Fr. Melvin Castro, an official of the Catholic Bishops’ Conference of the Philippines (CBCP), argues that the RH bill is not needed since maternal deaths have declined significantly, and the government only needs to improve existing reproductive health services for women. For the past few weeks, anti-RH campaigners were also arguing that the RH bill is not needed since it duplicates existing laws, policies and programs of government.
Now let me see if I can make sense of the anti-RH side’s “not needed” arguments:
- the RH bill duplicates existing laws, policies and programs (LPPs)
- which succeeded in reducing maternal mortality
- therefore the government should improve existing LPPs
- except that the government should not pass the RH bill
- not because of religious objections
- but because… (back to #1).
Maybe the anti-RH folks enjoy creating twisted mind-benders. Or they’re just patching together anything, coherence and honesty be damned, to obscure the religious nature of their objections.
Based on official government statistics, an estimated 6.5 to 11 maternal deaths occurred per day in 2010. The anti-RH group Filipinos for Life produced a lower estimate by the simple trick of using registered births in its calculation, ignoring the warning from its source, the National Statistics Office, that the published number is lower than actual due to late or non-registration.
Using a new statistical model, the World Health Organization (WHO) did come up with a lower estimate of maternal mortality for the country in 2008: 2,100 at the middle of the range, some 5.8 maternal deaths per day. Because of the inherent difficulties in recording maternal deaths, which the WHO report extensively discusses, varying methods which come up with varying but overlapping estimates is not unusual.*
But on the crucial part of the WHO report, on what has to be done, the anti-RH groups are characteristically silent. Perhaps because at the end of the estimation exercise, the WHO advocated for enhanced commitment to RH measures, almost all of which are in the RH bill. Here’s part of what the WHO said:
The international community has been increasingly concerned about the fairly slow progress in improving maternal health. During 2010, the United Nations Secretary-General launched the Global Strategy for Women’s and Children’s Health, which seeks to catalyse action for renewed and enhanced commitments by all partners for adequate financing and policy to improve women’s and children’s health. The commitments would support the following elements to accelerate progress towards MDG 5:
- Country-led health plans – development partners to support governments to implement country-led plans to improve access to reproductive health services.
- A comprehensive, integrated package of essential interventions and services – women and children should have access to a package of integrated services including family planning, antenatal care, skilled care at birth, emergency obstetric and newborn care, safe abortion services (where abortion is not prohibited by law) and prevention of mother-to-child transmission of HIV services.
We have an ongoing tragedy whether 5 or 11 maternal deaths occur per day. Half of all pregnancies are unintended, which means family planning—using artificial or natural methods—can potentially prevent up to half of these deaths. To overcome the routineness of maternal deaths which anti-RH groups exploit, think of the thousands of deaths as two to four shiploads sinking every year. Half of the women do not even want to be passengers at all. And of the willing passengers, more than half can be saved with measures in the RH bill.
——————-
* WHO, using three different methods, estimated the maternal mortality ratio (maternal deaths for every 100,000 live births) for the Philippines at 120–280 in 2000, 60–700 in 2005 and 61–140 in 2008.
Image used: Enrico Rastelli, available at Wikimedia Commons
Rick Perry on how abstince-only education is money well spent – despite his state having the highest teen pregnancies in the US.
http://www.huffingtonpost.com/shawn-lawrence-otto…
the arrogance, despite the obvious failure, he clings to the belief that he is right. lol
Let me help spell it out for you.
1) Maternal mortality can be lowered by improving access to prenatal, birthing, or postnatal health care (excluding access to contraceptives). This includes construction of health centers/facilities, health worker training, medications/immunizations etc.
2) The RH bill duplicates certain provisions aiming to lower maternal mortality which address #1. (probably to wittingly sugar coat #3)
3) What the RH bill wants to add to the menu is a) to force the entire country to fund contraceptives as essential medicine and b) sex education. (hmm.. useful tools for a palatable population control agenda, but ok let’s discuss this in another time…)
4) Without the RH bill adding #3, the country has achieved significant lowering of maternal mortality.
