My Take on the Reproductive Health Bill (Part 1)

For the first time in so many years and congresses, the debate on the Reproductive Health Bill has finally reached the Plenary. The debates are now raging, not just in the session hall but even in the media, with particular emphasis in print through the successive paid ads by the opposing groups.

In previous congresses, the bill did not make it beyond the committee hearings. On hindsight, it was a blessing in disguise, since it gave the bill time to be refined so as to become more palatable to a wider social spectrum. The bill in its present form is far from what the original bill used to be, which could be said to have been crude in present terms.
All the debates over the years have contributed to revisions and inputs that addressed the concerns from various sectors.

In all these discussions on the proposed measure, legislators are asked one basic and compelling question----“Where do you stand on Reproductive Health?”

I was in a forum with students of the Ateneo de Naga last month, and during the open forum, I was asked that question. Immediately, the thought that came to my mind was the fact that only a couple of weeks before, the university held a rally against Reproductive Health. Of course, that thought was quickly followed by a question to myself…How should I answer?

I answered the students’ question with a story. I related to them my grassroots experience, particularly with my constituents whom I deal with in the everyday performance of my job.

I told them the story of Grace, a constituent of mine who lives along the railroad tracks, one of thousands of informal settlers along the stretch of the right of way of the Philippine National Railways which cuts through 8 of the 9 barangays of Muntinlupa City.

Grace is 25 years old, and pregnant. I met Grace during one of my community visits and when I saw her bulging stomach, I asked her if it was her first baby, as is my habit whenever I see a pregnant woman during my rounds in the city. She said no, it is her fifth child, with the first one born when she was 18. Her husband is employed as a laborer, but only has work every now and then.

Asked if it was their desire to have that much children, she said if she had her way, she would have stopped having kids after the second. But they didn’t practice any family planning method since they didn’t know anything about it. She also said that when her husband comes home intoxicated with liquor, she has no way to turn down his advances. Lest he gets mad and violent. Obviously, Natural Family Planning will not work for her.

Other stories of my constituents include that of Marissa, a first time mother who was eight months pregnant when she availed of the free pre-natal medical mission that my office conducted. Marissa and her husband live with her mother in law in one of the urban poor communities in Muntinlupa. While she was waiting in line, one of the barangay health workers assisting us requested me to let Marissa go in front of the line, since she wasn’t feeling well and was bloated. I took a look at her and indeed, saw that her ankles were swollen, indicative of edema and pre-eclampsia.

I let her go in front of the line to see the OB-GYN and have an ultra-sound of her belly. The image revealed that Marissa’s baby was being compressed by an enlarged placenta and what appeared to be a myoma. The placenta also had dark blotches, indicative of an internal bleeding.

We immediately sent Marissa to the hospital, since it was determined that hers was an emergency medical condition. When we interviewed her, she admitted that it was the first time she had a pre-natal check up, since she did not have the money to go to a doctor, even in a government hospital. She said instead of spending for the fare going to the clinic, she just saves it up for their daily needs and saving for the baby’s needs when the baby is born.

Another story is that of Vilma, a utility worker in one of the Muntinlupa elementary schools. Aged 27, she has 3 children and her husband is a construction worker. Together, they earn around 10,000 pesos a month. After her third child, she decided to have a ligation because she felt that with three children to take care of, they wouldn’t be able to afford having an additional child without having to sacrifice some needs of the kids they already have. I asked her why she chose to have a ligation. Slightly embarrassed, she said she wanted to stop having children while at the same time fulfill her “marital obligations” to her husband. With a giggle, said it’s better than her husband find satisfaction elsewhere.

In a similar mindset is Rhodora, a school teacher who had a ligation after her second child, which was a special child. After her second kid, she wanted to have enough time and resources to attend to the needs of her special child, not to mention her first child as well. So she consulted her gynecologist and requested that the she undergo the procedure.

Her doctor refused, saying it is against his beliefs to do the procedure. Rhodora asked for a referral, and she was referred to a colleague of the doctor. But just like the first doctor, the second one also refused, trying to convince her not to proceed, citing that it is immoral. In the end, Rhodora had to look again for another doctor, since it she felt that the service she is looking for is being denied her on the grounds of personal beliefs of the doctors.

These are just some of the stories that I commonly encounter among my constituents. Such situations are most common in the poorer communities, resulting in high incidence of malnutrition, school drop-outs, maternal and infant death, birth complications and scarcity of family resources.

Since I regularly hold medical missions in my district, I get first hand experience and information on the health conditions in the communities. Hygiene is often a problem, especially that families live in confined spaces in the urban poor communities, so the spread of disease is more likely. One of my regular activities is the conduct of prenatal medical missions, There is not a mission where we do not encounter pregnant teenagers, the youngest of which has been 14 years old.

