Aileen Grace Delima BIO 199
January 18, 2008
Abortion in the Philippines: Reasons and Responsibilities
Abortion is a controversial issue but it should be discussed because it is happening, and is more widespread than we care to admit. If we truly care about life, then we must understand what is going on (Tan 2008). Ideally, pregnancy is a wanted and happy event for women, their partners and their families. Unfortunately, this is not always so. Around the world, millions of women every year become pregnant unintentionally. In the Philippines, as in other countries, some of these women are faced with a difficult choice: to give birth to a child that they are not prepared or able to care for, or to obtain an illegal, and often unsafe, abortion (Singh et al. 2006). Abortion and Philippines Laws
Abortion is illegal in the Philippines and is not permitted under any circumstance. The act is criminalized by the Revised Penal Code of the Philippines, which was enacted in 1930 but remains in effect to day. Articles 256, 258 and 259 of the Code mandate imprisonment for the woman who undergoes the abortion, as well as for any person who assists in the procedure, even if they be the woman's parents, a physician or midwife. Article 258 further imposes a higher prison term on the woman or her parents if the abortion is undertaken "in order to conceal [the woman's] dishonor" (Tan 2008 and Wikipedia 2008). The 1987 Constitution of the Philippines effectively any amendments to the Penal Code’s provisions on abortion because of Article II, Section 12, which states: “The State recognizes the sanctity of family life and shall protect and strengthen the family as a basic autonomous social institution. It shall equally protect the life of the mother and the life of the unborn from conception. The natural and primary right and duty of parents in the rearing of the youth for civic efficiency and the development of moral character shall receive the support of the Government.” In the the prin princi cipl ple, e, legal legaliz izin ing g abort abortio ion n woul would d requ requir iree a refe refere rend ndum um to amen amend d the the constitution, although the enactment of a more definitive provision sanctioning the ban was not successful. In 1999, Congressman Roy Padilla Jr. of Camarines Norte filed House Bill 6343 seeking to allow abortion in special cases (e.g., rape, congenital defects in the fetus or cases where the mother’s life is endangered). It is unlikely that the bill will be passed but it has stimulated discussion on abortion. The passage of HB 6343 will require amendment because the Bill as it presently stands is inherently unconstitutional (Wikipedia 2008 and Tan 2008). The United Nations recognizes that abortion in the Philippines is permitted only in instances in which the pregnant woman's life is endangered. However, there is no law in the Philippines that expressly authorizes abortions in order to save the woman's life; and the general provisions which do penalize abortion make no qualifications if the woman's life is endangered. It may be argued that an abortion to save the mother's life could be classified as a justifying circumstance (duress as opposed to self-defense) that would bar criminal prosecution under the Revised Penal Code. However, this position has yet to be adopted or debunked by the Philippine Supreme Court. Proposals to liberalize Philippine abortion laws have been opposed by the
Catholic Church, and its opposition has considerable influence in the predominantly Catholic country (Wikipedia 2008). Prevalence of Abortion in the Philippines
Accurate measurement of induced abortion levels has proven difficult in many parts of the world. Health care workers and policymakers need information on the incidence of both legal and illegal induced abortion to provide the needed services and to reduce the negative impact of unsafe abortion on women's health (Henshaw et al. 1999). Information on the current level of unintended pregnancy and abortion is essential for understanding the extent to which women face barriers in planning pregnancies and preventing unintended ones. Evidence on recent trends in these these import important ant indica indicator torss is also also crucia cruciall in assess assessing ing whethe whetherr changes changes in polici policies es and programs are necessary (Singh et al. 2006). Abortions cut across class, age, and marital status, and occur in both urban and rural areas. The UP Population Institute (UPPI) 1994 study estimates that between 300,000 and 500,000 women obtain induced abortions annually in the Philippines. Put another way, way, there may be 16 induced abortions ab ortions for every 100 pregnancies (Tan 2008). According to Singh et al. (2006), induced abortion in the Philippines is widespread and practice takes many forms.