5) Yet, we know for a fact that laws addressing #1 are not yet fully implemented. There are regions still in need of these services.
6) Therefore, the RH bill (or #3 for that matter) is not necessary to lower maternal mortality rates. Let us channel the fund instead to improve #1 to lower MMR further.
I personally agree to this logic. After all, #1 is necessary for the pregnant and has no other alternative. These constitute essential care and treatment for the pregnant in order for them to avoid morbidity/mortality. Family planning is only a secondary solution for which NFP is an effective but a less costly alternative.
http://humrep.oxfordjournals.org/content/22/5/131…
I’m convinced that the wisest way to deal with maternal mortality is to channel our LIMITED funds to #1 and promote NFP instead for family planning.
Besides, who has more right to our limited funds?
A. a pregnant patient about to die of post-partum hemorrhage and in need of oxytocin?
B. a couple who says they need a regular supply of pills and concoms because they can’t stand a few weeks of abstinence?
//After all, #1 is necessary for the pregnant and has no other alternative. These constitute essential care and treatment for the pregnant in order for them to avoid morbidity/mortality. Family planning is only a secondary solution for which NFP is an effective but a less costly alternative. //
1) For pregnant women, family planning is not even a secondary solution. Too late. Various elements of maternal care can keep her safe. All are in the RH bill.
2) For non-pregnant women who want to be pregnant, or those who will not mind getting pregnant, #1 above will work fine.
3) For non-pregnant women who do not want to be pregnant, family planning is both the right thing to do (avoid complications & health risks, follow one's plans, etc.) and the cost-effective thing to do. "Limited funds" is an argument for FP, since treating maternal complications is more expensive than preventing them).
//NFP is an effective but a less costly alternative//
Training for effective, scientific NFP (in the journal you linked) takes months and do need training costs. Yes there are no recurrent costs, but this is just similar to IUDs, tubal ligation and vasectomy. I think "less costly" may only be true if compared to certain methods.
//Family planning is only a secondary solution for which NFP is an effective but a less costly alternative. //
Effective? Really?
http://nsrc.sfsu.edu/article/abstinence_only_fail…
Lets have a more comprehensive study in http://ari.ucsf.edu/science/reports/abstinence.pd…
"Abstinence Only vs. Comprehensive Sex Education"
I love the hammer in the head conclusion.
"The $102 million currently being spent by the federal government on abstinence-only programming is designed to serve social and political goals, rather than produce solid public health outcomes for young people. "
i like this article since it has been quote-mined by the fundies to prove abstinence works. naturally they forgot to read the conclusion.
//My point is that you seem to have taken a hardline stance against passing the RH bill using maternal death reduction as one of its goals simply because family planning is in the bill, and it would be hard for you to argue to limit it to just NFP. //
Well first we don't have anything against family planning per se, but it has to be the natural methods which don't harm mother and child. We do in fact advocate 'responsible parenthood' but probably not interpreted on the same terms by people nowadays. Essentially, the couple must take into serious consideration 4 factors: health condition esp. of the mother; psychological capability of the parents; material resources; and social condtions. There is not supposed to be any magic number of children, it can be one, two, it can be more than a dozen – it depends. The couple must responsibly take these 4 considerations seriously in planning and spacing of children (they can even indefinitely postpone pregnancy). However (this is where both protagonists are locked into conflict), we will espouse only natural methods and not contraceptives (I'm sure you know why: abortifacient effects, serious side effects for the mother…) such as Standard Days Method, Two-Days Method, Billings Ovulation Method, Thermal, and Sympto-Thermal.
I will advise my friend (that couple who wished to stop at 3 children) that natural methods are the best approach.
I was just thinking– would the RH bill proponents agree to an amendment of the bill to strike out all the artificial contraceptive provisions but retain everything else?
