A Survey of Manual Vacuum Aspiration's Experiences Among the New Medical Graduates in Thailand

Overview

Journal Reprod Health

Publisher Biomed Central

Specialty Reproductive Medicine

Date 2013 Sep 13

PMID 24025699

Citations 2

Authors

Rapeepong Suphanchaimat

Nongluk Boonthai

Sasikan Tangthasana

Weerasak Putthasri

Viroj Tangcharoensathien

Kamheang Chaturachinda

Affiliations

Soon will be listed here.

Abstract

Background: Despite Thai laws permitting abortion conducted by registered medical practitioners, unsafe abortion still kills and maims Thai women as a result of inadequate access to safe abortion services. Surgical evacuation of the uterus by manual vacuum aspirator (MVA) is a safe and effective technique recommended by the World Health Organization (WHO) guidelines. This study assessed new medical graduates' MVA experiences during their clinical years in medical schools.

Methods: Cross-sectional questionnaire surveys on all new medical graduates participating in the annual assembly arranged by the Ministry of Public Health in 2010 and 2012 were applied. Descriptive and inferential statistics were employed for data analysis.

Results: The significant minority of new graduates (44% and 43% in 2010 and 2012 batches) had seen but never used MVA. The proportion of graduates who had 'never seen' reduced from 32% in 2010 to 23% in 2012 while the proportion of 'ever used' had noticeably increased from 24% to 34% in corresponding years. Graduates from medical schools outside Bangkok and vicinity and those reporting confidence in their surgical skills tended to have more MVA experience. The 2012 graduation year was also positively related to higher experience on MVA.

Conclusion: Though the proportion of graduates who had ever used MVA was still low in 2012, a positive change from that in 2010 was observed. Medical schools outside Bangkok and vicinity provided more opportunities for learning MVA. It is recommended that medical schools, especially in Bangkok and vicinity should provide more MVA learning opportunities for students. Adequate training and regular hands-on MVA practice should be incorporated into a wide range of clinical practice.

Citing Articles

A national survey on Thai medical students' attitudes towards abortion and their confidence in providing abortion services following the amendment to abortion law.

Leetrakool H, Wonglerttham T, Sonthyanonth S, Sothornwit J Eur J Obstet Gynecol Reprod Biol X. 2025; 25():100364.

PMID: 39850249 PMC: 11754686. DOI: 10.1016/j.eurox.2024.100364.

CPIRD: A successful Thai programme to produce clinically competent medical graduates.

Yi Y, Chongsuvivatwong V, Sriplung H, Rueanarong C F1000Res. 2015; 4:158.

PMID: 26594332 PMC: 4648210. DOI: 10.12688/f1000research.6638.1.

Commentary: Thailand: sexual and reproductive health before and after universal health coverage in 2002.

Tangcharoensathien V, Chaturachinda K, Im-em W Glob Public Health. 2014; 10(2):246-8.

PMID: 25524152 PMC: 4318085. DOI: 10.1080/17441692.2014.986166.

References

Haddad L, Nour N . Unsafe abortion: unnecessary maternal mortality. Rev Obstet Gynecol. 2009; 2(2):122-6. PMC: 2709326. View

Eley D . Junior doctors' perceptions of their preparedness for hospital work: support for the rural clinical school model as a key to better preparation. Med J Aust. 2010; 192(2):109-10. DOI: 10.5694/j.1326-5377.2010.tb03436.x. View

Warriner I, Meirik O, Hoffman M, Morroni C, Harries J, My Huong N . Rates of complication in first-trimester manual vacuum aspiration abortion done by doctors and mid-level providers in South Africa and Vietnam: a randomised controlled equivalence trial. Lancet. 2006; 368(9551):1965-72. DOI: 10.1016/S0140-6736(06)69742-0. View

Creinin M . Randomized comparison of efficacy, acceptability and cost of medical versus surgical abortion. Contraception. 2000; 62(3):117-24. DOI: 10.1016/s0010-7824(00)00151-7. View

