Breaking the Cycle

LOCAL VOICES

We speak with doctors, lawyers, professors, and teenagers about reproductive rights in the SARs.

Words Chermaine Lee, Rafelle Allego and Kary Lam | Photography Karma Lo and António Sanmarful

HONG KONG

TAKE CARE

Dr Kelly Chain, a registered Chinese medicine practitioner and co-founder of Chain’s Medicare Centre, helps women with reproductive issues:

“Nowadays, women are either getting married or starting family planning later, often in their late 30s. With age, complications in reproduction can arise, including a low ovarian implantation period.

“Diet and exercise are some of the ways to overcome these challenges. For women who have miscarriages early in their pregnancies, I advise them to take a confinement break for 12 days, during which they are advised to drink only rice tea and start their day with spoonfuls of rice to improve their spleen and gastrointestinal circulation. This helps their body and mind recover from the trauma and prepare for conception.”

PHYSICAL AUTONOMY

Helena Wong, a pro-democracy lawmaker, says the government fails women in its policies:

“Women in Hong Kong can abort but doctors still get to decide whether they can terminate their pregnancy. Do women have autonomy of their own body, when the abortion has to be determined by two registered doctors? Decisions around pregnancy or termination should belong to women.

“Hongkongers still enjoy the freedom to have children, according to the Basic Law Article 37, unlike in China [where there’s a two-child policy]. Yet, families now only give birth to one child, if any, and many prefer keeping pets instead. The government has nearly no effective policies to encourage reproduction. The lack of space, short maternity leaves, insufficient public childcare centres – all discourage women from giving birth.”

FREEDOM TO CHOOSE

Dr Ng Man-lun, foundation president of the Hong Kong Sex Education Association, says Hongkongers are typically aware of their reproductive rights:

“In general, the reproductive rights situation is not bad in Hong Kong – at least there are no laws to restrict the number of births. Couples have the freedom to use contraception and access to abortion, while artificial fertility is reasonably regulated.

“Many people know how to find alternative solutions easily, in case the local laws interfere with their special reproductive needs. They can go abroad for fetal selection service or an illegal abortion [after six months of pregnancy]. So, there is no need for them to ‘fight’ for those ‘minor’ rights.”

OUTDATED SERVICES

Dr Jean Hee Kim, social epidemiology professor at the Chinese University of Hong Kong, explains what’s lacking in the city’s reproductive legislation:

“Most of Hong Kong’s legislation on reproductive services was created decades ago. Currently, only married, thereby heterosexual, couples have access to assisted reproductive services such as invitro fertilisation, egg donations and gestational surrogacy in Hong Kong. It is illegal to procure reproductive services as a single person and it is not locally available for women older than 40.

“We conducted small surveys and found that Hongkongers are highly supportive of expanding these services and lowering the costs for married couples, but they are less supportive of nonheterosexual couples or single parents. The government needs to re-examine reproductive technology laws in accordance with Hong Kong socio-cultural norms rather than simply taking the advice of the medical establishment, which views infertility as a disease to be managed.”

YOUNG VOICE

Emily Cheung, an 18-year-old student, supports reproductive rights:

“Women should have autonomy on issues of abortion, artificial reproduction and surrogacy. These rights completely challenge the traditional Chinese belief that women have to give birth to carry on the family name.

“I think if a family doesn’t have the financial capability to raise a child, or a teenage girl cannot afford to give birth, abortion is a good choice. It might not be as good, though, if the family has the ability to raise a child but chooses to abort it.

If I couldn’t give birth in the future, options like artificial reproduction and surrogacy would be totally acceptable to me. I don’t think these are immoral at all; they should both be legal.”

MACAO

LEGAL BLUEPRINT

Vera Lúcia Carapeto Raposo, an associate professor at the University of Macau’s Faculty of Law, says the city needs a legal framework for reproductive techniques:

“Many of the current laws in Macao are similar to Portugal’s, but Macao is an even more conservative community. Here, there is no pre-existing regulation on reproductive techniques. In May 2017, the Health Bureau drafted a bill on assisted reproductive techniques but it has not yet entered the legislative process.

“Should couples suffer from infertility or other reproductive complications, they’d need to seek help outside of Macao since, at best, local hospitals just have the most basic procedures. If clinics start offering procedures before a legal framework is in place, it is like opening Pandora’s box. Many scenarios could happen, like destroyed embryos, but judges won’t know how to deal with it.”

HER CHOICE

Helen*, a psychology graduate, believes women should have greater access to abortion services:

“I’m pro-choice even though it might not be a choice I’d pick for myself. That’s my stance, simply because I think that people should be given access to these services instead of opting for illegal and dangerous means – though prevention is usually better than having to deal with the consequences.”

“Some people may go through mental health difficulties – pre-existing or not – after having an abortion. It’s not the same for everyone. There should be mental health support available if needed, especially after the operation due to hormonal issues, emotional distress, grief, or even PTSD.”

*Name changed at the request of the subject.

NATURAL METHODS

Carmen Iu Pek Man, a consultant from the Macao Catholic Family Advisory Council, says more families should use natural family planning methods:

“Because of society’s development, late marriages are on the rise. Many couples are usually advised by doctors to use artificial means to solve problems of infertility, sometimes without providing a clear diagnosis.

“A natural family plan can be developed instead, allowing women to know their fertile and infertile days by systematically observing and recording changes in cervical mucus. Doctors should look to natural means to respect the beauty of life and serve human fertility and dignity. Science that lacks conscience will only destroy humanity.”

SERIOUS PENALTIES

Dr Chan Iek Lap – a doctor, lawmaker and head of Macau Medical and Health Federation – suggests legislative improvements:

“As a medical worker, we cannot terminate a pregnancy at will. If the fetus is found to have developmental, intellectual or genetic problems during pregnancy, doctors and parents can choose to terminate the pregnancy after discussion. In that case, medically or personally, I’m in favour of terminating the pregnancy.

“As for Macao, it is legal to have an abortion as long as two gynecologists sign their names. When there is a dispute, it will be referred to the court, but sometimes it may take several years. In this case, women might try to access abortions illegally in neighbouring areas, which could pose a great risk to their health and safety.”

PATERNITY TIME

Debbie Yip, who is in her second trimester, believes that fathers should have longer paternity leave:

“Macao offers 70 days of maternity leave for mothers, which I think is acceptable. But at the same time, paternity leave is only five days long. I think at least 14 days should be given to fathers so they have two weeks to spend time with the baby and adapt to this new life.

“That way, mothers will have support from the father, too. Mothers are already very exhausted after giving birth and need a lot of rest. If fathers have only five days of leave, it doesn’t allow them to help at home and ensure their partners have time to recover.”

YOUNG VOICE

Alice Kong, a 16-year-old student in Pui Ching Middle School, says there are a few missing pieces:

“There is still room for improvement in the regulation of abortion. For instance, if a woman gets pregnant after being raped, the procedure can become lengthy and complicated if the accused party denies the rape. This also indirectly supports rapists, which causes serious harm to women physically and psychologically.

“As for schools, sex education is provided, however, most teachers only cover the biological differences between men and women. At most, they teach students how to prevent pregnancy. But they seldom mention reproductive freedom, reproductive health care or family planning.”

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