The Reproductive Health of Vietnamese Women Tina Bui

Ho Chi Minh City, Vietnam

Objectives To learn about the reproductive health needs of Vietnamese women To understand barriers that women face to quality reproductive healthcare, specifically in regards to contraception To learn and witness the provider perspective when providing reproductive healthcare at Tu Du OB/GYN hospital From the literature – patients cite negative encounters with their physicians and stigma from society in regards to matters of sexual and reproductive health

Background Information The country is cited to have one of the highest abortion rates in the world with low contraceptive use. The literature repeatedly notes stigma such as shame in a patriarchal society as a barrier to contraception. In a study published in 2012, female undergraduate students agreed that ‘men have more rights to access and learn the information’ and that ‘females are more likely to be scolded when elders about sexual matters’, contributing to the sexual double standards in Vietnamese society. This stigma directly affects women’s right to information about their health. In a survey asking female undergraduates ‘If an unmarried woman obtains a gynecological examination, will she be denigrated?’, 12.2% slightly agreed, 17.5% agreed, and 4.5% completely agreed on a 7 point scale (Bui, 2012). This culture shaming negatively affects women and their healthcare- seeking behavior. Bui, T., Markham, C. M., Ross, M. W., Williams, M. L., Beasley, R., Tran, L. T., et al. (2012). Dimensions of gender relations and reproductive health inequity perceived by female undergraduate students in the Mekong Delta of Vietnam: a qualitative exploration. International Journal for Equity in Health, 11(1), 63.

Tu Du Hospital Spent 6 weeks at the largest maternity hospital in Vietnam Departments spent time in: Family Planning, Complicated Pregnancy, and Delivery Room Other departments at the hospital: Fertility, Gynecology, NICU, Shadowed doctors, medical students, and midwife students Helped deliver babies, performed gynecological exams, interviewed the patient

What I Learned Doctors are pro-contraception and support their patients’ reproductive and sexual health In the family planning department (where abortions occur), some doctors rudely questioned why the patient wasn’t on birth control Patients were advised to get birth control and were given pamphlets Public hospital had limited privacy and space for patients Groups of patients at once would be given medical advice, given their same procedure, by one midwife Advice included birth control initiation and midwife would answer any questions they had Did not have time to shadow in GYN department From the medical students – they said the gynecologists did not discuss birth control methods or initiation as there were so many patients and not enough time This contrasts from my observation in the family planning department (abortion clinic)

What I Learned The medical students cited that they don’t particularly learn about contraception especially in contraception counseling They cited stigma from society that prevents them from learning and patients from seeking help Obstetrics patients who pay extra at the public hospital or have a complication are cared for by the doctors, while regular patients were cared for by midwives The doctors and midwives seem to genuinely care about the patients but their care contrasts with American healthcare During delivery, they comforted the mother and persuaded contractions by discussing the future health and education of their baby By pushing, the baby was going to be smarter and healthier Midwives and doctors would chastise the patient for taking too long in delivery

What I Learned - Clinically Learned to take blood and give shots Assisted in delivery Did patient interviews Became more fluent in medical Vietnamese

Conclusions Despite negative provider encounters in the literature and witnessed by me, most doctors care about the sexual and reproductive health and believe in contraceptive counseling There are not enough resources or time to adequately educate the patients in preventative medicine due to high patient to provider ratio Patients need awareness that doctors want to promote their reproductive and sexual health In order to change cultural and societal stigma