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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.

Read the entire article on Tonic here>>

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The New York Times sites Global Health Promise study

Cambodian sex workers waiting for customers at a public park in Phnom Penh.Credit Chor Sokunthea/Reuters
Cambodian sex workers waiting for customers at a public park in Phnom Penh. Credit: Chor Sokunthea/Reuters (published in the New York Times Feb. 20, 2017)

H.I.V. Stalks Prostitutes and Their Children in Cambodia

By Donald G. McNeil Jr.
New York Times
Feb. 20, 2017

Abortion and AIDS are the two most common causes of death among Cambodian female sex workers, and AIDS is the most frequent cause of death among their children, according to a small new study.

Prostitution in poor countries with high H.I.V. rates has lethal consequences not just for women but for their infants, the study found. Mothers engage in riskier sex acts to feed their children, but because they are socially shunned or threatened with arrest, they often cannot get drugs that would prolong their lives or prevent them from infecting their babies.

The study, by investigators at Global Health Promise, a nonprofit based in Portland, Ore., that researches prostitution in poor countries, was an attempt to shed light on a little-studied corner of the AIDS epidemic. The group takes no position on whether prostitution should be legal, its director, Brian Willis, said.

Read the complete article in the New York Times here>>

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Phnom Penh Post – Abortions pose hidden risk for Cambodia’s sex

Sex workers wait for clients late at night near Wat Phnom in downtown Phnom Penh in 2009. Sovan Philong
Sex workers wait for clients late at night near Wat Phnom in downtown Phnom Penh in 2009. Sovan Philong

Abortions pose hidden risk for Cambodia’s sex workers: study

Posted in the Phnom Penh Post
By Erin Handley
Publication date 28 November 2016

A shocking 40 percent of maternal deaths among Cambodian sex workers were the result of abortions, according to a recent study.

The research, published online last week in peer-reviewed journal BioMed Central Public Health, surveyed 271 female sex workers to ascertain the major causes of death for mothers in the industry and their children.

Study author and Global Health Promise director Brian Willis said his research found that of 194 reported deaths of female sex workers, nearly a quarter, 43, were maternal deaths, meaning women who died either during pregnancy, during childbirth or within six weeks of a termination or childbirth.

Willis said his team chose to focus on 32 of those 43 deaths because they occurred after the 2010 Cambodian Demographic Health Survey; his interviews took place in 2013, before the 2014 demographic survey was released.

A total of 13 women out of the 32 sex workers died from an abortion, while five (16 percent) died of complications related to HIV.

The report hinted that the high proportion of abortion-related deaths could indicate sex workers face barriers to reproductive health, safe abortions and post-abortion care….

Read the entire article in the Phnom Penh Post here>>