Philippines: Leave no woman behind: Why we fought for Reproductive Health Bill

By Miriam Defensor Santiago, Special for CNN

December 31, 2012

Supporters of the RH Bill celebrate, as lawmakers pass the landmark birth control legislation on December 17.

Editor’s note: Miriam Defensor Santiago is in her third term as a member of the Philippines Senate and a co-sponsor of the Reproductive Health Bill. She is also the founder of People’s Reform Party. Last year she was selected to be a judge in the International Criminal Court, though she has still to take office.

Manila, Philippines (CNN) — We were like David against Goliath. We fought long and hard, and in the end we prevailed.

After 14 long years in the dustbins of Congress, mainly due to strong opposition from the Catholic Church, the Reproductive Health (RH) Bill was approved by both the Senate and the House of Representatives on Monday, 17 December 2012.

Indeed, there is no force more powerful than an idea whose time has come. And the time for a Philippine reproductive health law is now.

Read: Philippines leader signs divisive bill

The Philippines remains one of the poorest countries in the world because, among other things, for a long time, it refused to acknowledge what could easily be seen when one glances out the window: the country desperately needs a reproductive health law.

Not having a reproductive health law is cruelty to the poor. The poor are miserable because, among other reasons, they have so many children. Providing reproductive knowledge and information through government intervention is the humane thing to do. It can help the poor escape the vicious cycle of poverty by giving them options on how to manage their sexual lives, plan their families and control their procreative activities. The phrase “reproductive rights” includes the idea of being able to make reproductive decisions free from discrimination, coercion or violence.

Read: A14-year fight for birth control

Many poor women do not receive information on how to receive reproductive health care. Our underprivileged women have to accept standards lower than what they need, want, or deserve. According to the Department of Health, the mortality rate for Filipino mothers increased to 221 per 100,000 live births in 2011 from 162 per 100,000 live births in 2009. But not only do the women suffer, the children do, too. The children remain undernourished and undereducated because their parents are ignorant about reproductive health care and choices.

In short, the bill merely wants to empower a Filipino woman from the poorest economic class to march to the nearest facility operated by the Department of Health or the local government unit, to demand information on a family planning product or supply of her choice. The bill, at the simplest level, wants to give an indigent married woman the freedom of informed choice concerning her reproductive rights.

If the bill is highly controversial, it is not because it is dangerous to humans or to the planet. It is not subversive of the political order. It is not a fascist diktat of a totalitarian power structure. The reason this bill is emotionally charged is because of the fervent opposition of the Catholic Church in the Philippines and those who wish to be perceived as its champions.

Yet the majority of Catholic countries around the world have passed reproductive health laws, even Italy where the Vatican City is located. Other nations include Spain, Portugal, Paraguay, Mexico, Guatemala, Ecuador, Colombia and Argentina.

Apart from the Catholic Church, all other major religions in the Philippines support the RH Bill. Other major Christian churches have not only officially endorsed the bill but have published learned treatises explaining their position. Support also comes from the Interfaith Partnership for the Promotion of Responsible Parenthood, the National Council of Churches in the Philippines, the Iglesia ni Cristo and the Philippine Council of Evangelical Churches.

The position of these Christian bodies is supported by the most authoritative body of Islamic clerics in the Philippines, the Assembly of Darul-Iftah of the Autonomous Region of Muslim Mindanao. These constitute the top-ranking ulama, deemed to have the authority to issue opinions on matters facing Islam and Muslims. In 2003, they issued a fatwah or religious ruling called “Call to Greatness.” It gives Muslim couples a free choice on whether to practice family planning.

The Filipino people, regardless of religion, are in favor of RH. In June 2011, the Social Weather Stations, a survey group, reported that 73% of Filipinos want information from the government on all legal methods of family planning, while 82% say family planning method is a personal choice of couples and no one should interfere with it. An October 2012 survey among young people aged 15 to 19 years old in Manila shows that 83% agree that there should be a law in the Philippines on reproductive health and family planning.

This is the will of the Filipino people; it is the democratic expression of what the public wants from government. The anti-RH groups are mute on this ineluctable fact.

Reproductive health care is a human right. The people are entitled to demand it from their government and the government is obligated to provide it to its constituents.

