Singapore

Singapore / Singapore

OVERVIEW

Singapore is an incredibly international city with some of the best health care in Southeast Asia. While you can access many health services, they often involve some level of restriction, especially if you are not a Singaporean citizen. Contraception is legal although a prescription is required. If you're under 16, it's entirely illegal to purchase contraception due to the strictly enforced age of consent at 16 years old. Emergency contraception is also available and a prescription is required, which is only available to women over 16 years old.

Regarding STIs, the government requires that all test results are reported to them. However, some facilities are legally allowed to offer confidential and anonymous STI tests and these are the facilities that we strongly recommend. Until recently, it was illegal to enter the country if you were diagnosed with HIV/AIDS. You may now legally travel to Singapore with HIV/AIDS but you are not allowed to immigrate or take up long-term residency. You can access Post-exposure prophylaxis (PEP) but not Pre-Exposure Prophylaxis (PrEP) in Singapore.

If you are pregnant, maternity leave is covered by the government, but full coverage only extends to women whose children are Singaporean citizens (i.e. one parent is a Singaporean citizen). Abortion is fully legal and available at many facilities. Technically, abortion seems to only be legal for Singaporean citizens and public hospitals will only provide abortion services to citizens. But it seems that some private hospitals do offer abortion services to foreigners, and Planned Parenthood Singapore can be good starting point to find more information if you're a foreigner.

Contraception (Birth Control)

General Note: There are many types of contraceptives, also known as "birth control," including IUDs, oral contraceptives, patches, shots, and condoms, etc. If you would like to view a full list, click here.

Laws & Social Stigmas

In Singapore, you'll need a prescription for birth control. If you don't already have one, you can visit a gynecologist for a consultation. They will ask you basic questions but will probably not require a pelvic exam. It appears that, if you're a minor, you can confidentially obtain contraceptives. As advised by WTF zine: "It is routine and lawful medical practice for your doctor to keep your medical records confidential. You can also consult a doctor other than the one your family sees. It is also easy to discreetly use birth control methods. For added confidentiality, ask your doctor about how you will be billed on your account or insurance statement. If it explicitly states birth control, you can request for it to show up as miscellaneous fees."

However, if you are under 16 years old (the age of consent), you should be aware of the laws and the fact that pharmacists may not prescribe birth control for you. As stated by the Singapore Medical Association Ethics Committee: "The Committee received a query from a doctor on prescribing contraceptive pills to a teenage girl, who is a foreigner, without her mother’s knowledge. As the girl is below the age of 16, and started sexual activities before turning 14, the doctor wanted to know the legality of continual prescription of contraception and whether he would be culpable in the event of a pregnancy. Based on the information provided, it was highlighted to the doctor that: If the sexual activities took place in Singapore, they would constitute a seizable criminal offence in Singapore under Section 376A of the Penal Code. It does not matter that the sex was consensual, as under the laws in Singapore, the patient is too young to be able to give legally effective consent, and the patient’s sexual partner was thus engaged in criminal activities. This is regardless of whether or not she gets pregnant."

For details on Singaporean population control history, check out the "Pregnancy" section.

What to Get & Where to Get It

Male condoms can easily be purchased in most supermarkets, convenience stores or pharmacies, for $4-15 for a pack. Other forms of contraception require a visit to your GP or polyclinic for a prescription. [1]

Common birth control brands in Singapore are Yasmin, Yaz and Diane-35.

Some people find it cheaper and easier to buy birth control in Malaysia, where brands like Marvelon, Mercilon, Gynera, Diane(35), Nordette, Novynette can be purchased over-the-counter for $6-10 (as of August 2014).

Costs

A one month supply of hormonal BC pills typically costs between $25-40. For an IUD, you can expect to pay around $400-500. For a contraceptive injection, you can expect to pay around $150-200. For a birth control implant, which lasts 5 years, you can expect to pay $400-500.