//Essentially, the couple must take into serious consideration 4 factors: health condition esp. of the mother; psychological capability of the parents; material resources; and social condtions.//
Agreed. But some people against the RH bill do not seem to know this. You need to propagate this some more to at least reduce the tension and maybe find more common grounds.
//There is not supposed to be any magic number of children, it can be one, two, it can be more than a dozen – it depends.//
Agreed. Most people in the RH movement pressed for this principle (reproductive rights) and produced results. An early version of the RH bill in the lower house had incentives for families with 2 children. The next version removed the incentive, and stated that the "ideal family size" is not compulsory. In the latest, we finally had a commitment from authors to remove in its entirety the "ideal family size" section. We had better results at the Senate, which did not carry this provision at all since the 14th congress, I think.
//However (this is where both protagonists are locked into conflict), we will espouse only natural methods and not contraceptives (I'm sure you know why: abortifacient effects, serious side effects for the mother…) such as Standard Days Method, Two-Days Method, Billings Ovulation Method, Thermal, and Sympto-Thermal.//
Which brings back my point that the debate about maternal deaths should not have happened, or should not have escalated. For a section of the population who are committed to scientific NFP and who want to space or limit pregnancy, then FP using NFP is a legitimate and effective method to avoid maternal complications and deaths.
//I was just thinking– would the RH bill proponents agree to an amendment of the bill to strike out all the artificial contraceptive provisions but retain everything else?//
You must think of an argument other than a religious tenet that will support this sweeping policy, of the State encroaching on individual choices. I think there is none. For example, tubal ligation, vasectomy and condoms cannot be associated at all with abortion, nor with the side effects and contraindications of hormonal methods. But on a case to case basis, RH advocates have opposed artificial contraceptives. Quinacrine sterilization is a good example (look it up); its current status can be read here http://whqlibdoc.who.int/hq/2009/WHO_RHR_09.21_en…
Edited (added): Women's groups against quinacrine here: http://www.cwpe.org/resources/healthrepro/quinacr…
Ok Arm I got you. I never mistook you for anyone else as your professional, incisive style and comments are familiar to me.
Challenging the data is par for the course, sneers and gestures aside…we don't parade sensitivity to those as a matter of argument. Why…we been ridiculed for objecting to Medeo's explicit exhibit and we are astounded at the negative attention given to Sotto's sneer which can be interpreted many ways. But that is another story, anyway…
There was no downgrading of the importance of MMRs. The redundancy was only being pointed out. Come to think of it, again I take off from my previous comments, what prevents the DOH from addressing it effectively given the current system? I don't recall them having been denied the budget specifically on maternal health concerns, and neither can the RH bill (assuming it is passed into law) be guaranteed of a budget to do precisely the same, same things that DOH is mandated to do with the added impetus of the magna carta law for women behind it? Trying to rationalize it makes my head explode 🙂
//what prevents the DOH from addressing it effectively given the current system?//
Your side's intense opposition to family planning is proof enough. A law should be passed or rejected so that a clear and authoritative policy, that encompasses even LGUs, is laid down on this contentious issue.
Care to answer my question about how your support for NFP and other non-controversial MMR-reducing measures should have stopped your side from attacking the veracity and importance of MMR data?
Most of government services have already been devolved to the LGU's with the passage of the Local Government Code in 1991. That is why the DOH directly ships the medicines to them for disposition. Recall that we already have a budget for contraceptives (admittedly small by pro-RH standards), yet the issue of ghost deliveries of contraceptives uncovered by Senate investigation has not been resolved to date. What gives us the assurance that the RH bill allotments for contraceptives won't end up as apparitions either? Better to put the resources to real and tangible health services where it matters. Pay medical personnel to be actually posted in the poor, rural areas where they can attend to maternal care. This for example is a non-controversial measure which we endorse. The utility for pregnancy related health care for the region of ARMM for example is a dismal 20% compared to 97% for NCR. Why don't we concentrate on improving this? MMR has its regional attributes and I don't see anybody delving into it.