 

Abortion in the Philippines

http://www.guardian.co.uk/journalismcompetition/abortion-in-the-philippines

Theme: The impact of unsafe abortions on MDG 5: Improve maternal health sponsored by Marie Stopes International

guardian.co.uk, Wednesday 29 June 2011 15.35 BST

“I heard a nurse say ‘If you die, it’s all your own fault'”. Ana, a 35-year old Filipino, looks down as she recalls the day she was brought to the hospital in a pool of her own blood. She had tried to induce an abortion.

The mother of seven, a survivor of domestic abuse, conceived most of her children by force. Poor and unable to care for them, she did not want more children.

But the government of the Philippines – a deeply Catholic state – imposes a blanket ban on abortion, even in cases of incest, rape or to save the mother’s life. It is one of the most restrictive laws in the world.

This does not stop women, like Ana, from undergoing over half a million procedures each year. Instead they take place underground, in murky backstreets, without professional oversight or sanitised equipment. Abortion drugs like misoprostol are widely available on the black market, along with traditional medicines and makeshift services. Ana opted for a “medical” intervention, where a catheter is inserted into a woman’s cervix for up to 48 hours.

One in six women who obtain illegal procedures in the Philippines suffer complications. Many of them die. While legal, even post-abortion services are limited and women often face prejudice and abuse by medical staff. But because abortion is criminalised, a culture of stigma and impunity prevails.

“I refused to be taken to the hospital,” explains Josie, another abortion survivor. “I was afraid that I would get imprisoned. I bled for more than a week.”

Millennium Development Goal 5 calls for a 50% reduction in maternal deaths and universal access to reproductive health by 2015. It is commonly known as the goal least likely to be fulfilled. Unsafe abortion accounts for 13% of maternal deaths – rising to 35% in certain regions. Most of these procedures are carried out in countries where abortion services are legally restricted.

According to research by the Center for Reproductive Rights, restrictive abortion laws lead to systematic abuses of women’s human rights – including the rights to life, health and equality.

“These are rights that are guaranteed very clearly under international treaty law,” says Melissa Upreti, the Center’s Regional Director for Asia. “So when a government denies access to safe and legal abortion they are essentially violating women’s rights.”

The Committee on the Elimination of Discrimination against Women has called on several countries, including the Philippines and Ireland, to liberalize their abortion laws. The UN Committee Against Torture described the blanket ban on abortion, reinstated in Nicaragua in 2006, as tantamount to cruel, inhumane and degrading treatment. Amnesty International described it as “a disgrace”.

In 2006, Colombian human rights lawyer Monica Roa successfully challenged the country’s total ban on abortion. The campaign, supported by Women’s Link Worldwide, was successful in large part because it managed to frame the abortion ban as a health and equal rights issue, rather than a religious or moral one.

They also chose not to bandy words with their most vocal opponent – the Catholic Church. “We decided not to engage with them, because we understood that it was not their decision to make,” says Monica. “We wanted to talk about what the state should do. And in a secular state like Colombia, and in countries, where there is at least freedom of religion and freedom of conscience, the state has to provide women with the freedom to make the decision whether to carry a pregnancy to term.”

But despite the clear implications for maternal health and growing body of human rights jurisprudence, the international development community has been reluctant to engage in the debate around abortion – even in extreme cases like the Philippines or Nicaragua.

All the major UN development agencies, including UN Women and the World Health Organization (WHO), have refused to condemn restrictive laws, despite implicitly recognising their harmful impacts on women. WHO has published vast guidance on safe abortion practices and added misoprostol to its essential medicines list in 2005.

“The UN agencies have been the worst,” says Monica. “It’s very problematic because many of them have a crucial role to play in implementing change in the lives of women.”

Political pressures have been substantial. In 2005, the Bush administration revoked funding from the UN Population Fund over claims that the organisation financed abortions. Despite reversing the decision in 2009, the current government has refused to endorse safe abortion as a human right. Except for Britain and Sweden, most governments share this stance. The mainstream focus remains on pregnancy prevention.

