While a public hospital in Hong Kong will perform an abortion at up to 24 weeks of gestation, long waiting lists and the city's notorious medical staff shortages can make it nearly impossible to get an appointment, a problem that's exacerbated during periods of high demand, such as cold and flu season. But there are also basic legal barriers: Hong Kong's abortion law states that, for an abortion procedure, two doctors must sign off that the birth of the baby would cause a female patient severe mental or physical harm, or that the baby would be born seriously handicapped. Private hospitals offer abortions without nearly as much red tape, and appointments are more immediate, but advocates say the procedure there can run as much as $2,000 and up. In 2012, the most affordable private hospital in the city—Hong Kong Central Hospital—closed. According to a South China Morning Post article from that year, it had provided a large percentage of the abortions in the city."The government doesn't have an official reason to oppose abortion. But they don't support it, so what they do is ignore it," said Bowie Lam, who runs Teen's Key, an organization dedicated to supporting young women in vulnerable situations. "If four out of eight doctors oppose abortion at a hospital, for example, the hospital will just shut down services, and the government leaves it."
In Hong Kong, discussions about basic sexual education are still shrouded in stigma and shame—and for the many young women who find themselves with accidental pregnancies, the city is a far cry from pro-choice.Carla, whom I met at Teen's Key, never had an illegal abortion—both of the procedures she underwent were legal, yet still difficult. She grew up in a wealthy family that sent her to an international school where she was never taught sex education. A counselor at the FPA tried to tell Carla about contraceptives after her first abortion, but Carla and the counselor didn't connect. Two years later, Carla found herself with another unwanted pregnancy."I ignored her suggestions—I don't think the counselor was effective," Carla said. "It wasn't counseling—she just came in and gave me information about contraception." When, working as a youth counselor at a local church, Carla found herself with an unwanted pregnancy again, she hadn't even considered using contraception with her sexual partners.
In Hong Kong, it's not abortion on demand. We cannot just say, 'OK, do you want an abortion? Fine. Which date?'
Meanwhile, some liberal, fully pro-choice support—while sparse—is out there. Lam's NGO, Teen's Key, has a new program supporting girls with unwanted pregnancies and new young mothers. She introduced me to Tina at her tiny office—a converted studio apartment in a gritty walk-up building across the harbor from Hong Kong's central financial district, in Kowloon.Tina never approached the FPA because, at the time of her first pregnancy, when she was 15, her boyfriend was 21—she feared they'd have him arrested for statutory rape. When she got pregnant, she heard through word of mouth that the black market for abortion—clinics that open, close, and constantly move—operated in Kowloon's Mong Kok neighborhood, famous for its thriving red-light district and neon-soaked shopping streets. Her friends told her to search the streets for flyers stuck to office buildings that read "GYN." Tina would find them, and then send a text message to the listed number on the flyer. On her seventh try, a doctor replied that he'd perform a surgical abortion for her.
The next time, though—a year later—Tina wasn't so lucky. Although she started taking birth control, she still got pregnant. Her boyfriend refused to pay $400 for a surgical abortion again, and he went to another illegal clinic to find pills to abort the fetus. They cost about $200. After Tina took them the morning before school, she found herself not only a social pariah—where "gossip spread to every corner," she says—but afraid of the law, since she had undergone an abortion illegally, which in Hong Kong can result in fines or imprisonment. "After school, I had to convince the doctor that I had a heavy period, and that this was normal," she said.
The government doesn't have an official reason to oppose abortion. But they don't support it, so what they do is ignore it.
Women in Hong Kong began to cross the border into mainland China for cheap and quick abortions started in the late 1980s. Lam says she worked with one young woman who needed an abortion in February—peak flu season—and couldn't afford the $2,320 bill an available private hospital would charge her. She was past 10 weeks and she couldn't go to the FPA, so Teen's Key suggested she go to a clinic in Shenzhen, and they accompanied her to ensure her safety. Lam remembers the walls and the beds were covered in stains, and that the doctor refused to explain anything about the procedure. The clinic was tucked away in a commercial building; girls as young as 14 sat in the waiting area."This clinic was the only option for her," says Lam. The abortion was a success, without complications.Lam worked with another girl who was turned down by the FPA because, although her pregnancy was under 10 weeks, she was a meth user—presenting a medical complication. Her mother escorted her to a large public hospital in Shenzhen, where she paid $250 for a successful abortion.While these procedures ended successfully, clinics in Shenzhen can be terrifying. Tales of girls coming back bleeding, infected, and still pregnant abound today. It's not uncommon to search for abortion clinics in Chinese, and find a clinic that looks nothing like the way it was advertised online. One 17-year-old girl who worked with Lam found a clinic online and set out for Shenzhen. The doctor woke her up in the middle of her abortion and demanded she pay more money—or the doctor would leave her."In Hong Kong, it's not abortion on demand," the FPA's Dr. Fan said. "We cannot just say, 'OK, do you want an abortion? Fine. Which date?'"