Antenatal Care in Wartime: A Report from the Thai-Myanmar Border

Summary: Pregnant mothers in wartime are often one of the most affected populations due to reduced access to healthcare services. The recent political situation in Myanmar, since its coup in 2021, has forced many pregnant women to seek healthcare services in and out across the borders of its neighboring countries. This study aims to describe antenatal care (ANC) undertaken in different settings along the Thai-Myanmar border in the last five years. Collected data included the number of ANC, attributions of the pregnant women, gestation stage, and pregnancy outcome. The results of anti-HIV screening were also collected, with the idea that this data will give us additional information on pregnant women’s healthcare service needs. Thai regulations state that all pregnant mothers should undergo infection screening two times, once at the first ANC visit and once at a later gestation stage. The study encompasses a variety of healthcare service settings: a government hospital, a private non-profit clinic, and others. The government hospital reported provisionally two confirmed HIV cases out of 1169 screening tests undertaken in one year, 2023-2024, which gives a crude seroprevalence of HIV 0.17% (95%CI 0.04-0.40). All confirmed HIV cases were migrants. A non-profit private clinic reported a case that tested positive for HIV screening in the last five years, but it turned out to be a false positive. Due to the limitation of data, the study does not detect any evidence of war’s impact on maternal healthcare. The study suggested, however, that infection screening tests, including anti-HIV, are regularly undertaken at ANC in the Thai-Myanmar border area, regardless of their immigration status. It also indicates the need for careful multi-language counselling for the result of HIV screening, where a high false-positive rate is expected.