But the Center for Reproductive Rights maintains that it is impossible to address one without the other. “Any attempt to promote women’s reproductive health has to include integrated strategies for addressing all these issues,” says Melissa. “In order to address maternal mortality you have to address unsafe abortion and the legal issue is critical. The international community has to do more.”

There is often a correlation between abortion restrictions and low contraceptive use. In the Philippines, the Catholic Church is currently challenging a proposed bill to expand the availability of birth control.

Marie Stopes International emphasises the value of reaching out to local communities and moderate religious groups. “Religion can be empowering as well as restrictive,” says Louise Lee-Jones, Senior Manager. “There are many people out there with strong religious ethos who take a more liberal stance.”

She adds: “It’s important that any effort to liberalise abortion laws comes from within a country. It’s about positioning it as a health issue and working with local people to establish what they want.”

The key, agrees Monica, is untangling the moral binary and breaking the taboo. “One of the reasons we were able to win in the public debate, was to push it away from the black and white,” she says. “It is very important to have catholic women understand that the position from their religion is one thing, but they still have the right to make a separate decision.” A global NGO – Catholics for Choice – also works with partners across South America to send the message that you can be pro-choice and Catholic.

In the end restrictive abortion laws punish the poor, young and vulnerable, says Monica. And it is their voices that need to be heard. “If women with power and money had to have unsafe abortions the law would have been changed a long time ago.”

 

Philippines: Unborn child bill slammed for delaying RH measure

http://www.manilastandardtoday.com/insideNews.htm?f=2011/june/1/news3.isx&d=2011/june/1

Manila Standard, Wed June 1, 2011

SENATORS opposed to the reproductive health bill are pushing for other bills outlawing contraceptives and drugs to counter the anticipated passing of the controversial measure in the House of Representatives, a move that a women’s group attacked on Tuesday.

Arguing for the provisions of the bill for the protection of the unborn child, Senate President Juan Ponce Enrile sought before the committee on youth, women and demography a list of contraceptives and drugs that intervene with fertilization at the onset of conception.

Enrile said the issue on reproductive health was being used as a “convenient excuse to advance population control,” yet it had been neglecting the rights of the unborn child.

Enrile and others opposed to the reproductive health bill—Senators Vicente Sotto III, Jinggoy Estrada, Ralph Recto and Ramon Revilla Jr.—are espousing the unborn child’s basic right to life and welfare and against acts that place it in danger of being harmed, injured or killed.

But medical practitioners led by former Health Secretary Alberto Romualdez said it would be impossible to ban products and drugs containing abortifacients as those substances were present in common anti-hypertensive and anti-cancer drugs.

The Democratic Socialist Women of the Philippines said the unborn child bill was an attempt to derail the passage of the reproductive health bill.

“They merely want to further delay the sponsorship of the RH bill in the Senate and that is frustrating,” group chairman Elizabeth Angsioco said.

Senator Miriam Defensor Santiago, author of the Senate version of the reproductive health bill, also slammed the Enrile group for trying to enact legislation that she said was establishing the views of the Catholic Church.

Santiago said the health of the unborn could not be separated from the mother, which was already being protected by the Constitution and the revised Penal Code.

She said the proposed law would make pregnancies even more risky for women. It would also remove decision-making during pregnancy complications away from the woman, her loved ones, and their health provider who were in the best position to balance the lives at stake and weigh the risks and consequences.

“It will transfer difficult choices to a distant, cold, and inflexible law,” Santiago said.

“In effect, the proposed law will treat women as mere incubating machines to ensure the life of the unborn.”

On Tuesday, Senator Panfilo Lacson moved to consolidate the bill on the protection of the unborn child with the Senate version of the reproductive health bill to defang the contraceptive component of the RH bill.

In the House, Gabriela Rep. Luzviminda Ilagan, an author of the reproductive health bill, urged her co-authors to have the population-control provisions deleted from the bill.

But her co-authors said the bill was not a population control bill but a measure aimed at establishing comprehensive reproductive health care for mothers and children.