Emergency Contraception (Morning After Pill)

Important Notes: Emergency contraception may prevent pregnancy for three days (72 hours) and sometimes five days (120 hours) after unprotected sex. Take EC as soon as possible after unprotected sex. If you don't have access to dedicated EC, oral contraceptives can be used as replacement EC, but remember the following: 1) Only some contraceptives work as EC 2) Different contraceptives require different dosages and time schedules to work as EC 3) You must only use the first 21 pills in 28-day packs and 4) They may be less effective than dedicated EC. For general information on emergency contraceptives, click here and here.

Laws & Social Stigmas

In Singapore, emergency contraception is only available with a prescription. This is hard rule -- you won't find that Singapore is a place where pharmacists still sell EC over-the-counter, despite the rules. You must go to a GP and get a prescription. Note that only the woman can visit the doctor for a prescription and the woman must be at least 16 years old (age of consent). If you can't get a prescription or obtain dedicated emergency contraception, you can also use oral contraceptives (regular birth control pills) are replacement EC.

What to Get & Where to Get It

Note: The longest-lasting EC is currently ellaOne. It lasts up to 5 days (120 hours) after unprotected sex, and it's been approved to be carried in Singapore. Also, copper IUDs may also prevent pregnancy up to 5 days after unprotected sex. If none of these options are available, and it's been over 3 days since you had unprotected sex, you can still take EC, which may work up to 5 days. Note that EC pills are not 100% effective and should be taken as soon as possible.

• To get a dedicated emergency contraception, you'll need get a prescription from a General Practitioner (GP). These appointments are quick and easy, but they can be expensive. One local reported the total cost at GP to be $80 ($30-40 for the consultation and $40-50 for the pill). However, another local says, "The cheapest clinics tend to be in the heartland HDB estates. My GP in such an estate charges $25 for a short consult. You can also opt to go to a polyclinic - for example, https://www.nhgp.com.sg/." Once you obtain an EC prescription, you can obtain dedicated EC. Some brands you can expect to see are Estinor, Postinor-2 and ella.
• If you can't access dedicated emergency contraception, you can use some regular birth control pills as replacement EC. You need to remember that, in 28-day packs, only the first 21 pills can be used. You can take Microgynon, Microgynon-30 or Nordette (take 4 pills within 120 hours after unprotected sex and take 4 more pills 12 hours later). You can also take Loette (take 5 pills within 120 hours after unprotected sex and take 5 more pills 12 hours later). For more information, visit the Princeton EC website.

Sexually Transmitted Infections (STIs/STDs)

Important Notes - Learn about PEP and PrEP: If you think that you've been recently exposed to HIV (i.e. within 72 hours), seek out PEP (Post-Exposure Prophylaxis). It's a month-long treatment to prevent HIV infection after exposure, and it may be available in your city. Take PEP as soon as possible; it's available in Singapore (see "Medications" section for where to find it in Singapore). For more information, click here. If you are at risk of HIV exposure, seek out PrEP (Pre-Exposure Prophylaxis). It's a daily oral pill that can prevent HIV infection before exposure. It's not yet available in Singapore but click here to learn more.

Laws & Social Stigmas

By law, if you are found to have any "serious" STI, such as chancroids, chlamydia, gonorrhea, hepatitis, HIV/AIDS and syphilis, the results must be reported to the Singapore Ministry of Health (SMOH). However, it seems that some clinics offer private and confidential STI tests in Singapore (see section below for details on this).

Regarding STIs, Singapore has especially strict laws concerning HIV/AIDS. Until recently, if you were diagnosed with HIV/AIDS, you weren't allowed to enter Singapore as a tourist or immigrant. While Singapore required no testing in order to receive a basic tourist visa and there were no health checks at the border, this was the official policy. However, in August 2015, Singapore lifted this ban for travelers. As reported by Action for AIDS Singapore: "The ban was lifted 'given the current context with more than 5,000 Singapore residents living with HIV and the availability of effective treatment for the disease.'"