I think I have to expand my point re a clear and authoritative policy so you can address it. This debate has surfaced many issues which should be settled by a law, one way or the other (we do contemplate the possibility of losing). Some examples: Can public funds be used to purchase contraceptives despite doctrinal opposition by leaders of the majority church? Are contraceptives essential medicines that must, in the spirit of nondiscrimination, be part of regular purchases of such medicines by national & local government? (Some LGUs answer no to these first 2 questions.) Are some contraceptives covered by the anti-abortion law and must therefore be prohibited? Should there be a common sexuality education in schools? Etc. Your point about devolution supports my case, that a national policy is needed to standardize the minimum health services available to people, regardless of where they happen to live.
//What gives us the assurance that the RH bill allotments for contraceptives won't end up as apparitions either?//
The same assurance for all other appropriations made by government (COA, Ombudsman, police, courts, media, etc.). This is an argument that can be used to stop all government spending.
//Pay medical personnel to be actually posted in the poor, rural areas where they can attend to maternal care.//
This is in the RH bill, sections on midwives/skilled birth attendants and hospitals for emergency obstetric and neonatal care, with a provision on equal access for geographically isolated and disadvantaged areas (GIDAs).
I think you have not answered my question re attacking the veracity and importance of MMR data. Was it unclear?
Arm,
I will quote the F4L statement partly as a response, as I happen to agree with it:
“Questioning the data peddled by pro-RH groups RHAN, Likhaan, and DSWP is far from belittling the problem of maternal deaths. The issue at hand is the pro-RH lobby’s emotional and exclusive use of ‘11 maternal deaths a day’ to scare lawmakers into spending billions of pesos in taxpayers’ money for its contraception and sterilization agenda,” it said.
“At any rate, it now appears that the range of daily maternal deaths is a wide one – anywhere from 6.5 to 11.1. It can be 6, it can be 11 (a nice, double-digit figure for PR purposes, especially). But lawmakers should have been informed ahead of floor debates that the numbers have changed significantly. [or that the figure has many caveats pala, may I add]
“We are astounded that the pro-RH lobby had to go to great lengths to justify the excessive and exclusive use of ‘11 a day.’ We wonder why the figure is now attributed to government statistical agencies, when before, credit was given to the UNFPA and other international bodies…
I emphasize that our questioning of the MMR data should not be construed as contradictory to our concern to minimize/eliminate maternal mortality. The point the Pro-RH hammering on MMR is clear to us: Need to pass RH bill to address maternal mortality. We strongly disagree to such a premise. We have already contested that premise in so many ways. The DOH is already mandated to address MMR. The Magna Carta for Women reinforces that mandate. We should expect the government to satisfactorily implement the existing system. You need a more specific law to strengthen prenatal, delivery, and post-natal care, then let the government put some teeth into the implementation of existing avenues.
The bloating/lying charges, I have already addressed adequately, I think. Unless you have more specific questions.
//Pro-RH hammering on MMR is clear to us: Need to pass RH bill to address maternal mortality. We strongly disagree to such a premise.//
I think your side do not accept the concept that spacing and limiting/capping pregnancies, according to the wishes of women/couples, is a valid and important way of reducing maternal mortality, in addition to other measures you were saying (prenatal, delivery, and post-natal care). These are all in the RH bill.
Suppose you are friends with a poor couple, who have decided they can only raise 3 kids. After the 3rd child, they have decided to stop childbearing through modern NFP. (Friends of yours talaga! ) The woman will be much safer from maternal morbidity and mortality by avoiding pregnancy. Is this not an acceptable and important way of reducing maternal deaths?
My point is that you seem to have taken a hardline stance against passing the RH bill using maternal death reduction as one of its goals simply because family planning is in the bill, and it would be hard for you to argue to limit it to just NFP.