House Minority Leader Edcel Lagman, the principal author of the bill, said population or demographic targets had already been deleted from the consolidated bill. Rey E. Salita, Christine F. Herrera, Macon Ramos-Araneta

 

Philippines: President says prepared to face excommunication to push condoms

http://www.metroradio.com.hk/1044/News/Default.aspx?NewsID=9b733a6a-824e-4d84-b9ac-94305d3fc9a8

18/05/2011 3:23PM

The president says he is ready to face excommunication from the Catholic Church for advocating free access to condoms. A boxing champion says he is the best example why contraceptives should never be allowed.

After simmering for months, a wide-ranging and acrimonious debate over government-funded access to contraceptives in the Philippines has entered the country’s Congress.

The issue pits the powerful and conservative Catholic establishment, which says contraceptives are as sinful as abortions, against reformers who want more openness about condoms and other birth control in the impoverished Southeast Asian nation to slow population growth and help prevent disease.

The reproductive health bill introduced Tuesday in the House of Representatives would require the government to provide information on family planning methods, make contraceptives available free of charge and introduce reproductive health and sexuality classes in schools.

President Benigno Aquino III, still widely popular a year after a landslide election victory, has backed artificial birth control even if it means going against the dominant Catholic church. He said last month he was ready to face the consequences and if necessary risk excommunication.

“I have been taught in school, which was a Catholic institution, that the final arbiter really is our conscience,” Aquino told reporters Wednesday. “We are not looking for a fight with the church. This is on the record. I have invited them many times so that we can have discussions, and we have focused on areas where we can agree on.”

Supporters believe the measure will slow the Philippines’ rapid population growth that some believe contributes to the country’s crushing poverty. About a third of the country’s 94 million people live on $1 a day.

Church leaders have lashed out at Arroyo and mobilized a formidable public campaign to defeat the bill, with some bishops threatening to launch civil disobedience protests.

The World Health Organization says condoms are highly effective in preventing HIV/AIDS. About 1.4 million people are infected in the Asia-Pacific region, more than double the number 10 years ago.

Condoms also are a protection against unwanted pregnancies while abortion remains illegal in the Philippines. Women are left with little choice other than back-alley clinics, where an estimated 560,000 of them seek abortions involving crude and painful methods every year, according to a report by the New York-based Center for Reproductive Rights.

About 90,000 women in the Philippines suffer from abortion complications and an estimated 1,000 die each year, said the report, published last year.

Influential bishops have blocked family planning bills in the past by arguing that they would erode moral values and encourage promiscuity and early pregnancies.

“Sex is not a game that should be taught to children along with the use of condoms supposedly to avoid disease,” Manila Archbishop Gaudencio Rosales told a crowd of 40,000 people assembled in the capital two moths ago in one of the biggest such rallies yet.

Instead, he called for abstinence.

One of bill’s opponents is the Philippine boxing star, Rep. Manny Pacquiao. He said he never would have been born, and never have become an international champion, if his parents practiced birth control.

“God said go forth and multiply. He did not say go and have just one or two children,” Pacquiao said Tuesday after meeting with the Catholic Bishops’ Conference of the Philippines.

Sen. Miriam Defensor-Santiago, who is in favor of the bill, called Pacquiao a “fundamentalist” and said he was interpreting the Bible literally.

Rep. Edcel Lagman, one of the bill’s main proponents, said the opposition mainly comes from the church hierarchy, not from ordinary citizens of the predominantly Roman Catholic nation.

Independent opinion polls in the last several years have showed strong public support for the measure.

 

PHILIPPINES: Condom prescription rules raise concerns

http://www.irinnews.org/Report.aspx?ReportID=92453

IRIN – humanitarian news and analysis
a service of the UN Office for the Coordination of Humanitarian Affairs

MANILA, 13 April 2011 (IRIN) – The growing number of villages seeking to outlaw the sale of condoms, birth control pills and other artificial forms of contraception without a prescription is worrying government officials and women’s rights groups.

Seven villages in Bataan, a low- to middle-income province west of the Philippine capital of Manila, are lobbying to enact a local ordinance to ban condoms and other forms of modern contraception without a prescription.

The ban comes on the heels of a similar ordinance passed in January 2011 in Ayala Alabang, one of the most affluent areas in the country.

“We feared that [the] Alabang [ordinance] would set a precedent and would only be the beginning. Alabang was never just a local issue, but one of national importance,” Elizabeth Angsioco, head of theDemocratic Socialist Women of the Philippines, told IRIN.