Figure 1. Nearly half of pregnancies each year end in an induced abortion or an unplanned birth. Unintended pregnancy is the root cause of abortion. Some 3.1 million pregnancies occur each year in the Philippines. Of these, 15% result in induced abortions, 31% in unplanned births, 39% in planned births and 15% in spontaneous abortions. An estimated 473,000 abortions occur annually. One-third of women who experience an unintended pregnancy end it in abortion. Thus, about 1.43 million pregnancies each year—nearly half of all pregnancies— are unintended. The annual rate of unintended pregnancy is 81 per 1,000 women of reproductive age, meaning that about 8% of Filipino women aged 15–44 conceive every year without intending to do so. Women from all segments of society experience abortion. Women who have had an abortion resemble average Filipino women: The majority are married, Catholic and poor. They have some high school education and have already already had several several children. In 2000, women in the Philippines had more than 473,000 induced abortions—compared with an estimated 400,000 in
1994. Because the population also grew during this period, the rate of induced abortion remained essentially constant—25 abortions per 1,000 women in 1994 and 27 per 1,000 in 2000.
Figure 2. Estimated abortion rate, by survey year and region. At the national national level, little change occurred occurred between 1994 and 2000 in the proportion proportion of all pregnan pregnancie ciess that were were uninten unintended ded or the rate rate of uninte unintended nded pregna pregnancy ncy.. Howeve Howeverr, both both indi indica cato tors rs incr increa ease sed d subs substa tanti ntial ally ly in Metr Metro o Manil Manila. a. By 2000, 2000, more more than than half half (56% (56%)) of pregnancies in this area were unintended than in any other major geographic region, a substantial increase from 1994 (46%), and the unintended pregnancy rate was 97 per 1,000 women, up from 68 in 1998. The situation differed in the other major areas of the country. country. In Rest of Luzon and in Mindanao, the proportion of pregnancies that were unintended changed little during this period, but the unintended pregnancy rate declined somewhat, from 85 to 78 per 1,000 women in Luzon and from 84 to 80 per 1,000 women in Mindanao, probably because the overall pregnancy rate fell in these regions. Visayas, the area with the highest unintended pregnancy rate in 1994, showed the most improvement, achieving an unintended pregnancy rate of 78 per 1,000 women by 2000 (down from 91 per 1,000 in 1994) and
experiencing a small drop in the proportion of pregnancies that were unintended, from 48% to 44% (Singh et al. 2006). The national abortion rate changed little between 1994 and 2000; however, large increases occurred in metropolitan Manila (from 41 to 52) and Visayas (from 11 to 17). The proportions of unplanned births and unintended pregnancies increased substantially in Manila, and the use of traditional contraceptive methods increased in Manila and Visayas (Juarez et al. 2005).
Figure 3. Between 1994 and 2000, abortion rates did not change chan ge much nationally, but they increased in Metro Manila and Visayas. Visayas. Rates of abortion in each region are expected to be related to the level of use of modern contraceptives, as well as the level of unmet need for contraception. Yet in some regions, such as Metro Metro Manila Manila,, Ilocos Ilocos Region Region and Centra Centrall Visayas isayas,, even as modern modern contrac contracept eptive ive use rose rose between between 1993 and 2003, abortion rates stagnated or increased increased slightly. slightly. In countries such as the Philippines, where women and couples increasingly want small families, contraceptive use may not at first keep pace with this growing motivation to control fertility. That is, for a transitional period of time, the proportion of couples who wish to space their births or end their childbearing but who are not using modern contraceptive contraceptivess may increase—an increase—and d as a result, result, more couples may experience unintended pregnancies and seek abortions. Eventually, evidence from other countries shows, contraceptive use becomes more widespread and abortion rates decline (Singh et al. 2006). Why Do Women Have Abortions?
Each year in the Philippines, hundreds of thousands of women become pregnant without intending to, and many women with unintended pregnancies decide to end them by abortion. There are a variety of reasons for abortion, quite often, the reasons are structural: economics, work policies, gender relations (Tan (Tan 2008).
The majority of having of women having abortions are: ■ Nine in 10 have ever been married or in a consensual union.
■ More than half have at least three children.
■ Roughly two-thirds are poor.