For example, not many people know that cervical cancer may be spread through sexual contact. Cervical cancer is caused by the Human Papilloma Virus, the cause of the common wart, which may be passed from male to female. Not many people know that hygiene plays an important part in preventing the spread and cause of cervical cancer, as well as prudent sexual practices. More importantly, not many know that cervical cancer is easy to detect and cure if diagnosed early. This is because there is no policy on reproductive health.

The fact of the matter is that many of the health problems encountered in the grassroots may be attributed to the lack of reproductive health services available to the people. While some limit themselves to the issue of population and birth control in the discussions about RH, the bill is not only about population and sex. It is more about the delivery of services to the people who are in need of it. The absence of a policy opens people up to medical risks and leaves them nowhere to go but to unreliable, ineffective and sometimes life threatening remedies.

A case in point is the proliferation of vendors right beside the Quiapo church who openly sell concoctions labeled “Pang-pa Regla”. It is common knowledge that many of those who patronize those vendors do so with the intention of getting rid of unwanted pregnancies. Even if they weren’t pregnant and just wanted to have regular menstruation, it is still the wrong place to go for treatment or service.

This is not to say that having Reproductive Health services will enable the availability of abortion. The bill expressly maintains that abortion continues to be illegal in the country. To say that the bill legalizes abortion is an outright lie and deception. My point in citing the “pang-pa regla” vendors is the fact that the absence of reproductive health services and information leads to people’s ignorance about reproductive health issues and their body’s reproductive systems. If they had the right information and services available, they would know that availing of the products sold by those vendors would not only be ineffective, it may even be harmful.

The intentions of the bill’s authors and supporters are not to legalize abortion, spread a culture of promiscuity or destroy the family. It is the intention of the bill’s authors and supporters to meet the needs of a significant portion of the population for reproductive health services and information. There is absolutely no intention to impose on couples particular methods that they should employ in planning their families. It is the intention of the bill to provide information to people about responsible parenthood, family planning, avoiding unwanted pregnancies and an informed choice on which method best fits their beliefs, convictions and needs.

To continuously insist that there are other ulterior motives other than the welfare of Filipino couples and families is to deny the existence of the problems faced daily by the people. To stop the adoption of a public policy on reproductive health is a denial of service to those who seek reproductive health care.

Some make it seem that the bill if passed into law will force people to use contraceptives. Even without the bill, contraceptives are available in the commercial market. What is not available in the present regime is the correct information about contraceptives and reproductive health. What the bill will provide if passed into law, is reliable and uniform information and services which people may avail of if they so desired. Whether it is modern or natural family planning method, the couple is left to decide after being properly informed.

Why do I support the bill?

Because there are those who have signified the need to have the correct information and reliable reproductive health services .

Because I have seen first hand during my service to my constituents the consequences of the continued denial of information and service to the people.

Because there are women whose bodies have been ravaged by multiple consecutive pregnancies even if they had not planned it.

Because there are women who have been physically abused by their husbands because they refused to indulge their spouses because “it is not the right time”.

Because I have seen too many teenage pregnancies which could have been avoided had these young women been informed about their adolescent reproductive system.

Because I have seen too many complications in pregnancies and births from the poor constituents that come to my office for medical assistance.

Because I have seen too many infant and maternal deaths, orphaned children, bereaved husbands.

Because I have seen children dropping out of school because their parents cannot afford to send all their children to school at the same time.

Because there are many malnourished children whose ability to learn has been impaired.

Because I have constituents who have acquired diseases that could have been prevented if only there was appropriate information and service available to them.

Some might say that instead of supporting the proposed measure, we should just allocate enough resources to other services such as education, housing and the eradication of corruption. There is no doubt to that. We should do those things. We are trying to do those things. But at the present situation, even if we are able to provide the right number of classrooms, the right number of teachers and all the books that the students need, the ability of poor families to send their children to school is hampered by their absolute lack of resources to provide for the cost of sending the kids to school ----- transportation, snack, uniforms, other miscellaneous requirements, etc.

Statistics show that of 10 children who enter elementary school, only 6 go on to high school, and only 2 finish high school. And based on actual experience in my district, it is not due to the lack of classrooms or teachers. It is the day to day difficulty of surviving through life with the severely limited resources of poor families. Bottomline is, how can a child who does not finish studies lead the ideal productive life?

The intention is not to prescribe a limit on the number of children but to enable couples to decide their family size based on correct information and according to their desired number of children and capability to provide support.

Those who oppose the bill cite various statistics and studies all done abroad. I’m taking a position that is based on what I see with my own eyes as I perform my duties. I see the living conditions of my constituents on a daily basis, especially many of them come to my office to seek assistance for various reasons---health, education, livelihood, etc. On the other hand, I also see what government is trying to do with the little it has to serve the needs of the people.

It is unfair to those who support the bill to be labeled “anti-life”, “anti-family”, “pro-abortion” and many other monickers on the basis of a pre-conceived notions. If there is anyone who desire the best for the Filipino family, that would be the one who is most familiar to the daily struggles of the poor families. The question should not only be whether you are pro-life or not (because there is absolutely no one who is anti-life), but also if the people deserve quality of life.