Birth Control Bill Has Enemies in Philippines - NYTimes.com

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By CARLOS H. CONDE

MANILA — Gina Judilla already had three children the first time she tried to terminate a pregnancy. “I jumped down the stairs, hoping that would cause a miscarriage,” she said. The fetus survived and is now an 8-year-old boy.

Three years later, pregnant again, she drank an herbal concoction that was supposed to induce abortion. That, too, failed.

Three years ago, in another unsuccessful attempt to end a pregnancy, she took Cytotec, a drug to treat gastric ulcers that is widely known in the Philippines as an “abortion pill.”

What drove Ms. Judilla, a 37-year-old manicurist, to such extreme measures is a story familiar to many Filipino women. She and her unemployed husband are very poor, barely able to buy vitamins for their youngest child or to send more than two of their older children to school.

“When I had my third child, I swore to myself that I will never get pregnant again because I know we could not afford to have another one,” Ms. Judilla said in a recent interview inside her home in Pasig City, on the eastern outskirts of Manila.

Abortion is illegal in the Philippines, though birth control and related health services have long been available to those who can afford to pay for them through the private medical system. But 70 percent of the population is too poor and depends on heavily subsidized care through the public health system. In 1991, prime responsibility for delivering public health services shifted from the central government to the local authorities, who have broad discretion over which services are dispensed. Many communities responded by making birth control unavailable.

More recently, however, family planning advocates have been making headway in their campaign to change this. Legislation before the Philippine Congress, called the Reproductive Health and Population Development Act, would require governments down to the local level to provide free or low-cost reproductive health services — from condoms and birth control pills to tubal ligation and vasectomy. It would also mandate sex education in all schools, public and private, from fifth grade through high school.

Supporters of the bill cite urgent public health needs. A 2006 government survey found that between 2000 and 2006, only half of Filipino women of reproductive age used birth control of any kind.

According to the Guttmacher Institute, a nonprofit organization based in the United States that works to advance reproductive health, 54 percent of the 3.4 million pregnancies in the Philippines in 2008 were unintended. Most of these unintended pregnancies — 92 percent — resulted from not using birth control, the institute said, and the rest from birth control that failed.

These unintended pregnancies, the institute says, contributed to an estimated half-million abortions that same year, despite the ban on the procedure. Most of these abortions are done clandestinely and in unsanitary conditions. Many women resort to crude methods like those Ms. Judilla attempted.

Moreover, maternal deaths in the Philippines are among the highest in the region: 230 for every 100,000 live births, compared with 110 deaths in Thailand, 62 in Malaysia and 14 in Singapore, according to the United Nations Population Fund.

The bill’s main proponent in Congress, Representative Edcel C. Lagman, also argues the need for a check on population growth in the interest of national welfare. The Philippine population is estimated at 92 million and is growing at more than 2 percent annually, one of the highest rates in Asia. “Unbridled population growth stunts socioeconomic development and aggravates poverty,” Mr. Lagman wrote in an op-ed column in The Philippine Daily Inquirer.

But attempts to make reproductive services more broadly available met stiff resistance, leading to the defeat of several earlier bills over the past decade.

The main opposition in this overwhelmingly Roman Catholic country has come from the church and affiliated lay organizations, which say the proposed law would legalize abortion.

One organization, the Catholic Alumni United for Life, said in a position paper that the legislation would promote abortion by financing abortion-inducing drugs, and therefore “violates explicit Catholic teaching.” Bill supporters counter that the legislation says birth control pills should be made available but that these do not constitute abortion-inducing drugs.

The Rev. Melvin Castro of the Episcopal Commission on Family and Life of the Catholic Bishops Conference of the Philippines said the Catholic Church and the laity would fight the bill, if passed into law, up to the Supreme Court.

“The Constitution is very clear that the state should protect life from conception up to its natural end,” Father Castro said in an interview. “Regardless of their religion, Filipinos are God-fearing and family-loving. This bill will change that culture.”

Still, proponents of the bill are optimistic, noting that this is the first time such legislation has won the support of the House committee on health. They also cite opinion surveys that show support for the bill and hope it can be passed before Congress adjourns in June.

It seems certain that debate over the legislation will heat up with the approach of the May national elections. Father Castro said the church wanted the bill to be an election issue.

“The more time is given to all the parties concerned to debate the bill, everybody will come to realize that there is no need for it,” he said.

Already, the church has issued statements calling on Senator Benigno Aquino III, expected to be the opposition’s presidential candidate, to oppose the bill. Mr. Aquino, the son of the late president Corazon Aquino, who was extremely close to the church, has said he would not do this.

President Gloria Macapagal Arroyo, who is barred from running for another term, has been sending mixed signals of late about her position. In previous statements, however, has said she would let her Catholic faith guide her. “My faith has a very, very strong influence on me,” she said in a speech last year.

Other politicians, particularly those on the local level, have chosen to side with the church. In 2000, Jose Lito Atienza, who was mayor of Manila at the time, issued an executive order ending government-financed birth control in the capital. Condoms and other contraceptives were removed from government clinics and hospitals. Patients who asked for them were turned away.

Mr. Atienza, who is now the environment secretary, defends his order as “the right thing to do.”

“Contrary to what many are saying, that policy was meant to protect women, to protect their wombs from those who want to take away life,” he said.

Passage of the reproductive health bill would automatically nullify Mr. Atienza’s order, said Clara Rita A. Padilla, executive director of EnGendeRights, a nonprofit group that supports the bill. “The poor women of this country need this law to protect them,” she said.

Some communities have taken a different approach. In 2005, Rodrigo Duterte, mayor of the southern city of Davao, offered 5,000 pesos, or roughly $100, to anyone who would undergo a vasectomy or tubal ligation. The church authorities responded by saying they would remove women’s IUDs for free.

Ms. Judilla’s community did not have the same restrictive policy as Manila — there were simply no contraceptives available when she visited the public clinic, a situation the legislation promises to change. She said she had decided against tubal ligation when she was told that she would not be able to work for a week after the surgery.