This new ease on restrictions does not apply to long-term visitors, expats or immigrants. As stated by HIVTravel: "Foreign nationals with AIDS or who are HIV-positive are expelled. HIV-positive foreign spouses of Singaporeans are exempt and allowed to remain in Singapore. Entering with ARVs for personal use requires approval by authorities. Use local hospitals with caution: Singapore doctors are required to report anyone found to be HIV-positive to the authorities. Air travellers in transit in Singapore are not affected." Furthermore, "HIV-positive spouses of Singaporean citizens are allowed to stay in the country. Entering with antiretroviral medication for personal use: Prior approval by the Health Sciences Authority (HSA) is required, e-mail: hsa_info@hsa.gov.sg. In practice, such a permit will only be granted to HIV-positive spouses of Singaporean citizens. A declaration is not required at customs, however, the HSA permit needs to be presented in case of a routine check."

It also seems that anyone with an STI is technically not allowed from to immigrate to Singapore. According to Singaporean guidelines, "any person suffering from mental disorder or being a mental defective, or suffering from a contagious or infectious disease which makes his presence in Singapore dangerous to the community" is barred from immigration. However, there is no evidence that the government requires tests for all STIs (other than HIV and perhaps syphilis) in order to grant immigration status.

Supposedly, the most common STI in Singapore in gonorrhea.. HIV is also reportedly on the rise and there were 5000 people living with HIV in Singapore in 2015.

What to Get & Where to Get It

Testing Facilities

• DSC Clinic: Seems to be cheapest option in Singapore. "Anonymous HIV testing is offered by Action for AIDS at the DSC clinic and at designated GP clinics. Anonymous testing does not require you to provide any name, NRIC number or contact information. Rapid HIV testing is also now available. Rapid HIV tests are screening tests that produce very quick results, in approximately 20 minutes. All HIV test results are kept strictly confidential." HIV rapid test is $8.50. Tests for other STIs, like gonorrhea, herpes or syphilis, range from about $10-20 each. They say that the average bill for a female visitor comes out to $100-140. Visa and MasterCard accepted. Address: 31 Kelantan Lane, #01-16, Singapore 200031, Tel: 6293 9648, Fax: 6299 4335.
• Shim Clinic Singapore: Address: Private and confidential clinic. Cheaper than most other clinics. You can get basic tests $12-60. Get "8 test panel" for $250. Full female comprehensive for $759. Address: 168 Bedok South Avenue 3, #01-473, Singapore 460168, Hours: 7–11 PM, Phone: +65 6446 7446
• Q Medical Clinic: Screens for Syphilis, HIV, Herpes Type I & II, Hepatitis B, Hepatitis A, Hepatitis C, Chlamydia, Gonorrhea, Candida, Trichomonas, Gardnerella, Mycoplasma, Ureaplasma, Urine Feme & Culture and HVS Feme & Culture. You can request a female doctor. There's 2 locations. Address 1: 428 River Valley Road, #01-09,l Loft @ Nathan, Singapore 248327. 308 Address 2: Telok Kurau Road,#01-06. Vibes @ East Coast, Singapore 423858. Tel: +65 67 026 608 (River Valley), Tel: +65 63 489 068 (Telok Kurau). SMS: +65 98 537 537. Email: health@Qmedical.com.sg.
• Tanjong Pagar Medical Clinic: Provides anonymous HIV tests. Basic screening for $60, standard screening for $200. Full female screening for $380. Address: BLK 1 Tanjong Pagar Palaza #01-06 S(082001), Tel: 64433101, Fax: 64433881, SMS: 96622880, Email: info@tanjongpagarclinic.com.
• Eylon Family Clinic and Surgery: Blood Tests – HIV, Syphilis, Hepatitis A/B/C, Candida Antibody, Herpes Simplex Virus Type I and II, Urine/Swab – Chlamydia and Gonorrhoea PCR, Monilia, Trichomonas, Mycoplasma, Ureaplasma, Urine microscopy and culture, Candida, Vaginal swab culture. Comprehensive Female with additional DNA Probe for Gardnerella, Trichomonas and Candida. Address: 78B, Telok Blangah Street 32, #01-22,, Singapore 102078, Phone: 6802 7208, 8418 7208 (Call for appointment), Mobile: 8418 7208, Fax: 6377 1318, Email: enquiry@elyonclinic.com.sg.
• Kensington Family Clinic: Tests Blood - HIV, Syphilis, Hepatitis A/B/C, Candida Antibody, Herpes Simplex Virus Type I and II, Urine/Swab - Chlamydia and Gonorrhoea PCR, Gardnerella*, Trichomonas*, Candida*, Mycoplasma, Ureaplasma, Urine microscopy and culture, Vaginal swab culture. STI tests range from $60-200, depending on how extensive you want them to be. $20-100 consultation fee. 14D Kensington Park Road, Serangoon Garden Estate, S(557265), Tel: 6288 4882 SMS: 9295 9585
• Dr. Tan & Partners: Does a full range of tests for a bit more expensive than the other private clinics (full women's exam is $525 excluding GST and consulting). They seem very responsive to people on their website. The HIV tests are anonymous. Has 6 locations so check the website for each address.

