Knowledge and Attitudes of Pregnant Thai Women Regarding Modes of Birth: A Hospital-Based Study in Southern Thailand

Objective: This study aimed to determine the knowledge and attitudes of pregnant Thai women regarding modes of birth. Methods: A cross-sectional study was conducted at Songklanagarind Hospital. A total of 605 women with a singleton pregnancy and gestational age >20 weeks who attended an antenatal clinic from September 2018 to June 2019 were recruited. Women having a history of cesarean section, or any condition associated with indications for cesarean section, having a fetus with an obvious anomaly, could not read or write in the Thai language, or could not complete the questionnaire were excluded. Their knowledge and attitudes regarding modes of birth were evaluated through self-administered questionnaires. Results: Most women (69.4%) had poor knowledge scores (<5), with a median score of 3 (range, 0-9). Only 14.5% of women knew about serious complications of cesarean section in future pregnancies(placental adherence). Multivariate logistic regression analysis showed that factors associated with adequate knowledge scores (>5) were high educational levels (OR 2.06; 95% CI 1.23-3.47), high incomes (OR 1.96; 95%CI 1.32-2.90), and multiparity(OR 1.73; 95%CI 1.18-2.52). Most women had positive attitudes towards vaginal birth. Only 10.2% of women had a preference for cesarean birth. Factors associated with the preference for cesarean birth were advanced maternal age (OR 3.10; 95%CI 1.72-5.60), having an underlying disease (OR 3.61; 95% CI 1.79-7.25), and poor knowledge scores (OR 2.43; 95% CI 1.21-4.91). Conclusion: Most pregnant Thai women had poor knowledge of the modes of birth. However, the majority of women had positive attitudes towards vaginal birth.

The Quandary of Thai Women Prostitutes: Contemporary Situations of Poor and Working Class Thai Women Sex Workers in Thailand and New Zealand

<p>As a Thai feminist scholar, I engaged in a study of the economic and social circumstances of a particular group of women, poor and working class Thai sex workers, over the late 1990s to 2001. In this thesis, Thailand and New Zealand are the primary geographical points for the commercialisation of poor and working class Thai women prostitutes. The rational is to present an explanation for why these women engaged both in the Thailand and New Zealand sex trade. In addition, my thesis investigates the causes and consequences of Thai women being traded nationally and globally, as though they were a form of merchandise. The chief assumption underlying this study is that the effects of female poverty, such as the deficiency and inadequacy of education and of work opportunities, influence the numbers of poor and working-class Thai girls and women entering the sex industry. These women are additionally constrained socially by their gender, their poverty and their class position combined. Inequality between males and females in Thai culture is the overriding factor contributing to unjust profiteering by the sex businesses that employ these women sex workers. The causes and consequences of sex work among poor and working class Thai women are investigated by interviewing thirty former and current prostitutes in Thailand and in New Zealand. The hypothesis that their plight is mainly a result of sex discrimination in Thai society is examined by using Thai feminist methodologies. The interviews show that these sex workers initially entered prostitution in order to escape from poverty, and continued to do sex work because of particular controlling factors in their lives such as the obligation to support their families/children. The interviews also implied the misleading belief of Thai women sex workers that sex work would bring them economic security. However, as the findings show, sex work does not always engender such financial security, but frequently begets painful experiences. In spite of this, most prostitutes assent to this situation and prolong their sex occupation. Later, these Thai prostitutes struggle and hope for self-sufficient improvement of their lives in first world regions and countries other than Thailand. The difficulty of avoiding sexual exploitation in Thailand pressurised them into migrating to other countries, including New Zealand. In general, the findings of my research establish that Thai women prostitutes have little control over their economic state in overseas countries. However they had less power over their lives in Thailand and elsewhere than in they had in New Zealand. In addition, gambling and alcohol seem to be used as the primary methods of comforting their personal stress. The negligence of their money discipline is also the cause of Thai sex workers intermittently re-entered prostitution. In particular, the stigma of sex work is an outstanding aspect in their later lives after giving up sex work. I conclude that sex work is a destructive work alternative for most Thai sex workers, though it obviously offers the possibility of making some money. Furthermore, I assert that their individual rights must be upheld as equivalent to those of other women, so that these sex workers are empowered in their 'life situation'.</p>

The Quandary of Thai Women Prostitutes: Contemporary Situations of Poor and Working Class Thai Women Sex Workers in Thailand and New Zealand

