Most abortions in Vietnam occur among students, with a medical expert warning that frequent terminations could increase the risk of infertility.

Nearly 300,000 abortions are performed annually across Vietnam, with the majority involving individuals aged 15 to 19, the Vietnam Family Planning Association reported, noting that 60-70 percent of these cases involve students.

Approximately 80 percent of the procedures take place after 12 weeks, during the first trimester.

In Vietnam, abortion is legal up to 22 weeks under Article 44 of the 1989 Public Health Protection Law.

Adult remorse for teenage decisions

In 2023, there were 528 cases involving minors among the almost 43,600 births and abortions performed, according to a Ho Chi Minh City-based hospital's data, meaning nearly two teenagers visited this hospital to give birth or have an abortion.

M., 26, fell in love at 16 with someone who was five years older than her, appearing to have more knowledge of relationships and love.

She never imagined that the decisions she made as a teen would have long-term implications.

"At that time, I didn't understand much about sex and felt perplexed about sexual relationships," M. told Tuoi Tre (Youth) newspaper. 

"When I discovered I was pregnant, I experienced a crisis. When I was 12 weeks pregnant, my boyfriend took me to a clinic for an abortion.

"Our relationship ended shortly after."

M., who is now married, has been trying to conceive with her spouse for three years.

She recently went to the hospital and was diagnosed with Asherman's syndrome, or intrauterine adhesions, which make natural conception extremely difficult.

She has been told that her diagnosis is connected to the abortion she had at 16.

Currently, M. is still being monitored and treated in the hospital. 

Young Vietnamese find support online 

There are almost 18,000 members in the social media group 'Unwanted Pregnancy,' and dozens of fresh postings are added every day, discussing fears and worries about pregnancy during adolescent relationships.

Among them are many stories of students who became pregnant unexpectedly due to unprotected intercourse.

To protect their secret from relatives and avoid a life of hardship, they quickly go to clinics or hospitals to get an abortion.

An anonymous user wrote, "I am not quite 16 years old, but I had sexual relations and learned I was pregnant. I was terrified and wished I could keep the child, but my circumstances made that impossible. My boyfriend is still responsible; he cares for me and is the one who took me to get an abortion." 

During hospital examinations, doctors encounter many cases of infertility and subfertility caused by a history of surgical abortion, said Dr. Phan Chi Thanh, chief of staff at the National Hospital of Obstetrics and Gynecology's Training and Medical Referral Coordination Center.

Thanh said due to a lack of resources or follow-ups, patients have had numerous abortions, not realizing the long-term effects.

Unfortunately, many people believe that if their menstrual cycle continues normally, there is nothing to discuss or be alarmed about.

It is not until they are discussing family planning with their doctor that they learn about the risks of a procedure they had over a decade ago. 

Grieving the loss of parenthood

Thanh said that the endometrium serves as a nutritional environment for embryo implantation.

With each abortion, the surface of the endometrium gradually erodes, making it extremely difficult for the embryo to implant and increasing the likelihood of miscarriage. 

"Patients with a history of multiple abortions learn too late that their endometrium has been 'eroded,'" the doctor explained.

"Strong abortions, or abortions that should not have been completed in particular, will cause damage to the uterine lining, resulting in scars and intrauterine adhesions.

"This causes the uterus to lack the necessary room and volume to bear a fetus.

"The endometrium, particularly in the case of intrauterine adhesions, is unable to expand, preventing the woman from becoming pregnant or, if she does become pregnant, frequently leading to miscarriage or preterm birth.

"Having multiple abortions indiscriminately will completely destroy the uterus and fallopian tubes, resulting in a loss of the opportunity to become a mother in the future." 

Sexual education for youth 

According to Thanh, resolving the issue of unwanted pregnancy among adolescents necessitates a shift in attitudes from adults, particularly their parents or teachers.

"Since children enter puberty, parents and teachers need to provide clear sexual education," Dr. Thanh said. 

"It is vital to educate children on safe sexual behaviors and the repercussions of unintended pregnancy.

"Sustainable education and accompanying children will be the foundation to help them overcome this stage, equipping them with essential knowledge so that they do not 'navigate their own way' and end up in a series of repercussions afterward."

Dr. Vu Thi Thu, an obstetrician at Thu Duc General Hospital in Ho Chi Minh City, has encountered many distressing cases of parents bringing their pregnant children for prenatal care.

Thu recalled speaking with patients as young as 13 who were unaware of their pregnancy and hesitant to inform their parents, particularly when the identity of the baby's father was unknown or deliberately kept anonymous.

According to Thu, adolescence is a period marked by curiosity and peer influence, particularly regarding sexual topics.

She attributes the rise in adolescent pregnancies to a lack of sexual education, leaving young people in the dark about the associated risks.

"When they discover they're pregnant, both children are still reliant on their parents," Thu said. "A single decision, driven by curiosity, shouldn't dictate the rest of their lives."

Complications from early abortions can include menstrual irregularities, retained placenta, uterine perforation, and infections.

Early abortions may also lead to infertility, with increasing cases of women experiencing difficulties conceiving.

Those who do conceive after an abortion face a higher risk of miscarriage due to cervical damage or ectopic pregnancy.

The procedure can have serious mental health repercussions, including depression and anxiety.

Dr. Thu advises parents to begin discussions about reproductive health and sexual education with their children as young as 12.

"Providing accurate information and awareness at an early age is crucial to preventing long-term damage and consequences," Thu said.

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