ˇ@ˇ@The improvement of medical care and nutrition, has increased the Taiwanese life expectancy. ˇ@Like most societies in the world, Taiwanese women's life expectancy is higher than men's. For example, in 1996 the former is 77.92 years old while the latter is only 71.87 years old. At first glance, it's easy to jump to the conclusion that Taiwanese women are healthy and have been receiving good medical care. However, lots of women who were not in the labor market and did not have health insurance. Not until March 1995, when the National Insurance system began, did all women have the same health benefits as men. For a long time, women's health in Taiwan has been neglected because of incomplete medical insurance, management problems in the medical system and negative impacts from the birth control policy.
Health Problems Women Encounterˇ@ˇ@In the past, there has been little medical research focussing on women's health or needs. ˇ@As a result, women's rights are seriously ignored in the following ways:
- Men have been dominating the medical care system and overlooking the common health problems that women suffer. Take menstrual aberration (menoxenia) and menstrual pains as an example. Treatments from the western and eastern medical systems are sometimes conflicting but neither reduces the pain.
- Although birth is a major event in Taiwanese culture, women usually do not receive equal attention from the formal medical system. The Taiwanese government is proud of its success of the birth control movement; however the downside is the side effects of drugs and contraceptives on women's health. Information about birth control is limited. There is little information for adults and sexual education in schools is minimal contributing to unplanned pregnancies and the prevalence of abortion. Other issues stemming from a predominately male dominated system include: trauma from infertility, gynecologic infections, hysterectomy, unnecessary hysterectomy, and the abuse of estrogen. Prevention of cervical cancer is not seriously addressed.
- The target populations for treatment and prevention of AIDS and sexual diseases are sex workers and men, neglecting other women.
- The number of women with melancholy and ranges from 1.4 to 2.5 times that of men's. In 1996, suicide was the third reason of death among women aged 15 to 39 and was among men aged 15 to 19 and men aged 25 to 29. However, medical research still pays little attention to the causes of suicide and the relationships between psychological diseases and the social environment.
- The medical system often ignores the psychological condition and needs of victims of violence. Even worse, the medical personnel discriminate against the survivors, adding additional stress.
Birth Control: Women's uterus--whose right?
Birth and Abortion: Women's Business Only?ˇ@ˇ@The crude birth ratio of Taiwan has been similar to those of western economies after the 1990s. Considering that the crude birth ratio in 1951 was about 50 per 1,000 and in 1995, 15.5 per 1,000, the achievement of birth control is tremendous and revolutionary. However, it is at the expense of Taiwanese women's health.
ˇ@ˇ@According to the statistics from the Family Planning Institute of Taiwan Province, from 1972 to 1993 only 6.5% men of 780,000 men and women were sterilized. Why is the gender gap is so huge? Maybe the major factor is not as optimistic as some people claim. The family planning policy which is dominated by the male government officers, purposely chose married women as targets, because they would be receptive to a hysterectomy. In the process of promoting this policy, they didn't provide the necessary information to make an informed decision, or provide other choices or provide the evaluative data of the recommended contraceptive methods. As a result, lots of married women suffered from avoidable bleeding, pains and side effects. The medical system reinforces men's choice to walk away from the responsibility of contraception and leave women to endure the medical risks of birth control.
ˇ@ˇ@Another phenomenon that illustrates gender inequality is that male doctors have a huge influence over a woman's decision of abortion since the law only tolerates abortion for medical considerations. The need for abortion is high, it seems. The real rate of abortion is difficult to determine in part because of the prevalence of illegal abortion in private clinics. ˇ@ What we already know is from some government surveys and academic investigations. ˇ@ In 1972, the estimated rate of abortion among the women aged 20 to 39 years old is about 45 per 1,000, and in 1983 the rate is about 40 per 1,000. Other research shows that 35% of the interviewed women have had at least one abortion.
ˇ@ˇ@The Law of Eugenic and Health Protection, enacted in 1984, broadens the medical purposes for legal abortion, from prevention of damage to the mothers' life to the protection of women's psychological and physical health. This is a great conceptual leap, but the design and execution of the new law still carries old concepts that are unfriendly to women. For example:
- Married women who need an abortion for medical reasons can't have it without their husband's agreement. For adult single women, conditions for a legal abortion are rape, or seduction. If the father is a married man, abortion is also granted. It is obvious that patriarchal values and morality still rule.
- After the enactment of the law, the organizations and offices in charge didn't communicate important information including the management of the clinics, the standard insurance payment, etc. ˇ@ Some teaching hospitals even refuse to perform abortions, and seriously hinder women's choices about their health and family planning.
The High-ratio of Caesarian Operation and Hysterectomyˇ@ˇ@The meeting of the professionalization of medical care, with the birth control movement has forced women to submit their bodies to medical teams and give up most of their control over their bodies. The highly professional language and the standard process of medical treatment can be intimidating and women often do not express their own opinions or doubts. Because of this unfriendly situation, women often lack the information needed to evaluate the doctors' suggestion. This situation does not enhance optimal health.
ˇ@ˇ@For example, although a caesarian costs more than natural childbirth in Taiwan, the ratio of women who choose a caesarian are quite high, which vastly differs from rates in other countries. Why? Among other reasons, doctors seldom warn their patients of the negative side effects from the operation. Women choose a hysterectomy as a form of birth control. However, since the patients are not well informed, most don't relate their discomfort with a hysterectomy to their doctors or suffer more than they should have. However, the medical system still has not responded to this issue and has not taken actions to improve it.
Conclusionˇ@ˇ@The medical care system in Taiwan only pays full attention to women's bodies for childbirth and child raising. Yet, the medical team seldom puts the needs of women's bodies as a first priority, and as a result the women patients suffer the side effects. It is no surprise that unusual trends exist in Taiwan including
- the target population of birth control is only woman,
- a woman needs her husband's approval to have abortion,
- the ratio of receiving a hysterectomy among mothers is quite high.
ˇ@ˇ@There are promising factors ahead for women's health. These factors include the enactment of the National Health Insurance, the promotion of women's health from women's organizations and academic research. Maybe women's health will become a new focus of the medical spotlight.
The Report on Women's Status in Taiwan, 1998 Legal Status Welfare Resources Population and Family Education Physical Safety Working Status Political Involvement Health Statistics Related to the Women's Status Report
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updated : 1998.10.27