<p>As a Thai feminist scholar, I engaged in a study of the economic and social circumstances of a particular group of women, poor and working class Thai sex workers, over the late 1990s to 2001. In this thesis, Thailand and New Zealand are the primary geographical points for the commercialisation of poor and working class Thai women prostitutes. The rational is to present an explanation for why these women engaged both in the Thailand and New Zealand sex trade. In addition, my thesis investigates the causes and consequences of Thai women being traded nationally and globally, as though they were a form of merchandise. The chief assumption underlying this study is that the effects of female poverty, such as the deficiency and inadequacy of education and of work opportunities, influence the numbers of poor and working-class Thai girls and women entering the sex industry. These women are additionally constrained socially by their gender, their poverty and their class position combined. Inequality between males and females in Thai culture is the overriding factor contributing to unjust profiteering by the sex businesses that employ these women sex workers. The causes and consequences of sex work among poor and working class Thai women are investigated by interviewing thirty former and current prostitutes in Thailand and in New Zealand. The hypothesis that their plight is mainly a result of sex discrimination in Thai society is examined by using Thai feminist methodologies. The interviews show that these sex workers initially entered prostitution in order to escape from poverty, and continued to do sex work because of particular controlling factors in their lives such as the obligation to support their families/children. The interviews also implied the misleading belief of Thai women sex workers that sex work would bring them economic security. However, as the findings show, sex work does not always engender such financial security, but frequently begets painful experiences. In spite of this, most prostitutes assent to this situation and prolong their sex occupation. Later, these Thai prostitutes struggle and hope for self-sufficient improvement of their lives in first world regions and countries other than Thailand. The difficulty of avoiding sexual exploitation in Thailand pressurised them into migrating to other countries, including New Zealand. In general, the findings of my research establish that Thai women prostitutes have little control over their economic state in overseas countries. However they had less power over their lives in Thailand and elsewhere than in they had in New Zealand. In addition, gambling and alcohol seem to be used as the primary methods of comforting their personal stress. The negligence of their money discipline is also the cause of Thai sex workers intermittently re-entered prostitution. In particular, the stigma of sex work is an outstanding aspect in their later lives after giving up sex work. I conclude that sex work is a destructive work alternative for most Thai sex workers, though it obviously offers the possibility of making some money. Furthermore, I assert that their individual rights must be upheld as equivalent to those of other women, so that these sex workers are empowered in their 'life situation'.</p>

Health Status and Barriers to Healthcare Access among “Son-in-Law Westerners”: A Qualitative Case Study in the Northeast of Thailand

The northeast of Thailand is well-known as a popular destination where many male Westerners marry Thai women and settle down there. However, little is known about their health and well-being. This study aims to explore the Western husbands’ health status and identify barriers hindering their healthcare access. A qualitative case study was conducted from November 2020 to May 2021. In-depth interviews and focus group discussions with 42 key informants who were involved with social and health issues among these expatriates were carried out. The social determinants framework was adapted for guiding the interviews. Data were triangulated with field notes, document reviews, and researchers’ observations. Inductive thematic analysis was applied. Results showed that most male expatriates who married Thai women in the northeast were in their retirement years and had non-communicable diseases, health risk behaviors, and mental health problems. Most of them did not purchase health insurance and held negative impressions toward Thai public hospitals’ quality of care, which was denoted as the main barrier to accessing healthcare services. Other significant barriers consisted of high treatment costs commonly charged by private hospitals and language issues. While the improvement of healthcare quality and the provision of friendly health services are important, public communication with foreign residents, especially male expatriates, is recommended to increase understanding and improve perceptions of the Thai healthcare systems. A regular population-based survey on the health and well-being of expatriates in Thailand, a cost study of a health insurance package, a survey study on willingness to pay for health insurance premiums, and a feasibility survey exploring the opportunity to establish either voluntary or compulsory health insurance among this group should be undertaken.