The Philippines is the only country in the Southeast Asian region without national legislation to institutionalize access to reproductive health information and services.

Delaying Reproductive Health Bill

Some say the recent legal moves are meant to distract from the bigger issue – the impending, highly contentious passage of the nation’s first legislation on reproductive health (RH).  Its provisions to make condoms and other forms of contraception readily available in hospitals have been debated for almost 20 years.

“We see these ordinances as the work of the anti-RH camp to deliberately thwart the passage of the RH Bill,” said Ramon San Pascual, executive director of the Philippine Legislators’ Committee on Population and Development, a policy advocacy institution pushing for development policy reforms.

Recently, the RH Bill made significant progress. The current Aquino administration has openly stated its support for “responsible parenthood”, unlike the previous administration, which promoted only natural family planning methods.

“If the national government doesn’t put its foot down, they [anti-RH groups] will become bolder and pass similar ordinances. We cannot let our 42,000 villages impose their will, contrary to the interests of their constituents. We need the RH Bill to ensure access to reproductive health services and information for the poor, who need it the most,” said former Department of Health Secretary Esperanza Cabral, who is also a resident of Ayala Alabang.

If the bill is passed, it will overrule all other local laws.

Condom use shamed

Condom use and contraception have always been a dilemma for this Catholic country of more than 100 million inhabitants. The Church has adamantly opposed any form of modern contraception, saying they are abortifacients that promote promiscuity. A strong social stigma surrounds condom use as a result.

“When I buy condoms at the drugstore, the cashier will look at me and I just know they’re thinking I’m too young to be using the stuff,” said Jet, a 22-year-old college student, who preferred anonymity.

The National Demographic Health Study of 2008, showed condom use at a mere 2.8 percent. Those surveyed preferred other methods, including unprotected withdrawal, at 9.8 percent.

As a result, the government of this lower-middle income country has been labouring to support a ballooning population with growth pegged at 2.04 percent, one of the highest in the region.

According to the National Statistics Coordination Board, 32.9 percent or 28 million Filipinos live on less than US$1 a day.

Constitutional questions

Government agencies have declared the proposed ordinances unconstitutional.

“A local council cannot regulate drugs and determine what’s safe and what’s not. Under the Food and Drugs Administration [FDA] Law, it is only the FDA who has the full powers to regulate food, drugs and other devices,” said Pia Cayetano, head of the Senate Committee on Health and Demography.

However, in 2000, in Manila, an executive order was passed, declaring that only natural family planning methods would be promoted in government-owned hospitals and clinics. As a result, birth control pills, intrauterine devices and condoms are unavailable in government clinics and thus inaccessible to the poor. Under the same ordinance, which remains in effect today, vasectomies and tubal ligation are also illegal.

“We already saw this kind of religious bigotry before in the City of Manila,” said Junice Melgar, executive director of the NGO Likhaan Women’s Health Center. “We cannot let this happen again.”

Supporters remain adamant that the RH Bill is not only necessary, but urgent.

“There are 11 mothers who die every day in the Philippines because of pregnancy-related deaths. That alone is enough reason to pass the RH Bill and make family planning accessible to all,” said San Pascual of the Philippine Legislators’ Committee on Population and Development.

 

 

Philippines: The Abortion Scare versus Human Rights Standards

The abortion scare is truly just a scare.

The religious right would use all kinds of scare tactics and disinformation by claiming that contraceptives are abortifacients and that the reproductive health care bill (RH bill) promotes abortion. They have long been using these arguments in public fora and debates. Both these two arguments of the religious right are, of course, untrue. Their arguments are not based on medical science and factual content of the RH bill which, in truth, does not allow a single ground for safe and legal abortion.

What legislators, reproductive rights and women’s rights activists, people in government and the public should bear in mind is, in this day and age, our discourse should be raised to the level of international human rights standards, realities women face, public health, medical science, and legal reform.

