More than 500,000 Filipino women abort pregnancies in high-risk conditions each year, according to the Guttmacher Research Institute. About 1000 of them die from complications during the procedure. In addition, it is estimated that about 100,000 were hospitalised for the same reason in 2012. Despite the figures, demands from the population and recommendations from the United Nations (UN), abortion is still illegal under any circumstances in the Philippines, and promoting reproductive health is a challenge. Women’s rights experts and activists have criticised the lack of debate and commitment around this issue during the campaign for the upcoming general elections on May 9.
Noelia Martínez Castellanos
Ligaya (29), Beverly (23) and Cherry (20) were 20, 18 and 16 years old, respectively, when they got pregnant for the first time. They are users of one of the family planning clinics provided by Likhaan, a NGO that has offered contraception, sex education and other services around reproductive health in the poorest areas on the outskirts of Manila since 1994. For all three of these women pregnancy was not sought. Then, why did it happen? Lack of sex education and limited access to modern contraceptive methods or the use natural birth control methods such as periodic abstinence or withdrawal. In the Philippines, these are not isolated situations. On the contrary, more than 50% of pregnancies are unwanted, according to a study run by the Guttmacher Institute in 2013.
Although abortion is illegal in this country, 17% of Filipino women who experience unintended pregnancies find their only way out in this procedure. The South Asian archipelago has one of the most restrictive abortion laws in the world, without exceptions in cases of rape, incest, severe fetal malformation or even when the mother’s life is in danger. As a result, a large majority of women seeking abortions are forced to resort to underground (1) clinics where the risk of complications, and even death, is very high. In 2012, 610,000 women resorted to abortion and 100,000 of them were hospitalised. It is also estimated that every hour, about 70 women miscarry and 11 are hospitalised due to the use of unsafe procedures. At least three of them will die.
These deaths are also associated to the stigmas and prejudices that surround abortion in a culture where the pro-life values of Catholicism prevail. Although post-abortion services are very limited, they are legal but many women avoid using them due to fear of reprisals, imprisonment or abuse from medical personnel. Although nearly 90% of those women who have abortions in the Philippines are Catholic, according to a 2004 study, the church continues to condemn this practice without taking into account the circumstances of these women and the moral dilemma they face.
As a consequence of this situation, coupled with the lack of appropriate facilities and trained personnel (only 60% of the parts are supervised by midwives (2)), last year, Philippines failed to reduce the ratio of maternal deaths from 162 to 52 per 100,000 women, the agreed target set in the Millennium Development Goals for the period 1990-2015.
Young, poor, and with no support
The criminalisation and illegalisation of abortion and the lack of access to adequate contraception methods and health care services particularly affects the most vulnerable parts of the population: young, poor women in rural areas. In the Philippines, one in ten teenagers aged 15 to 19 years old, are already mothers or pregnant, according to a government study from 2013. According to a survey of fertility and sexuality in adolescents, the percentage of mothers in this age range increased from 4.4% in 2002 to 11% in 2013. In the same period, pregnancies in adolescents rose from 6.3% to 13.6%.
Girls under 15 fare no better. Their number of pregnancies nearly doubled in a single decade, with 755 births registered in 2000 and 1324 in 2010. Not surprisingly, a 2015 report from the United Nations Population Fund pointed to the archipelago as the only country in Pacific Asia that has not experienced a decline in the fertility rate in adolescents over the past two decades. The Philippines also has the third highest number of teenage pregnancies in the ASEAN countries, according to a 2012 report from the University of the Philippines Population Institute based on the most recent UN statistics.
The NGO Likhaan is aware of this issue and has focused many of their efforts in reaching this part of the population. “We have special days dedicated exclusively for girls who are 19 years old or younger so they don’t feel out of place. We want to prevent unwanted pregnancies. The problem that we find is that it is very difficult to identify those who are sexually active. Our new strategy is to find those who are already mothers. We know that we are late, but at least we are confident that we are getting the sexually active ones”, explains Linda Bacalando, coordinator in Tondo’s clinic.
But problems do not end there. To this very serious emergency situation we need to add an increasing poverty rate –despite of high economic growth in the country– and the overpopulation (over 100 million people); two realities that affect mostly women. In 2012, more than 25% of the population (over 96 million) were poor, 13% lived below the threshold of $1.90 a day, according to World Bank data. Within these percentages, women occupy the fifth place in the poverty rate of the 13 basic sectors established by the National Anti-Poverty Commission of the Philippines. Thus, 90% of women who has unwanted pregnancies has no access to family planning or contraception. 68% of the ones who resorted to abortion, were poor also.
The Reproductive Health Law
For more than a decade, several NGOs and social movements for women’s rights have urged the government to pass a Reproductive Health Bill that obliges schools to provide sex education and ensure free access to contraceptives and other family planning services.
The ultimate goal is to address the high rates of unwanted pregnancies, unsafe abortions, teenage pregnancies, maternal morbidity and mortality, and the increased exposure to HIV and other sexually transmitted diseases. These have resulted from policies that have “Prioritised religious ideology, stereotypes and cultures over the rights of women,” according to the Convention on the Elimination of all Forms of Discrimination Against Women (CEDAW).
This law “will help give parents the chance to exercise their right to free and responsibly plan the number and spacing of their children, and help improve maternal newborn education and reduce infant and maternal mortality. It will also give women more opportunities to finish their education and secure productive work, help reduce poverty by curbing the population growth rate and help reduce abortion by preventing unwanted pregnancies.“, explains Edcel Lagman, congressmen and one of the main advocates of the RH Law.