//I will quote the F4L statement partly as a response, as I happen to agree with it: //
So you're in agreement with a group that has a track record for making blatant lies? https://filipinofreethinkers.org/2011/04/08/lying-…
don't forget: conspiracy theorists, crack pots, quote-miners, fear-mongerers and compulsive liars. all in the name of christ our lord.
Replying to Willyj77 from here https://filipinofreethinkers.org/2011/09/07/sen-so…
//Are not those who trumpet the "11 mothers die everyday" mantra a tad dishonest too? How come all these heavy analysis of the stats came out ONLY now? 11 sounds like a nice rounded figure though… //
Minor point: Frankly I thought your side will not attack the maternal mortality issue. Bad taste, and too risky that your side will come out uncaring about maternal deaths. I thought you will focus more on your attacks on the safety and mechanism of action of contraceptives.
Major point (see article above for sources):
In 2007, two figures of maternal mortality came out. First was an estimate by the WHO based on a statistical model. Result: MMR range of 60 to 700; midpoint of 230 or 4600 annual or 13 deaths per day. The MMR of 700 is equivalent to 38 deaths per day. RH advocates did not use “13 deaths per day” or “up to 38 deaths per day” to score propaganda points because we knew enough by reading the whole report about the weaknesses and limitations of model-based data.
Later in 2007, the results of the sisterhood method (survey of 49,974 households) by the NSO was released. Result: MMR range of 128 to 196; midpoint of 162. No estimate of total deaths was published online, but 162 is almost the same as the 172 recorded in the previous survey (1998 NDHS), which was the basis of WHO’s MMR figure of 200 (adjusted upwards to compensate for underestimation inherent in the sisterhood method) in the year 2000, equivalent to 11 deaths a day. Sisterhood method is more accurate than statistical model, but more expensive (see WHO MMR reports).
WHO 2010 and Hogan 2010 (Lancet) estimates are both statistical models. These may be newer but not more accurate than NSO 2007 due to the methods used. NSCB came up with an interim estimate in 2010, fitted to the NSO 2007 data which it deemed to be the most accurate. The NSCB method actually implies no improvement in over-all risk of maternal death from 1990 to 2010 (PMDF set at a constant range of 7% to 12%; see WHO 2010 for explanation of PMDF).
Bottomline: 11 deaths a day is an accurate estimate based on NSO 2007, and is within the range of NSCB 2010 (the current official figure). Pro-RH groups did not engage in propaganda. Whatever the number, preventable maternal deaths should be solved.
Wes,
Thank you for the explanation. Now my head is spinning 🙂
Your analysis appears plausible, but then again I am just basing off on what you posted:
"Based on official government statistics, an estimated 6.5 to 11 maternal deaths occurred per day in 2010…Using a new statistical model, the World Health Organization (WHO) did come up with a lower estimate of maternal mortality for the country in 2008: 2,100 at the middle of the range, some 5.8 maternal deaths per day. Because of the inherent difficulties in recording maternal deaths, which the WHO report extensively discusses, varying methods which come up with varying but overlapping estimates is not unusual."
Would the ordinary citizen understand sisterhood method, statistical method, midpoints, etc., and so forth? The proponents just flaunted the "11 deaths" to the public at every opportunity and pounded on that soundbyte mercilessly. Please do not fault protagonists for the supposed "bad taste", for the MMR issue is capitalized upon as a MAJOR, major issue by the proponents themselves to justify the RH bill. I thought it is fine to question everything in the sacred interest of "freethinking" diba? It would be reasonable to say 6.5 or 5.8 or even 11, as long as the caveats are pointed out. Even in the Senate sponsorship speeches it was not done so, and a clarification is in normal order here. But no, we never, ever heard any and it is amazing that Sotto and the anti-advocates are pilloried for merely questioning the data, and uncalled-for personal insinuations are resorted to.
Hi Willy, this is Arm (my full name initials), not Wes. We had a long discussion before, and welcome back.
