GHP report investigates the causes of maternal deaths among sex workers

An Abortion Is Still a Death Sentence for Many Cambodian Sex Workers

Posted in Tonic
by Holly Robertson
June 13, 2017

A recent report is the first to investigate the causes of maternal deaths among sex workers anywhere in the world.

Sreyleap* had been a sex worker for two years when she first realized she was pregnant. She had moved from rural Cambodia to the capital, Phnom Penh, when she was just ten to work as a babysitter, and then at 16, turned to the “entertainment industry”—the broad-sweeping term used in Cambodia for the karaoke bars, beer gardens and nightclubs where female sex workers often ply their trade.

“I didn’t know who the child’s father was because I had slept with many partners and I sometimes did not use condoms,” says Sreyleap, who is now 24. Newly married at the time, she decided to seek an abortion, visiting a medical clinic where she was given “a kind of medicine.” Although she was unsure what doctors had prescribed, Sreyleap trusted their advice and took it. “My body hurt all over for around a week and I felt weak afterwards,” she says.

Despite enduring a physically and emotionally trying experience, Sreyleap was one of the lucky ones. A study released late last year found that while an astounding 30 percent of the total number of maternal deaths in Cambodia are caused by abortions, the number gets bumped to 40 percent when you look exclusively at sex workers.

The report, by Portland-based non-profit Global Health Promise, is the first to investigate the causes of maternal deaths among sex workers anywhere in the world. In interviews with 271 women across four major cities in Cambodia, researchers gathered information on 194 deaths.

Of this small albeit revealing subset of women studied, a quarter had reportedly died from maternal health complications. Abortion was the most common cause of maternal deaths, followed by HIV infection. Global Health Promise director Brian Willis, who received a Fulbright grant to pursue the research, says the study did not reveal why abortions killed so many women but adds that “clearly this issue warrants additional research.”

Cambodia’s government legalized abortion in 1997 in an effort to help bring down the maternal mortality ratio, which reached 1,000 deaths per 100,000 live births in 1990 after devastation caused by the Khmer Rouge and decades of civil war left health services in the country deeply strained.

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