Lyus R, Gianutsos P, Gold M . First trimester procedural abortion in family medicine. J Am Board Fam Med. 2009; 22(2):169-74. DOI: 10.3122/jabfm.2009.02.070204. View

Westfall J, Sophocles A, Burggraf H, Ellis S . Manual vacuum aspiration for first-trimester abortion. Arch Fam Med. 1998; 7(6):559-62. DOI: 10.1001/archfami.7.6.559. View

Grimes D, Benson J, Singh S, Romero M, Ganatra B, Okonofua F . Unsafe abortion: the preventable pandemic. Lancet. 2006; 368(9550):1908-19. DOI: 10.1016/S0140-6736(06)69481-6. View

Milingos D, Mathur M, Smith N, Ashok P . Manual vacuum aspiration: a safe alternative for the surgical management of early pregnancy loss. BJOG. 2009; 116(9):1268-71. DOI: 10.1111/j.1471-0528.2009.02223.x. View

Okonofua F . Abortion and maternal mortality in the developing world. J Obstet Gynaecol Can. 2006; 28(11):974-979. DOI: 10.1016/S1701-2163(16)32307-6. View

10.

Efetie E, Umezulike A, Okafor U . Clinical and demographic characteristics of women with intrauterine adhesion in abuja, Nigeria. Obstet Gynecol Int. 2011; 2012:435475. PMC: 3236412. DOI: 10.1155/2012/435475. View

11.

Darney B, Weaver M, VanDerhei D, Stevens N, Prager S . "One of those areas that people avoid" a qualitative study of implementation in miscarriage management. BMC Health Serv Res. 2013; 13:123. PMC: 3637834. DOI: 10.1186/1472-6963-13-123. View

12.

Nothnagle M, Sicilia J, Forman S, Fish J, Ellert W, Gebhard R . Required procedural training in family medicine residency: a consensus statement. Fam Med. 2008; 40(4):248-52. View

13.

Wibulpolprasert S, Pengpaibon P . Integrated strategies to tackle the inequitable distribution of doctors in Thailand: four decades of experience. Hum Resour Health. 2003; 1(1):12. PMC: 317381. DOI: 10.1186/1478-4491-1-12. View

14.

Lumsden M, Symonds I . New undergraduate curricula in the UK and Australia. Best Pract Res Clin Obstet Gynaecol. 2010; 24(6):795-806. DOI: 10.1016/j.bpobgyn.2010.05.002. View

15.

Sedgh G, Singh S, Shah I, Ahman E, Henshaw S, Bankole A . Induced abortion: incidence and trends worldwide from 1995 to 2008. Lancet. 2012; 379(9816):625-32. DOI: 10.1016/S0140-6736(11)61786-8. View

16.

WILSON N, Bouhuijs P, Conradie H, Reuter H, van Heerden B, Marais B . Perceived educational value and enjoyment of a rural clinical rotation for medical students. Rural Remote Health. 2008; 8(3):999. View

17.

Hemlin J, Moller B . Manual vacuum aspiration, a safe and effective alternative in early pregnancy termination. Acta Obstet Gynecol Scand. 2001; 80(6):563-7. View

18.

FREEDMAN M, Jillson D, Coffin R, Novick L . Comparison of complication rates in first trimester abortions performed by physician assistants and physicians. Am J Public Health. 1986; 76(5):550-4. PMC: 1646611. DOI: 10.2105/ajph.76.5.550. View

19.

Mhlanga R . Abortion: developments and impact in South Africa. Br Med Bull. 2004; 67:115-26. DOI: 10.1093/bmb/ldg006. View

20.

Eley D . Postgraduates' perceptions of preparedness for work as a doctor and making future career decisions: support for rural, non-traditional medical schools. Educ Health (Abingdon). 2010; 23(2):374. View