11 deaths is not a soundbyte as I have tried to explain. It continues to be a good estimate. And we have not "capitalized" on the issue in the sense of bloating the figures. When people on your side (including Sotto) began questioning the figure, there were 2 things that triggered the, for lack of a better word, counterattack. One is the bloating, lying accusation (which is different from just saying that we made a mistake). And the other is the message that xx number of maternal deaths is something to sneer about (I personally saw Sotto sneer at the Senate's webcast). So no, we were not reacting to mere questioning of the data. As you can see here in my response to you, if asked in a straightforward manner, we can explain the history & background of the data.
My 'bad taste' comment flows from this thought: Your side accepts natural family planning as a means to space or limit/cap pregnancies. I know that other religious groups attack even NFP, but I am assuming that your side does not (I may be mistaken if you have a heterogenous mix). Now spacing or limiting/capping pregnancies, based on the wishes of couples of course, is an important way to prevent maternal deaths. The other important means are skilled birth attendance and emergency obstetric care, which your side also do not oppose. So reducing maternal deaths per se should not be a problem at all for your side, and should have not been a subject of attacks regarding the veracity of data or importance of the problem. Your side's position on maternal deaths is what makes my head spin 🙂
I find it odd that their newest tactic seems to be to try to trivialize the issue. But when you look at all the effort and resources the catholic church is pouring into shutting down the RH Bill from full-page ads, billboards, pamphlets, stickers, banners, media campaigns, celebrity endorsements, anti-RH seminars held in very expensive venues… it seems kinda obvious that for them, its anything *but* trivial.
Just taking a peek at the Catholic Bishop's own website, it's painfully obvious with all the anti-RH propaganda plastered all over their site that anti-contraception is their number one priority right now – not helping the poor, not spiritual enlightenment, and certainly not helping save dying mothers from needless suffering… I must have missed the memo when they revised the 10 Commandments to say "…and the greatest commandment of all is: Thou shalt not use contraception".
yeah had an argument with one of them last time. they computed that the deaths were MERELY 6.5 not 11. they accused: why does the proRH have to lie?
the death rates are going down anyway. to them 6.5 preventable deaths are ok, so we do not need the bill. they forget that's 2,300 average deaths a year.
// Thou shalt not use contraception.//
but they break the Ninth Commandment: Thou Shalt Not Bear False Witness – all the time. they have a loophole for that though: Mental Reservation.
what do you expect from that site? its just a bunch of loons. it has been quite established that they are very antiUN and anti-science. since those two tend to shoot down their beliefs.
their site is chock full of logical fallacies, ad hominems, conspiracy theories, fear-mongering, misinformation, quote mining and eternal damnation to all those who disagree.
they are as low and as sickeng scum of the earth. but hey, as long as it is done in the name of god it's all good.
they also forgot the part as contraception increases maternal deaths decrease. there is even a graph.
these nutjobs just read one part of the report, the one they like,(aka quote mining) then forget about the stand of the source and the conclusions.
The position of these so-called "pro-life" groups against the RH Bill clearly displays a healthy dose of doublethinking to achieve.
Thanks for this effective rebuttal, ARM. 🙂
anubayan, kung sino pa ang "prolife", sila pa yung nag-bubulag-bulagan sa dami ng mga inang namamatay sa pagdadalang-tao.
yan ang tunay na OXYMORON, with a capital '-MORON'
The only thing pro-life about the the CBCP and their affiliates are their self-proclaimed titles. It doesn't take a rocket scientist to know that women are the least of their concerns.
They're too busy running around being douchebags.
I beg to differ.
Sometimes, they sit around and talk on the radio, but the douchebag thing is consistent.
I've pointed the belittling of maternal deaths twice already in the gmanews tv fanpage in facebook. However, it seems the administrator of the site is anti-RH that he reposts it just so my old comments cannot be seen in the reposts (because it makes sense).