Lorna Villar gave birth seven times in 14 years. After her last pregnancy pushed the 34-year-old’s blood pressure to dangerous levels, the Manila mom says contraception became a life or death matter.
Villar now lines up in a crowded clinic between an auto repair shop and a kiosk selling sodas to avoid more pregnancies. The intrauterine device she had inserted free by a charity puts her among the 34 percent of Filipino women ages 15 to 49 using modern birth control -- about the same proportion as in Myanmar and Iraq, United Nations data show.
“It’s such a relief to know I won’t fall pregnant again,” says Villar, sitting on the concrete floor of her windowless, 20 square meter (215 square feet) home in Tondo, one of Manila’s poorest neighborhoods. The 7,000 pesos ($160) a month her husband makes driving cranes and ferrying people in a tricycle taxi is barely enough to live off, she says.
One in five women of reproductive age in the Philippines have an unmet family planning need, the UN Population Fund says, leading to unintended pregnancies and population growth twice the Asian average. Relief may come from a reproductive health bill backed by President Benigno Aquino that promises free or subsidized contraception, especially for the poor, says Ugochi Daniels, the fund’s country representative in the Philippines.
“This bill is the silver bullet to make the problem more manageable,” says Carlos Celdran, an activist in Manila who was jailed for a day after a protest he staged at a 2010 bishop’s meeting in the city’s cathedral. “How can people not see this as an emergency situation?”
The bill has been re-filed and blocked in each three-year congressional term since it was introduced in legislature 14 years ago amid opposition from the Catholic Church -- the faith of at least 80 percent of the nation’s 95 million people. This time, with presidential support, it may be put to a vote in congress in three months.
“It’s the closest it’s come to being legislated,” said Ramon San Pascual, executive director of Manila-based lobby Philippine Legislators’ Committee on Population and Development Foundation Inc. “If it doesn’t get voted on in June, we may have to wait another two years.”
Likhaan, the non-governmental organization running the women’s health center where Villar had her IUD fitted, says the bill will curb poverty by reducing unplanned pregnancies for young, working-age women, improving their household finances. State assistance will also reduce the queues at the clinic, run out of a lime-green, single-story building, where women wait as long as two hours for condoms, birth-control pills and other contraceptives.
Using artificial contraception “is a denial of the natural life-giving powers that God gave us,” said James Imbong, assistant legal counsel to the Catholic Bishops’ Conference of the Philippines. “Who are we to say that five children are too many? Children are gifts. If you interfere with that, you are denying that creative role God gave us.”
The Philippines doesn’t have a national reproductive health policy, the Population Fund says, giving it no mandate for state-supported family planning services or a standardized model for school-based sex education. That leaves low-income families like Villar’s turning to non-governmental organizations and charities for help.
While the wealthiest 20 percent of women in the country have an average of 1.9 babies, the poorest fifth deliver 5.2, according to the 2008 National Demographic and Health Survey. In the bottom income bracket, 44.1 percent of women aged 15 to 24 had begun childbearing, according to the survey, more than three times of those in the same age range of the wealthiest quintile.
Thirty-seven percent of pregnancies in the Philippines are unplanned, according to World Health Organization data. Of those, more than a third end in abortion that’s illegal and often unsafe, the Guttmacher Institute, a New York-based sexual and reproductive health policy researcher, says.
If the contraceptive pill, condoms, intrauterine devices and other means of modern birth control were extended to all women at risk of unintended pregnancies, there would be 2,100 fewer maternal deaths and 500,000 fewer induced abortions each year, the Guttmacher Institute says. The country’s progress on improving reproductive care means the Philippines has a “low” probability of attaining UN Millennium Development Goals on maternal health, according to the UN Development Programme.
“The Philippines can definitely do much better in terms of reproductive-health goals if they want to sustain their development,” says Saramma Mathai, team coordinator and maternal health adviser for the UN Fund’s Asia Pacific Regional Office in Bangkok.
The Philippine economy grew 3.7 percent last year, slower than the 5.8 percent average clip for Southeast Asian neighbors Indonesia, Malaysia and Vietnam, according to data compiled by Bloomberg.
Among ages 15 to 24, premarital sexual activity increased to 23 percent in 2002 from 1994, according to a 2004 University of the Philippines Population Institute study. The Church says giving teens contraceptives will push that rate even higher.
“There are no circumstances where the Church supports the use of contraceptives for the purposes of preventing conception,” said John Haas, president of the Philadelphia-based National Catholic Bioethics Center, who was appointed as an ordinary member of the Pontifical Academy for Life at the Vatican by Pope Benedict XVI. Instead, the church recommends natural family planning, where married couples refrain from sex at times of the menstrual cycle when the woman is most likely to conceive, he said.
“When one uses contraception, it violates what makes sense of marriage of a man and a woman coming together: the child,” said Haas, who has nine children. “If children didn’t result from copulation, there wouldn’t be the institution of marriage. Marriage is to protect children that arise from sexual relations.”
The self-rated poverty rate last year was 52 percent, according to SWS, a nonprofit social research institution. In 1986, when Ferdinand Marcos’s presidency ended and the country had 39 million fewer people, the rate was 66 percent.
“We are close to hitting 100 million people,” says Celdran, the reproductive health activist. “People say if we keep trying to teach the poor, we will solve this problem. That’s shocking.”