■ Nearly 90% are Catholic.
■ Seven in 10 have at least some high school education.
Women have many reasons for choosing abortion (Singh et al. 2006). Here are the following: Inability to afford the economic cost of raising a child - most common reason as cited • by 72% of Filipino women who have attempted to have an abortion. Although the
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financial cost of raising a child and the desire to space births or limit family size are among the leading reasons cited by both poor women and better-off women who have sought to end a pregnancy, these reasons are given by larger proportions of poor than of wealthier women. But they do not justify the taking of life of the unborn. Allowing abortion will not necessarily lessen poverty, malnutrition, and child deaths in our country; abortion will only be the easier way out o f honestly confronting our problem. The number of hungry children will increase--not because there are more being born, but because the exploitation is more intensive (Pro-Life Philippines 2005). More than half of abortion seekers gave a reason relating directly to unmet need for family planning : Some 54% felt they had enough children, while 57% believed that the pregnancy occurred too soon after their last one. fearred that that a Thir Thirty ty-on -onee perc percent ent of women women soug sought ht an abor aborti tion on becau because se they they fea pregnancy would damage their health and another 32% because they felt that their husband, partner or relatives did not want the pregnancy. pregnancy. problems with their partner ; One in four women tried to end a pregnancy because because of problems that is, their partner had abandoned them, was not their husband or was not deemed to be a good go od father. Some 13% of women who ever attempted an abortion reported having done so because their pregnancy resulted from forced sex or rape. When a child is unwanted, abortion is certainly an extremist response - taking the life of the unwanted child (Pro-Life Philippines 2005).
Fig.3. Both poor and nonpoor women seeking abortion are concerned with the high cost of raising children. •
One characteristic that is closely associated with a woman’s reasons for attempting to end an unintended pregnancy is her age her age.. Larger proportions of younger than of older women try to terminate their pregnancies because they want to avoid conflicts with school, have problems with their partner or the man who made them pregnant, or consider themselves too young to have a baby.
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Sometimes, society’s Sometimes, society’s moralism itself pushes women to have induced abortions. Even the Penal code organizers this in the way it states the penalties for abortion: “Any woman who shall commit this offense (abortion) to conceal her dishonor, shall suffer the penalty of prison correctional in its minimum and medium periods.” Society stigmat stigmatize izess single single mother mothers, s, someti sometimes mes even punishi punishing ng them them severe severely ly.. Pregna Pregnant nt unmarried students face not just of ridicule from classmates, but expulsion by school authorities (Tan 2008).
Addressing the Problem
Action on many fronts is needed to reduce levels of unintended pregnancy and unsafe abortion abortion in the Philippine Philippines. s. In 2000, more than 473,000 Filipino women underwent induced abortions, one in every seven pregnancies was terminated and 27 in every 1,000 women aged 15–44 had an abortion. These figures expose the reality that a substantial proportion of women in the Philippines rely on abortion to control their fertility—despite laws that prohibit it, social mores that stigmatize it and health risks that make abortion complications a significant cause of morbidity and mortality for women. Women often have to go to great lengths to end their pregnancies, many suffer extensive physical harm and some die. The Philippine government and society have not effectively addressed these problems (Singh et al. 2006). ■ Abortion Abortion is common in the Philippines Philippines because unintended unintended pregnancy pregnancy is common. Increased Increased use of effective contraceptives would help women achieve their desired family size, and thus prevent unintended pregnancies, which, in turn, would reduce the need for abortion and the grave health consequences and costs of unsafe abortion. This will require increasing knowledge about, access to and government funding for modern methods, especially among poor and rural women. The U.S. Agency for International Development is phasing out donations of modern contra contracept ceptive ivess for distri distribut bution ion throug through h the Philip Philippin pinee governm government ent and will will complet completely ely end donations by 2008. In addition, Philippine President Gloria Macapagal-Arroyo has vowed that her administration will support only natural family planning methods, and opposes the proposed Responsible Parenting and Population Management Act of 2005, which would encourage smaller families and ensure “access to a full range of legal, medically safe and effective family planning methods.” ■ Increased resources should be directed at improving the quality of postabortion care for women women with with compli complicat cation ionss by expandi expanding ng service servicess such as those those offer offered ed under under the PMAC PMAC (Prevention and Management of Abortion and its Complications) program. (PMAC) (PMAC) progra program m was establ establish ished ed in 2000 by Engende EngenderHe rHealt alth, h, an intern internati ational onal nongovernmental organization, and the Philippines Department of Health (DOH). PMAC aims to strengthen the capability of the country’s health care system in the prevention and management of abortion and its complications, and to improve the accessibility of quality postabortion care services to all women of reproductive age in the country. ■ To ensure that all women receive the care they need, medical professionals should be trained to carry out the full range of reproductive health services—including legal abortions, postabortion care and contraceptive counseling—in a client-centered, compassionate manner.