Support

• 24-hr AIDS/STI Helpline: 6295 2944 (pre-recorded messages in 4 languages)
• AIDS/STI Information Hotline: 1800 252 1324 (to speak to a counsellor during office hours)
• Action for AIDS Singapore: "AFA was formed in 1988 in response to the global and local spread of HIV infection. It is a registered Charity and is recognised by IPC (Institution of Public Character) since 2004." Mailing Address: 9 Kelantan Lane #03-01, Singapore 208628 or c/o DSC Clinic: 31 Kelantan Lane #02-16, Singapore 200031. Tel : (65) 6254 0212, Fax : (65) 6256 5903, Email : info@afa.org.sg.

Costs

At DSC (the public clinic), you'll probably find the cheapest rates, where average bills come out to $100-140 (including the consultation). At private clinics, for a comprehensive STI and women's health test, prices will generally be between $400-500 with a $20 consultation fee. If you want a "basic" test, which usually means HIV, syphilis and hepatitis B, that'll be around $20-60 with a $20 consultation fee. For $100-200, you can get a test that covers all STIs without the additional women's wellness/health exam plus the $20 consultation fee.

Medications & Vaccines

What to Get & Where to Get It

Where to get Post-Exposure Prophylaxis (PEP):

• Tanjong Pagar Medical Clinic: $2000 for PEP. "At Tanjong Pagar Medical Clinic, we offer HIV PEP treatment that is safe, well-tolerated, widely used in public government hospitals and in line with international HIV post exposure prophylaxis guidelines." Address: BLK 1 Tanjong Pagar Palaza #01-06 S(082001), Tel: 64433101, Fax: 64433881, SMS: 96622880, Email: info@tanjongpagarclinic.com.
• Shim Clinic Singapore: $2200 for PEP. Address: 168 Bedok South Avenue 3, #01-473, Singapore 460168, Hours: 7–11 PM, Phone: +65 6446 7446

Menstruation

Note: In addition to pads and tampons, you can also use menstrual cups and menstrual underwear for your period. To learn more about menstrual cups, click here. To learn more about menstrual underwear, click here.

What to Get & Where to Get It

In Singapore, you can find pads, pantyliners, tampons and menstrual cups. Many of the tampons come from international brands found in the US, China, Japan and Europe.

Regarding menstrual cups, you can buy Mooncups at Mummy's Milk (Bedok, Singapore, tel: +65 81212840). You can also get them through First Aid Tuition. Also, a Singapore local says "I've seen them at Naiise at 112 Katong and somewhere in Marina Sq." You can purchase a variety of reusable menstrual products such as menstrual cups, cloth pads and sea sponge at LiveLoveLuna, as well. There are no known DivaCup or LadyCup sellers in Singapore. If you're interested in those brands, they should be purchased online. For menstrual underwear, they also will probably need to be bought online.

Organizations that work on menstrual issues in Singapore:

• Days for Girls - Singapore: "Our Mission is Simple: Creating a more dignified, free and educated world through access to lasting feminine hygiene solutions." Contact: singapore@daysforgirls.org. Robin Austin Smith, Leader. Belle Nef, Co-Leader. "This Team is new! They need a little time to get up-and-running, but you are welcome to contact them to see how you can help."

