Women Seeking Reproductive Healthcare In Malaysia?

The Health Ministry practices a no-discrimination policy when it comes to reproductive healthcare but some women claimed it’s different in practice.

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The Health Ministry has a no-discrimination policy when it comes to providing access to birth control options. However, in practice, some women may face hurdles or struggle to access birth control or contraceptives due to stigma from society and what they feel as biases from medical professionals.

The topics surrounding sexual health, sex education, and even family planning are still stigmatized in Malaysian society.

The stigma is most often felt by single women considering getting contraceptives. This is usually due to the misconception and false belief that women get birth control so they can sleep around or engage in pre-marital sex.

The stigma also stems from the lack of awareness that birth control methods such as Implanon are also used to regulate menstrual cycle, regulate hormones, manage acne flares, and manage other health issues such as polycystic ovary syndrome (PCOS) and endometriosis.

What is Implanon?

Implanon is a highly effective and reversible contraceptive. The device is shaped like a small, plastic flexible stick about 4cm long and injected under the skin of an arm using a specialized insertion device.

The device releases a hormone called etonogestrel which imitates progesterone. It works by thickening the mucus at the entrance to your uterus so sperm can’t get through and prevents ovaries from releasing eggs (ovulation). Implanon can prevent pregnancies for up to three years.

Implanon is also a birth control option given to women who recently gave birth as part of family planning and to protect the health of the new mom and future baby.

Implanon can be expensive to get in private clinics in Malaysia. It can cost between RM600 to RM2,000.

Implanon is not the only birth control method available here. Other birth control methods include the intrauterine device (IUD), Depo-Provera injection, oral contraceptive pills, and morning-after pills.

Image: Klinik Uzma

How does the Implanon insertion process go?

A trained doctor or nurse should explain the process and how birth control works to the patient before inserting the device.

The doctor or nurse would apply a local anaesthetic to numb the skin before injecting the Implanon device.

To remove it, the doctor or nurse will apply a local anaesthetic again and a new device can be put in in the same session.

Just like any medication, some people may experience side effects such as weight gain, mood swings, acne flares, loss of libido (resulting in low sex drive), headaches, or breast tenderness.

Malaysian women shared their experiences in seeking sexual healthcare

Some women have shared that they felt shamed by medical professionals when they sought help or advice regarding birth control methods or health checks such as pap smears.

If they enquired about birth control, they felt hounded by invasive questions from medical staff, especially to find out why they were not planning to have children.

Unmarried women who wanted to do a pap smear test were allegedly turned away by medical staff.

Some said there’s no stigma but a misconception

On the flip side, a few people disagreed that there’s a stigma from medical professionals.

One user said the choices of contraceptives at Klinik Kesihatan are limited. The user claimed she had been assigned to work at a Klinik Kesihatan where contraceptives were prioritised for married women to “enforce better family planning”.

“If you’re unmarried you can go to private with no issues. I know some unmarried girls getting contraceptives in Malaysia with no fuss,” the user said.

Another user, Dr Syazana Ali who is a primary healthcare specialist, said doctors generally do not ask a lot of questions just to discriminate.

She emphasized that not all public healthcare workers are judgemental and advised people to consult with doctors.

She added that they do offer contraceptives to all reproductive age groups who are planning or are sexually active on a case-to-case basis, it’s just that cost-effectiveness can be challenging in Malaysia.

The discussion also shed light on the Implanon quota in Malaysia. A netizen shared she was recently informed that only a specialist can administer Implanon and there’s a quota for birth control.

Previously, Obstetrics and Gynaecology (O&G) specialist, Dr Imelda Balchin explained the issue of pap smears for unmarried women or women who were not sexually active.

First things first, Dr Imelda said a pap smear test is not to check for cervical cancer but a preventative screening measure.

She explained that a pap smear test is not recommended for every woman but only for women aged between 20 and 65 who have had sex or are sexually active.

Dr Imelda explained that unmarried women who have not had sex do not need the pap smear test because they have a lower chance of getting cervical cancer, not because medical professionals want to keep women’s virginities intact.

For women who are unmarried but have had sex, Dr Imelda said they can be truthful to doctors and will be allowed to undergo the pap smear test.

She also shared that an HPV screening test is better and easier for unmarried women who have not had sex. This is because an HPV test doesn’t require a speculum, known as a non-speculum HPV test. Instead, a swab can be taken using a vaginal swab or brush.

As always, side effects rear differently in everyone so it’s always important to have the full facts at hand and go over birth control options with your doctor.

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