Righting a wrong with another wrong isn't the answer. Adoption agencies are loaded with applicants for adoption, meaning that there are many who want the children if the mothers are unable to raise them up for one reason or another. What is needed is immediate medical care and counselling. counselling. Rape victims need our help to overcome overcome their emotional problems, problems, even if they do not become pregnant. The few who do become pregnant need additional help, i.e. financial, medical medical,, and moral moral suppor support. t. Educat Education ion and discip disciplin linee in sexual sexual respons responsibi ibilit lities ies should should be emphasi emphasized zed.. Our country country should begin begin to put up Rape Rape Treat Treatmen mentt Center Centerss for emerg emergency ency assistance to rape victims. A non-judgmental and compassionate staff must be trained to run these centers (Pro-Life Philippines 2005). ■ Young people, as well as adults, need complete and accurate information on reproductive health and contraception, the risks of unsafe abortion, and the health and societal benefits of family planning. Abortion has increasingly become a quick-fix solution to escape the burdens of raising a child—despite the medical risk it poses (Quito 2007). As many as 17 percent of all unsafe aborti abortions ons are done on teenage teenage or young young mother mothers, s, accord according ing to the Depart Departmen mentt of Health Health.. Compounding the problem is the fact that 36 percent of Filipino women become pregnant before marriage and 45 percent of all pregnancies are either unwanted or ill-timed, according to the World Health Organization (Conde 2005). 2005 ). ■ Policymakers must clarify the legal and medical grounds on which abortion may be allowed and ensure that women are able to access safe, humane abortion services services to the extent they are permitted. To meas measur uree prog progre ress ss towa toward rd impr improv ovin ing g publ public ic heal health th—s —suc uch h as reduc reduced ed level levelss of unintended pregnancy and unsafe abortion among Filipino women—policymakers must have access to reliable information on the public’s health needs and the services being provided. In the Philippines, complications following unsafe abortions (an indicator of levels of these procedures generally) are a leading cause of hospitalization, yet reports that would permit documentation of these these cases cases (as well as the full range range of the causes for hospit hospitali alizat zation ion)) are not compile compiled, d, processed or tabulated at the national level. In addition to retrieving official reports submitted to the national Department of Health, researchers collecting data for this study had to visit many regional department of health offices to obtain reports for the more than 2,000 hospitals in the country—a process that took several months. Improving government data collection and analysis would enable decision makers to develop better-info better-informed rmed public policies, policies, monitor monitor the implementati implementation on of policies policies and programs, programs, and evaluate progress. Such results are critical to efforts to meet the Millennium Development Goals and ensure a healthier society. Ratification of the 1986 Constitution (within which is enshrined the protection for the unborn) will not be sufficient to stop abortion. Congress will have to pass supportive laws that will effectively deter criminal abortion and establish support systems for the protection of both mother and unborn child. Legalized abortion does not reduce the number of illegal abortions. Drs. Hilgers and Shearin of the Ma yo Clinic discovered that when permissive abortion laws were passed in eight European countries, the number of illegal abortions stayed about the same (ProLife Philippines 2005).