Gynecological Exams

What to Get & Where to Get It

• Wendy Teo Mt E Novena
• Dr. Choo Wang Ling. 6471 1233

Pregnancy

Laws & Social Stigmas

In 1970, Singapore began to advocate for population control, telling its citizens to "Stop at Two." The government legalized sterilization and abortion as well. However, by the 1980s, the birth rate had significantly dropped. In reaction to this change, the Singaporean government changed its stance and Prime Minister Goh Chok Tong's government developed a new slogan: "Have Three or More (if you can afford it)." Incentives were also given to mothers who had more than two children. For example, families with a third child received 750 SGD in child relief.

As written on Wikipedia: "Though newer modern policies exhibit 'signs that the government is beginning to recognise the ineffectiveness of a purely monetary approach to increasing birth rates', a former civil servant noted that the government needs 'to learn to fine-tune to the emotions rather than to dollars and cents. It should appeal more to the sense of fulfilment of having children'. Such measures include promoting workplaces that encourage spending time with the family, and creating a 'Romancing Singapore Campaign' that '[directly avoided being linked] to pro-children and pro-family initiatives," since "people get turned off' when the government appears to intervene in such intimate social affairs as marriage."

In Singapore, maternity leave of 16 weeks (with 100% pay) is given to mothers. But this is only for married women whose children are Singaporean citizens (i.e. at least one parents is a Singaporean citizen). The mother must also have worked for at least 90 days before the birth of the child in order to receive maternity leave. The father can get one week off with 100% pay. If the child is not a Singaporean citizen, the mother can take off 12 weeks with 67% of her payment covered.

What to Get & Where to Get It

• Babes: "Babes Pregnancy Crisis Support Ltd (Babes) proactively reaches out to anyone aged 21 and below needing support with her pregnancy so that she is aware of her options and is able to make an informed decision with regard to her pregnancy." Babes 24-hour toll-free hotline: 1800 – TEENMOM | 8111 3535. Mailing Address: Babes Pregnancy Crisis Support Ltd, 26 Jalan Klinik, #01-42/52, Singapore 160026. Phone: 6664 8591. Email: hello@babes.org.sg
• Dr. Marianne Sybille Hendricks: Has good bedside manner and very responsive.
• Dr Anita Kale: "Dr Kale looks after women in all age groups, from adolescent to elderly, who are seeking care for any gynaecological complaints. She also provides obstetric care to all pregnant women. Her special interest is in high risk pregnancy and fetomaternal medicine."
• Dr Joycelyn Wong at ACJ women's Clinic (Thompson Medical Center): She is highly recommended by one user.
• Dr Anne Hagarty: She comes highly recommended. Address: #09-01 Paragon, 290 Orchard Road, 238859. Singapore.

Abortion

Important Note: There are two main types of abortions: medical (also known as the "abortion pill") and surgical (also known as "in-clinic"). For medical abortions, you take a pill to induce abortion. For surgical abortions, a procedure is performed to induce abortion. For general information about medical and surgical abortions, click here.

Laws & Social Stigmas

In Singapore, abortion is fully legal during the first 24 weeks of gestation. But it's only available for citizens of Singapore, wives of Singapore citizens and women that have resided in Singapore for a minimum duration of four months in public hospitals. In private hospitals, it appears that foreign women can receive abortions (though there may be some legal grey area around this).

For women who seek abortions, all reasons for abortion are permitted, including to save the life of the woman, to preserve physical health, to preserve mental health, rape or incest, fetal impairment, economic or social reasons and available on request. After 24 weeks of gestation, abortion is only permitted to save the life of the woman. The abortion must be performed in a government hospital or an institution approved by the government for abortions. Furthermore, different restrictions on physicians apply. If gestation is under 16 weeks, the physician must have at least 24 month's worth of experience in an ob/gyn unit. After 16 months of gestation, the physician is required to have more experience.

The gestational limit of 24 weeks is calculated in the following way: "Gestational limits are calculated from the first day of the last menstrual period, which is considered to occur two weeks prior to conception. Where laws specify that gestational age limits are calculated from the date of conception, these limits have been extended by two weeks."

