Posted on 31 May 2011.
If I remember it right, it’s been already a decade of almost nonstop controversy regarding the reproductive health and contraceptives issue. The earliest that I could remember was how Mayor Lito Atienza came under fire for banning Manila public clinics from distributing free contraceptives and teaching any other methods of contraception other than natural family planning, which is the only “contraception” method espoused by his religion. Human Rights Watch HIV program research, Jonathan Cohen, even went far in saying that “the Philippines is courting an AIDS epidemic with its anti-condom approach…the casualties will be millions of people who cannot protect themselves from HIV infection“. Lito Atienza and his wife may have had pro-life projects that truly helped impoverished women, especially those who suffered from post-abortion trauma, but still, their anti-contraceptiion stance is immovable.
And such stance has pervaded, unfortunately, some of the country’s lawmakers. For this reason, the fate of the Reproductive Health Bill, hangs in a balance.
And unfortunately, the anti-RH force is moving heaven and earth just so that this bill will not be passed.
But what is it in the Reproductive Health Bill that has enraged the Catholic clergy?
I have actually written about this particular subject several years ago (see “What the RCC hates in the RH act“). But, since this bill has gone some revisions, we shall try to review it again, during the course of which I’ll try to dismantle the misinformation being propagated by the so-called “pro-lifers” (who have more than successfully hijacked the term just so to gain unfair advantage over their opponents).
The elements of reproductive health care that are being espoused by the bill are as follows:
family planning information and services;
maternal, infant and child health and nutrition, including breastfeeding;
proscription of abortion and management of abortion complications;
adolescent and youth reproductive health;
prevention and management of reproductive tract infections (RTIs), HIV and AIDS and other sexually transmittable infections elimination of violence against women;
education and counseling on sexuality and reproductive health;
treatment of breast and reproductive tract cancers and other gynecological conditions and disorders;
male responsibility and participation in reproductive health;
prevention and treatment of infertility and sexual dysfunction;
reproductive health education for the adolescents
mental health aspect of reproductive health care.
But for this post, I shall be limiting myself in those concepts that has lighted the fire under our beloved clergy’s butts.
1) Family planning information and services
Beloved Catholic clergy did not want taxpayers’ money to fund public health clinics giving out pamphlets and lectures regarding modern artificial contraceptives. Neither does it want it to be giving away free contraceptives. The clergy wanted ONLY natural methods of family planning to be endorsed and taught by these clinics. The clergy has successfully convinced some of its members to disagree with the bill by cleverly insinuating that their taxes go to activities deemed immoral by their church (not considering that NOT everybody in this country belong to their church). And so the statements, “I will not allow the government to use my taxes to pay for your condom” and “let them buy their own condoms”. Well, the idea is to help out the impoverished who cannot afford to buy contraceptives. For those who do not know, contraceptives are considered essential medicines (see section 18, WHO list of essential medicines March 2010 update). The WHO list of essential medicines is a list of minimum medicines needs for a basic health care system. If the clergy wanted to prevent contraceptives from being able in a basic health care unit, then they are, basically, preventing the government from addressing basic health care needs.
The clergy is also frowning upon the use of IUDs and tubal ligation as contraceptive measures. What most of them are blind to is the provision in the bill that these procedures will not be FORCED upon women, but rather, it would be made available to those who may wish to have these procedures.
SEC. 7. Access to Family Planning
All accredited health facilities shall provide a full range of modern family planning methods, except in specialty hospitals which may render such services on an optional basis. For poor patients, such services shall be fully covered by the Philippine Health Insurance Corporation (PhilHealth) and/or government financial assistance on a no balance billing.
After the use of any PhilHealth benefit involving childbirth and all other pregnancy-related services, if the beneficiary wishes to space or prevent her next pregnancy, PhilHealth shall pay for the full cost of family planning.
SEC. 11. Procurement and Distribution of Family Planning Supplies
The DOH shall spearhead the efficient procurement, distribution to LGUs and usage-monitoring of family planning supplies for the whole country. The DOH shall coordinate with all appropriate LGUs to plan and implement this procurement and distribution program. The supply and budget allotment shall be based on, among others, the current levels and projections of the following:
(a) number of women of reproductive age and couples who want to space or limit their children;
(b) contraceptive prevalence rate, by type of method used; and
(c) cost of family planning supplies.
SEC. 24. Right to Reproductive Health Care Information
The government shall guarantee the right of any person to provide or receive non-fraudulent information about the availability of reproductive health care services, including family planning, and prenatal care.
The DOH and the Philippine Information Agency (PIA) shall initiate and sustain a heightened nationwide multi-media campaign to raise the level of public awareness of the protection and promotion of reproductive health and rights including family planning and population and development.
2) Proscription of abortion and management of abortion complications
As early as now, I’m going to say there is nothing (I repeat, NOTHING) in the reproductive health bill that is espousing abortion (abortion being “expulsion from the uterus of the products of conception before the fetus is viable”, according to an online medical dictionary). The bill, rather, wants to strengthen postabortion care. Now, some will say this is indirectly encouraging women to have abortion. But I’m going to stop you right there. Every woman who has had an abortion, whether spontaneous or induced, whether the abortion hurts you as a believer or not, has a right to obtain good postabortion care.