In Davao City…
“An absence of comprehensive local health ordinance in the city manifests the increase of numbers of unwanted pregnancies pregnancies and alcoholism alcoholism that resulted resulted to abortion and early marriages marriages among youth. In fact, this year, there are abrupt increases of case of abortion in the city…” Local legislative body are still deaf and blind in solving it that evidently shows that it is not their top priority to solve, despite the Non-Government Organization’s initiatives to augment solutions to the issue of reproductive health of the city. Dr. Roberto Alcantara, national president of Family Planning Organization of the Philippines (FPOP), alleged that they initiated lobbying effort to the councilors for the passage of Reproductive Health Bill to holistically solve the Reproductive Health issue in Davao City however until now, there are no local resolutions made to give way for inclusion to their legislative agenda (Macla 2007). City Councilor Angela “Angging” Librado-Trinidad has underscored the need in Davao City for an institution and a piece of legislation that will address reproductive health care for women due to the series of discoveries d iscoveries of aborted fetuses dumped in the city’s trash bins. “Such practice only describes the present culture and mindset of most women today who are not well-equipped or fully aware that they have other alternatives, and who are deprived of much needed services by the state,” the councilor, who has a young daughter, said in a statement. There are also provisions to provide women with pre- and post-natal care to address the poor delivery of health services especially among women, as well as provide reproductive health and rights rights educati education. on. The Reproduc Reproductiv tivee Health Health Care Care Act provid providing ing for the establ establish ishmen mentt of a Reprod Reproduct uctive ive Health Health Clinic Clinic will will also also design design and implem implement ent sustai sustained ned reprod reproducti uctive ve health health education program for women and men (DavaoToday 2007). "We don't want this to be viewed as merely a police criminal report. It is not just to pursue who these women are and punish them," she said. She said abortion is related to other women's issues that have to be addressed. For Trinidad, women are victims in this case, not the perpetrators. Trinidad said the fetus dumping cases made it more urgent to put up the clinic so that there will be a venue to discuss abortion and other reproductive health issues with the public thoroughly (MindaNews 2007). Recommendations
In the Philippines, women’s willingness to seek abortions from untrained providers and in unhygienic places, using techniques such as painful massages and ingestion of bitter herbs, and to try again and again when a method fails, makes it clear that legal barriers are not preventing abortions from taking place. What will reduce abortion is helping women and couples get better information about sexuality, reproductive health and contraception, and better access to modern contraceptives, so they can prevent unintended pregnancies. For national, regional and local policymakers, and government agencies at all levels, this means taking the necessary steps to address this problem.
LITERATURE LITERATURE CITED
CONDE, C.H. MAY 16, 2005. Philippines abortion crisis: Religious women trun o illegal procedures. Manila date accessed 9 January 2008. DavaoToday. 2007. Dumped Fetuses in Davao Annging. this> date January 2008.
Worries accessed accessed 9
HENSHAW, S.K., S. SINGH, and T. HAAS. 1999. International Family Planning Perspectives, 1999, 1999, 25(Sup 25(Supple plement ment):S ):S30–S 30–S38. 38. The Inciden Incidence ce of Aborti Abortion on Worldwi orldwide. de. The Alan Alan Guttmacher Institute. g/pubs/journals/25s3099.html> ouths hs urge Dav Davao ao bet betss to pri priorit oritize ize rep reprod roducti uctive ve Macl Macla, a, J. L. 2007 2007.. Dava Davao o Today oday.. Yout health
MindaNews.2007. date accessed 9 January 2008. Pro-Life Philippines. 2005.< http://www.prolife.org.ph/page/abortion4> date accessed 9 January 2008. Quito, S.G. October 22, 2007. SPECIAL REPORTABORTION: SILENT SCREAM. Women Consider Abortion An Escape. SING SINGH, H, S., S., F. JUAR JUAREZ EZ,, J. CABI CABIGO GON, N, H. BALL BALL,, R. HUSS HUSSAI AIN, N, J. NADE NADEAU AU.. 2006 2006.. Unin Uninte tende nded d Preg Pregna nancy ncy and and Induc Induced ed Abor Aborti tion on in the the Phil Philip ippi pine nes: s: Caus Causes es and Consequences, New York: Guttmacher Institute. 44 p. Wikipedia, 2008. Abortion in the Philippines. > date accessed accessed 9 January January 2008.
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