But the arguments of the Catholic Church, an institution with great power to influence the Filipino State, always seem to be more convincing to politicians than the figures. In a pastoral letter published in 2012, the Catholic Bishops’ Conference of the Philippines claimed their opposition to the law, arguing that “contraception is corruption”, “a contraceptive mentality [is] the mother of an abortion mentality” and that “contraceptives destroy the family and increase violence against women”.
The same year, RH advocates won their first battle against the Catholic hierarchy when President Benigno Aquino III ratified the law, despite the pressures. This was the prelude to the Supreme Court endorsement of the Parenthood and Reproductive Health Act, which declared the law constitutional in 2014, excluding eight points.
The inactivity of the government
The first data since the adoption of the law shows its effectiveness. According to former health secretary Esperanza Cabral, “in Manila the contraceptive prevalence rate among poor women was almost zero because of a former executive order depriving women of their reproductive health rights. But since the implementation of the Reproductive Health Law, contraceptive prevalence has gone up to 42 per cent in Metro Manila.”
However, despite the achievements, advocates of the RH law are unhappy with the lack of involvement of the central government and the many barriers that still exist to ensure that services reach every corner in the country. “After passage of the law, there has been a lot of silence,” said Payal Shah, senior legal adviser of the New York-based Center for Reproductive Rights (CRR) in an interview to Rappler. “There’s still many vulnerable women without access who are unaware of the law.” As if there were not enough challenges, at the end of 2015 the law suffered its first cuts. In a decision took “behind closed doors – not open in plenary”, the committee in charge of the national budget in the Congress eliminated a fund of 1 billion pesos (£ 47,753 million) intended to provide contraception to the poor.
Dr. Junice Melgar, founder of Likhaan, expressed her concerns in an interview to Take Action: “The budget cut is totally worrisome (3) and cruel. I worry about the millions of women who source their supplies from government. They will run the risk of having unintended pregnancy and the possible consequences of unsafe abortion and even maternal death.” In the same interview, Melgar states that she suspects that the cuts has been the result of the pressure over the Government by Catholic groups: “Our problem is the minority of powerful Catholics, like the Catholic Bishops Conference and pro-life groups who continue to obstruct reproductive health and family planning even if there is already a law”.
The silence of the presidential candidates
The ball is now in the court of the candidates for the general election on May 9. 95% of the population consider family planning a priority and 66% of voters are willing to vote for candidates who consider a full implementation of the bill.
According to a report by Rappler, four of the five presidential candidates claim to be in favor of the Reproductive Health Bill. Six of the eight candidates aspiring to the Vice Presidency also agree with it. Of the 13 candidates none are in favor of abortion. But, despite these statements of intention, and a recent UN report that blames the Philippine government for “serious and systematic” violations of reproductive rights of women, the Reproductive Health Law has hardly been mentioned during the campaign.
- Definition: a secret group organized to work against, or despite of, the wider regime.
- Example: “a large majority of women seeking abortions are forced to resort to underground clinics where the risk of complications” “una gran mayoría de las mujeres que quieren abortar se ven obligadas a acudir a clínicas clandestinas donde el riesgo de complicaciones”
- Translation: clandestino, oculto (literalmente. “bajo tierra”)
- Comment: The word “clandestine” exists in both English and Spanish (“clandestino”). However, in English it has a military connotation, or one of espionage. In this case, “underground” is figurative and doesn’t literally mean “bajo tierra”.
- Definition: Person who assists women in the birth.
- Example: “only 60% of the parts is supervised by midwives” “solo un 60% de los partes está supervisado por comadronas”
- Translation: comadrona
- Definition: causing worry or distress.
- Example: “The budget cut is totally worrisome and cruel.” “Este recorte es muy preocupante y cruel.”
- Translation: preocupante, angustiante.
- Comment: You can also say “worrying” (e.g. “The budget cut is very worrying”), which is the more traditional form. “Worrisome” is a North American version of the word which wasn’t used much before 1950 and still remains uncommon.
Have worked in this article:
Author: Noelia Martinez
Translating: Noelia Martinez
Editing: Alex Owen-Hill
Use of English for Spanish Speakers: Alex Owen-Hill
- Header image by Noelia Martínez (A homeless woman sleeps with her daughter in Luneta Park, Manila)
- Image: “Save the unborn” vy Ramon FVelasquez – Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=25331351
- Image: “Life is God sacred gift” by Ramon FVelasquez – Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=26741720
- Image: “A new tomorrow, a new hope” downloaded from website: http://hain-news.blogspot.co.uk/search/label/adolescent%20reproductive%20health
- Image: Demonstration in support of the Reproductive Health Law. CC Attribution-ShareAlike 3.0 Unported License, http://www.indymedia.org.nz/articles/763
- Imagen: Supporters of the Reproductive Health Law. CC Attribution-ShareAlike 3.0 Unported License, http://www.indymedia.org.nz/articles/763
- Image: procession by Denvie Balidoy. – http://www.flickr.com/photos/denvie/4253256805/., CC BY 2.0, https://commons.wikimedia.org/w/index.php?curid=15320142
- Image: Candidates to the 2016 presidential elections. Image with Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. https://verstehenonline.org/2016/02/22/editorial-its-campaign-season-again/