I remember how it was in the different hospitals I have rotated before…girl coming to the hospital complaining of vaginal bleeding and by history, it was evident that she had induced abortion. Health care providers, then, would be rough and tough on her, just so she’d remember the pain and thus, “remember the lesson”. And some even threatened to be denied anesthesia during curettage, just so they’d break down and cry, the health care provider thinking she’d someday learn to keep herself from getting pregnant again, having more than 5 children or so at the tender age of 20. I remember crying at the time I assisted in the vaginal delivery of a 12-year old girl, a pregnancy that was a product of rape of her father. I remember her as a pained girl, who was so restless on the delivery table, not knowing what to do and too much in pain even to think, as the ob-gyne resident shouted down on her to keep her legs apart. “Ayoko na po! Ayoko na po!” were the words she had ceaselessly shouted until she was able to deliver her baby. I imagined it must be the same set of words that she have shouted back to her father while she was being raped.
No, I’m not saying that this girl should have outright abortion because of rape. But if reproductive health assistance are in place, she could have had proper prenatal care and a planned cesarean section would have been done, as her body frame is so small, she might be better off with a C-section rather than risking a vaginal delivery. However, she did not have prenatal care and the only consultation with a health professional that she had was when she was already in active labor. Or she could have had emergency contraception hours after the attack on her.
For you Anti-RH doctors out there, I don’t understand why you still can’t agree to pass the RH bill, with all that you’ve seen since medical school and clerkship. I bet almost everyone of you has rotated in government hospitals. You have seen the numerous poor pregnant women who have come in and out of these hospitals. You have heard their stories, of how they wanted only few children, but were stuck with 10 or more because they cannot refuse a husband asking for sex. You must have heard how most of these women would say they cannot complete their prenatal care because they’d rather spend on food and electricity than on transportation to hospital and medicines. You have seen how some of the health providers in these government hospitals have been rough and tough on these women, just so that they remember the pain and hardship enough to make them think twice before going into another pregnancy. You have seen the scope of how access to reproductive health medicines and procedures are sorely lacking in this country. How can you not agree with the passage of the bill? Because of your alma mater? Because of your religious convictions? This is not an issue of religion; this is a secular issue. Let these women have their choice!
3) Reproductive health education for the adolescents
The clergy keeps on asking, “do you want your children as young as 5 years old to learn about sex?” My answer to this is YES. Whether parents would be honest to themselves or not, one cannot deny the curiosity of a growing child. Yes, even at the young age of 5, kids do already have some questions related to gender and sex. As the kids grow older, the questions grow more mature and complicated. And it is the responsibility of parents to address these questions. But not every parent can be comfortable discussing sex with their children. Come on, be honest with yourselves. Have you ever discussed sex at any length with your mother/father? The all-too-common scenario at home is this: parent and youngster watching a movie on TV, then a kissing scene comes up. Father/mother brings up one hand to cover youngster’s eyes until the scene ended. “Don’t look, you’re too young for this!” And the youngster is either left bewildered at why he shouldn’t see those scenes or he already knows what those scenes are because he already saw movie at a friend’s house. Most Filipino parents would be just content at “screening out” the topic of sex without ever venturing into trying to give the appropriate knowledge to their kids. And unfortunately, these kids would learn about sex and reproduction through friends only. Talk about the blind leading the blind. And it is at this point that the whole barrage of misinformation and myths start and sometimes will culminate into teen pregnancy or other complications regarding relationship with another person.
And here comes the clergy telling us that only the parents should teach their kids about sex.
In the amended reproductive health bill:
SEC. 16. Mandatory Age-Appropriate Reproductive Health and Sexuality Education
Age-appropriate Reproductive Health and Sexuality Education shall be taught by adequately trained teachers in formal and non-formal educational system starting from Grade Five up to Fourth Year High School using life skills and other approaches…
…Parents shall exercise the option of not allowing their minor children to attend classes pertaining to Reproductive Health and Sexuality Education.
I’m not sure where the clergy got the idea that the kids will be forced to attend sex education classes. It is rather clear that the parents have the option to let their children attend these classes. However, in my opinion, children as young as those in the 5th grade should have these classes already. Fifth graders are usually in the age of 11-12 years old and this age is the start of puberty. With many changes in their bodies, these children should be enlightened and armed with knowledge they need to understand these changes.
There is still plenty left to be discussed regarding the reproductive health bill, now that the clergy and their loyal followers are so hell-bent on obstructing the passage of this bill into law. This has also brought out the worst in some people, even if they think they mean well and are only fighting for what they think is right. However, what we must remember that reproductive health bill shouldn’t even be an issue anymore. Every country needs a good reproductive health care available to its citizens. We have our own personal beliefs regarding it, whether it be religious or not. But reproductive health is a secular issue and citizens must decide on this with the objective that the laws to be passed should be beneficial and appropriate to EVERYONE in the country.
Please see these related articles:
Complete Reproductive Health Bill Text http://rhbill.org/about/rh-bill-text/
Authors’ Amendments to HB 4244 http://rhbill.org/about/amendments-hb4244/
My older posts regarding the issue:
What the RCC hates in the Rh act http://prudencemd.com/?p=488
Family planning will be taught in classes in qc http://prudencemd.com/?p=428
Courting health disaster with Philippines’ anti-condom policies http://prudencemd.com/?p=396
The blog rounds: The State of Reproductive health in the Philippines http://prudencemd.com/?p=492