Prevalence and Factors Associated with Antepartum Depression: A University Hospital-Based

Objective: This study aimed to assess the prevalence of and factors associated with antepartum depression among Thai women. Materials and Methods: All pregnant women attending the Antenatal Care Clinic at Songklanagarind Hospital from June to August 2020 were invited to participate and evaluated through self-administered questionnaires. Multivariate logistic regression models were used for the data analysis in order to control for potential confounders. Results: 435 women were in their first, second, and third trimester of pregnancy (20.2 %, 39.5 %, and 40.2 %, respectively). The majority of them reported normal Rosenberg’s Self-esteem Scale scores (83.4 %) and a high level of perceived social support (74.5 %). Moreover, according to the Edinburgh Postnatal Depression Scale (EPDS) scores, the prevalence of antepartum depression was 10.6 %. A multivariate logistic regression analysis showed that factors associated with antepartum depression were second trimester of pregnancy, survival and below-survival levels of income, unintended pregnancy, and low level of self-esteem. Conclusion: One-tenth of pregnant Thai women suffered from depression. Advanced gestational age, low income, unintended pregnancy, and low self-esteem were significant factors associated with antepartum depression.

Differences of body composition and physical strength among Japanese and Thai older adults living in Chiang Mai, Thailand: an inter-ethnic cross-sectional study

Background The number of adults aged over 65 years is rapidly increasing in several Southeast Asian countries. Muscle mass decreases with age, leading to sarcopenia. The primary objective of this study was to determine whether differences exist in the body composition and physical strength, according to ethnicity, among community-dwelling Japanese and Thai older adults living in Chiang Mai Province, Thailand. Methods A survey was conducted in February and March 2019. Japanese and Thai adults aged ≥ 60 years living in Chiang Mai Province were recruited through community clubs. Participants completed a self-administered questionnaire that enabled collection of data on age, sex, educational background, marital status, annual income, current medical conditions, smoking and alcohol consumption, and exercise habits. Measurements were collected on height, weight, body composition, blood pressure, hand grip, and walking speed for 6 m. Body composition was measured using a standing-posture 8-electrode multifrequency bioimpedance analysis analyzer. Hand grip of each hand was measured with the patient in the standing position using a digital grip dynamometer. Multivariable logistic regression was used to determine factors associated with skeletal muscle mass index (SMI). Results Of the total 119 participants, 47 were Japanese (26 men, 21 women) and 72 were Thai (16 men, 56 women). The prevalence of a low SMI was 3/26 (12%), 1/21 (5%), 6/16 (38%), and 5/56 (9%) among Japanese men, Japanese women, Thai men, and Thai women, respectively. The prevalence of low muscle strength was 2/26 (8%), 2/21 (10%), 3/16 (19%), and 13/56 (23%) among Japanese men, Japanese women, Thai men, and Thai women, respectively. There were significant differences between ethnic groups in body mass index for both sexes, percentage body fat in women, SMI in men, and average grip strength in men. Ethnic group, sex, age, and body mass index were independent predictors of SMI. Conclusions Ethnicity had a clinically important effect on body composition and physical strength among older Japanese and Thai adults living in a similar environment.

Correlation of Hyperandrogenemia and Metabolic Syndrome in Thai Women With Polycystic Ovary Syndrome (PCOS).

Objective: To investigate the prevalence of metabolic syndrome compared between hyperandrogenemia and non-hyperandrogenemia in Thai women with PCOS, and to identify factors significantly associated with metabolic syndrome in this PCOS population.Methods: Thai PCOS women were conducted during 2010-2018. Patients were categorized into the non-hyperandrogenemia group or the hyperandrogenemia group defined by total testosterone >0.8 ng/mL or free testosterone >0.006 ng/mL or dehydroepiandrosterone sulfate (DHEA-S) >350 mcg/dL. Metabolic syndrome was diagnosed according to National Cholesterol Education Program-Adult Treatment Panel III criteria. Demographic, anthropometric, clinical, and biochemical blood data were collected and analyzed.Results: 520 PCOS women were included. 22.6% had metabolic syndrome and 75.0% had hyperandrogenemia. Free testosterone cut-off to define hyperandrogenemia for determining metabolic syndrome in PCOS yielded the highest sensitivity (88.9%) and the highest negative predictive value (90.8%). The prevalence of metabolic syndrome was 27.1% in hyperandrogenemia and 9.2% in non-hyperandrogenemia. Factors significantly associating with metabolic syndrome in Thai PCOS women were age, BMI, free testosterone, and DHEA-S.Conclusion: The prevalence of metabolic syndrome was to be significantly higher in hyperandrogenemia women than in their non-hyperandrogenemia counterparts. Older age, higher BMI, higher free testosterone, and lower DHEA-S were all identified as factors significantly associated with metabolic syndrome.