The criminal law on abortion is an outdated colonial law that violates the rights to health and life of Filipino women. It was a direct translation of the old Spanish Penal Code of 1870s that used to criminalize abortion—in the time of the Spanish friars and conquistadores. Without knowing the full consequences of such a harsh and restrictive law, our congress enacted the criminal provision in our Revised Penal Code of 1930. At the time the law was adopted, Filipino women did not even have the right to vote, there was no Universal Declaration of Human Rights and no international human rights treaties such as the International Covenant on Civil and Political Rights (ICCPR), the International Covenant on Economic, Social and Cultural Rights (ICESCR), Convention on the Elimination of All Forms of Discrimination against Women (CEDAW), Convention on the Rights of the Child (CRC). These came much later.

In this day and age, we talk about a humane society where no woman should die from pregnancy, childbirth and unsafe abortion. We talk about the right to control one’s fertility with proper access to reproductive health information and services, the right to sex and sexuality education where we should be discussing delaying sexual debut, safe sex, risks of early sex, sexually transmitted infections, reproductive tract infections, risks of early pregnancy, risks of early marriage, violence against women, empowerment of women and girls, and the right to sexual orientation and gender identity, among others.

Our discourse and standards should include separation of church and state where the church should not be meddling with affairs of the state, where there is non-establishment of religion, where the standard is not religious standards from the Catholic, Islam or whatever religion but the standard should be secular morality. All these constitutional guarantees are there to maintain public good and uphold human rights.

The international human rights standard is to liberalize abortion laws to make it safe and accessible to women and thereby lessen maternal mortality related to unsafe abortion. The Philippines is duty-bound to fulfill its treaty obligations to uphold the right to equality, equal protection of the law, non-discrimination of women, right to health and life under the ICCPR, ICESCR, CEDAW, and CRC. Recognizing that the criminalization of abortion does not lessen the number of women inducing abortion but only makes it dangerous for women who undergo clandestine and unsafe abortion, in 2006, the Committee on Elimination of Discrimination against Women (CEDAW Committee)[1], urged the Philippine government to consider reviewing the laws relating to abortion with a view to removing punitive provisions imposed on women who undergo abortion and provide them with access to quality services for the management of complications arising from unsafe abortions and to reduce women’s maternal mortality rates in line with the Committee’s general recommendation 24 on women and health and the Beijing Platform for Action.[2] In 2008, the Committee on Economic, Social and Cultural Rights (CESCR) [3] expressed its concern that “abortion is illegal in all circumstances, even when the woman’s life or health is in danger or pregnancy is the result of rape or incest, and that complications from unsafe, clandestine abortions are among the principal causes of maternal deaths.†The Committee encouraged the Philippines to address, as a matter of priority, the problem of maternal deaths as a result of clandestine abortions, and consider reviewing its legislation criminalising abortion in all circumstances.

With the stark realities of not having access to sex and sexuality education, poor and adolescent women and girls not knowing how to properly manage their fertility and where to get the proper information and services, with policy restrictions in place such as the Manila EO 003 denying access to modern contraceptives and discouraging ligation to the poor women who need them, with the prevalence of rape, and the overall impact on reproductive health with more than half of all pregnancies being unintended and statistics ranging from 17% to one-third of these unintended pregnancies ending in abortion, 560,000 women who induced abortions, 90,000 women hospitalized and 1,000 women who died from complications from unsafe abortion in 2008 alone, we simply cannot be scared by the religious right or succumb to conservative discourse. The women who were hospitalized and maltreated by doctors and nurses and the families of the women who died due to complications from unsafe abortion, the rape victims who were tortured from the pregnancy resulting from rape have long been waiting for humane laws, policies, and practices. How do we prevent such discrimination and violation of human rights? On one hand, we should prevent unwanted pregnancies through sex education and increased access to the full range of contraceptive methods, provide access to skilled birth attendants, provide emergency obstetric care, overturn policies that restrict access to reproductive health information and services, pass a comprehensive RH bill, and implement it to the full extent. At the same time, we should provide access to safe and legal abortion either on certain grounds (rape, danger to the health and life of the woman, fetal impairment) or on broader grounds to do away with judicial and medical interpretation.***

1 The committee tasked to monitor the implementation of CEDAW by the Philippines as a state party.

2 2006 CEDAW Committee Concluding Comments.

3 The committee tasked to monitor the implementation of CESCR by the Philippines as a state party.