Note that, in Singapore, there appears to be required counseling and 24-hour wait period (and other reports say 48-hour wait period) before the abortion was performed. These laws were implemented in 1987. According to the UN Report, "In 1987, these regulations were amended to introduce mandatory counselling prior to and following the performance of an abortion. In addition, they require a pregnant woman to wait twenty-four hours after receiving the counselling until the abortion is performed unless performance of the abortion is immediately necessary to save the life or prevent grave permanent injury to the physical or mental health of the pregnant woman. Pre-abortion counselling is reportedly intended to provide women with information that may allow them to continue their pregnancy and post-abortion counselling to discourage them from seeking repeat abortions."

Historically, Singapore was not always so liberal regarding abortion law. According to the UN Report, "Until 1969, abortion legislation in Singapore was based on British laws adopted in the nineteenth century. The performance of an abortion was in general a criminal act punishable under sections 312-316 of the Penal Code. However, an abortion was permitted if performed in good faith to preserve the life of the pregnant woman." The abortion laws began to change in the 1970s to offer more general access.

Here's a personal account of getting an abortion in Singapore in the early 2000s. Here's another personal account where the abortion seems to have taken place in 2016 or 2017.

What to Get & Where to Get It

Misoprostol (the abortion pill) is available under the names Misel and Cytotec.

• Singapore Planned Parenthood Association (SPPA): Block 3A, Holland Close #01-55, Singapore 272003, Singapore, Tel: +65+65 6775 8981 , +65 67751174 , Hotline (+65 1800 775 8582), Fax: +65+65 6776 8296.
• Singapore General Hospital: Outram Rd, Singapore 169608, Local / Singapore Patients: +65 6321 4377, Overseas Referral: +65 6326 5656, Email: ims@singhealth.com.sg.
• KK Women's and Children's Hospital: 100 Bukit Timah Road, Singapore 229899, Phone: +65 6225 5554

Costs

"I'm guessing $900 is for an early pregnancy (8 weeks max) and $1500 is for those farther along."

"It costs about SGD $12 - 15 to get referred to gynaecological services at a public hospital for abortion services. It will cost about SGD $35 - $40 for first consult in a public hospital. In general, the costs for an abortion in public hospitals will be much less (about SGD $500) than in private hospitals."

Advocacy & Counseling

What to Get & Where to Get It

• Star Shelter: "In March 1999, Star Shelter opened its doors. It is a registered charity with IPC Status, and is the only secular crisis centre in Singapore. Star Shelter aims to provide a safe temporary refuge for women and their children who are victims of family violence regardless of race, language, creed or religion. We also empower the victims to manage and take responsibility for their lives, and assist them in rebuilding their lives free from violence. All the residents are referred by the Family Court, Family Service Centres, the Police, Hospitals and other Agencies." Phone: +(65) 6571-0192, Fax: +(65) 6837-0081, Email: counsel@scwo.org.sg
• SOS: "SOS (Samaritans of Singapore) is the only suicide prevention centre in Singapore. It is a secular non-profit organisation which provides 24-hour confidential emotional support to people who have difficulty coping during a crisis, who are thinking of suicide or affected by suicide." Call us (24-hr): 1800-221 4444 Need help? Email us: pat@sos.org.sg

List of Additional Resources

• AWARE: "AWARE is Singapore’s leading gender equality advocacy group. AWARE believes in the rights of women and men to make informed and responsible choices about their lives and to have equal opportunities in education, marriage and employment, and in the right of women to control their own bodies, particularly with regard to sexual and reproductive rights."
• Singapore Council for Women's Organisations: "The Singapore Council of Women’s Organisations (SCWO) is the National Coordinating body of women’s organisations in Singapore. Our 58 Member Organisations represent more than 500,000 women in Singapore."
• Singapore Women's Association: "The SWA is a non-governmental and non-profit organisation committed to actively provide opportunities for women to help one another and to serve the community with a special focus on the elderly."
• The Local Rebel: "Based in Singapore. We are a group of intersectional feminists from the ages of 16-20 striving to raise awareness about social issues and educate the youths of our sunny city. Watch out for the first edition of our zine, coming to you soon!"
• WTF!: A Singapore-based website/zine focused on sexuality, relationships, LGBTQ, sexual assault and safe sex
• GLBT Voices Singapore: a Facebook group and online community