Information about abortion can be difficult to come by in Cambodia, especially for expats. Here’s what you need to know. Abortions are legal in Cambodia up to 12 weeks of pregnancy. After that, abortions are allowed if the pregnancy is developing abnormally, if there is risk to the mother’s life, or in case of rape. However, many of the hospitals and clinics that deal with foreigners (i.e., the ones with English-speaking staff who have trained abroad) will not terminate pregnancies — or even perform a D&C after a miscarriage — and the Khmer clinics may shy away or even refuse to treat foreign women.
Even in situations where abortion is legal in Cambodia, it is frowned upon. Unmarried women are expected to remain abstinent until marriage, and if they do get pregnant, they are expected to marry the father rather than terminate the pregnancy. For married women, abortions are more acceptable, but the husband must give his permission for the procedure if it is done in a government clinic or hospital.
Finding information on abortion in Cambodia can be difficult, and many providers may be hesitant to talk about it; some are unaware that it is now legal. Clinics may tell you over email or the phone that they do not offer the procedure when they actually do, so it’s worth going to talk to the clinics in person.
However, many expats who have had the procedure done in Cambodia report having trouble finding an appropriate hospital or clinic. “The first providers I contacted weren’t able to do a D&C and referred me to the government-run Referral Hospital,” said an expat who needed to get the procedure after a miscarriage. “Unfortunately, the doctors at the Referral Hospital weren’t comfortable performing the procedure on a foreigner and in the end I was forced to travel from Kampot to Phnom Penh to get it done. Trying to find someone locally to do the D&C compounded an already traumatic situation.”
If you’re living outside of Phnom Penh and aren’t able to travel abroad to get the procedure done, it’s recommended that you go to Phnom Penh, where they are more used to doing medical procedures on foreigners.
Here are a few clinics that offer the procedure around the country:
Marie Stopes International
Marie Stopes International is the best-known and most reputable chain of women’s health clinics in Cambodia. They offer a range of both short-term and long-term family planning methods as well as permanent methods of vasectomy and tubal ligation. In accordance with Cambodian law, they also offer on-site safe medical abortion up to 9 weeks gestation and surgical abortion up to 12 weeks. They have seven clinics, including in Phnom Penh, Siem Reap, and Battambang. The cost of either a medical or surgical abortion for a foreigner is $100, plus a $50 charge for an English translator. If the doctor on duty happens to speak English, you do not need to pay for a translator. However, a translator is probably helpful to make sure that you understand everything that is going on. You also have the option of bringing a Khmer speaker with you to translate.
It is advisable to email them directly (rather than call) for more information on safe abortion or family planning options, including booking the appointment and any questions or concerns you might have; that gives them a chance to have an English-speaking health professional get in touch with you. You can email them at [email protected] and find a list of their clinics at mariestopes.org.kh.
Reproductive Health Association of Cambodia (RHAC)
Another well-regarded clinic is the Reproductive Health Association of Cambodia, more commonly called RHAC. They offer all kinds of family planning services, including birth control pills, injections, implants, and IUDs, as well as vasectomy and tubectomy surgery. If it’s too late for that, they also offer safe abortions.
We were quoted $40 for a medical abortion (usually up to 8 or 9 weeks) or $60 for a surgical abortion; these prices seem low so they may end up being higher. They will give you an ultrasound to which type is appropriate for you. RHAC is very much focused on a Cambodian clientele, and although there were staff on hand with basic English skills when we went to check the price, it’s recommended that you bring a Khmer speaker or translator with you if you need anything explained in detail.
It’s best to show up in person to make an appointment at RHAC as they do not respond to emails. If you speak Khmer, you can make an appointment by phone; their phone number in Phnom Penh is 077 995 394. They have clinics in Siem Reap, Battambang, Kampot and elsewhere, for the complete list of clinics see rhac.org.kh.
Options in Phnom Penh
In Phnom Penh, Naga Clinic, which has English-speaking staff and doctors, performs abortions for between $300 and $400 for foreigners. They offer both medical and surgical abortions, and seem to have a little bit of flexibility regarding some of the details, so it’s worth contacting them regarding your specific situation.
Khema Clinic will perform the procedure, despite telling us over the phone that they do not. One expat reported that she paid $520 for an abortion at 8 weeks. Overall, she had a good experience.”The place has hygiene and technology standards way above anything else I have ever seen in Phnom Penh (and perhaps even in the Western world), but you pay Western-world prices. However, I never for one second felt like i was compromising my health.” She said that the process took three days and involved a consultation, ultrasound, and pre-meeting with an anesthesiologist before the D&C procedure. While she sang the praises of the nurses and most of the staff, she was not happy that one of the consulting doctors made an already difficult day more so by trying to argue her out of the procedure.
Calmette Hospital will also perform abortions, including later-term ones if legal guidelines are met (for example, in case of miscarriage or abnormal fetal development). They have English-speaking doctors and we’ve heard good reports, although generally they have a lukewarm reputation. According to one expat who had a D&C after a miscarriage, the entire process took two days and cost approximately $450.
Royal Phnom Penh Hospital will only perform the procedure if the mother’s life is at risk.
A doctor in Cambodia advises that going abroad is preferable, if at all possible. “Although abortion is illegal in Thailand, it is performed there,” he said. “It is the preferred place because the hospitals are clean, the doctors well trained, and the procedure is performed under hygienic standards.” The laws in Thailand are ambiguous but widely interpreted as meaning that abortions are only legal in cases of rape or fetal impairment, or to preserve the health of the mother. In practice, though, the procedure is available in several clinics. Although this site is in Thai (use Google Translate), the owner speaks English and is happy to offer advice via email or phone.
Abortions are widely available in Vietnam, up to 22 weeks of pregnancy, but after 12 weeks they must be performed in a hospital.
Singapore is not an option for those living in Cambodia — patients are required to provide evidence of Singapore residency.
Medical abortion (pills)
A medical abortion is one initiated by medication rather than surgery. For medical abortions in Cambodia, two medications are commonly used: Medabon and Mariprist. (The latter is manufactured by Marie Stopes International). These medications are used to induce abortions in women who are up to 9 weeks pregnant. Both drugs contain a combination of mifepristone and misoprostol, which are available separately over the counter at many pharmacies in Cambodia. Medabon can be found at some pharmacies for $15. Although the medications are widely available, they should not be self-prescribed.
We contacted a doctor in Phnom Penh who advised against using these medications except under the care of a physician. “Patients think that taking an ‘abortion pill’ is easy and simple,” the doctor warned. “In fact, non-surgical abortion is a procedure that requires two doctor visits and 24-hour coverage for emergencies. There is a significant risk of excessive bleeding, which would mean admission to a hospital for suction curettage.”
For more information on medical abortion, read more at Women on Waves.
Note: I am not a doctor or medical professional. I am also not a lawyer. Information in the above blog is not medical or legal advice. Please see a doctor to talk about your options.