On December 10 the world will celebrate World Human Rights Day. This event is especially meaningful to Soroptimists because of the numerous human rights conventions, covenants and proclamations that affirm and uphold the basic human rights of women – rights which have been denied them for centuries.

It would not be an exaggeration to say that these human rights conventions and covenants which protect, promote and fulfill the rights of women were instrumental to the creation of civic organizations such as Soroptimist International which focuses on the upliftment of the lives of women and girls.

I am therefore heartened that your organization has chosen to discuss the reproductive health bill as the highlight of your Human Rights Day celebrations. This is clearly an acknowledgement of the fact that the right to reproductive health, including the right to plan one’s family, is a vital and indispensable right of all people, but principally of women, who bear the brunt of pregnancy, childbirth and childcare.

Forty years ago, the International Conference on Human Rights in the Proclamation of Teheran articulated unequivocally that “The protection of the family and of the child remains the concern of the international community. Parents have a basic human right to determine freely and responsibly the number and spacing of their children.” The Philippines is a signatory to this convention.

But even up to now, this right remains illusory for 2.6 million Filipino women who, according to the 2006 Family Planning Survey, would like to plan their families but lack information and access to do so.

With the poorest of our sisters still having an average of six children, which is almost three times their desired number of children, and with 44% of their pregnancies unwanted, it is clear that the most poverty-stricken women in the country are denied their basic human right to plan their families.

While the RH bill assures an enabling environment where women and couples have the freedom of informed choice on the mode of family planning they want to adopt based on their needs, personal convictions and religious beliefs, RH is certainly not merely about contraceptives and family planning.

ELEMENTS OF RH - Family planning is only one element of reproductive health. Equally important are the other elements of RH which include: (1) maternal, infant and child health and nutrition; (2) promotion of breast feeding; (3) prevention of abortion and management of post-abortion complications; (4) adolescent and youth health; (5) prevention and management of reproductive tract infections, HIV/AIDS and STDs; (6) elimination of violence against women; (7) counseling on sexuality and reproductive health; (8) treatment of breast and reproductive tract cancers; (9) male involvement and participation in RH; (10) prevention and treatment of infertility; and (11) RH education for the youth.

It is a pity that the debate has been confined to contraceptives because the other elements of RH, which will similarly protect and promote the right to health and reproductive self-determination, have been largely ignored.

MIDWIVES FOR SKILLED BIRTH ATTENDANCE – The bill supports safe motherhood. It proposes that every city and municipality shall endeavor to employ an adequate number of midwives and other skilled attendants. This will help prevent maternal and infant mortality which are both alarmingly high in the country. Currently, only 57% of Filipino women give birth with the assistance of a trained medical professional.

EMERGENCY OBSTETRIC CARE - Each province and city shall endeavor to ensure the establishment and operation of hospitals with adequate and qualified personnel that provide emergency obstetric care. If we are to make headway in our commitment to the Millennium Development Goals (MDGs) to lower infant mortality and improve maternal health, it is imperative to provide emergency obstetric care to those who need them. The miracle of life should not mean death for 10 mothers daily and the importance of facilities that can provide life saving services to pregnant women cannot be overemphasized.

HOSPITAL-BASED FAMILY PLANNING - Family planning methods requiring hospital services like ligation, vasectomy and IUD placement shall be available in all government hospitals. Maternal and infant mortality and morbidity are public health concerns that government can address if effective and long-term methods such as IUDs and permanent methods like ligation and vasectomy are readily available in government hospitals – the health facilities the poor and marginalized regularly utilize.

CONTRACEPTIVES AS ESSENTIAL MEDICINES - Reproductive health products shall be considered essential medicines and supplies and shall form part of the National Drug Formulary. The classification of contraceptives as essential medicines will help the poorest of our women, who continue to have an average of six children, avoid unplanned pregnancies and maternal death. Both the WHO and UNFPA have declared that contraceptive use can prevent 1/3 of all maternal deaths.

Our maternal mortality rate which is pegged at 162 deaths out of every 10,000 live births is both alarming and insidious. Fourteen percent of all deaths in the female population can be attributed to pregnancy and childbirth-related causes (DOH and NDHS 2003). This is unacceptable. No woman should die giving life to another human being.

It should be underscored that modern contraceptives are included in the World Health Organization Model List of Essential Medicines. Their inclusion in the National Drug Formulary will enable government to purchase contraceptives and not merely rely on unpredictable donations.

REPRODUCTIVE HEALTH EDUCATION – RH education in an age-appropriate manner shall be taught by adequately trained teachers from Grade 5 up to 4th Year High School. As proposed in the bill, core subjects include values formation; prevention and avoidance of sexual advances and molestation from acquaintances and strangers; parts and functions of the reproductive system; responsible parenthood; natural and modern family planning; proscription and hazards of abortion; reproductive health and sexual rights; abstinence before marriage; and responsible sexuality, among others.

Sexuality education seeks to assist young people in cultivating a positive view of sexuality; provide them with information and skills about taking care of their sexual health; and help them make sound decisions now and in the future. It has also has been shown to make adolescents more sexually responsible and adds a level of maturity to their attitudes towards sexual relations.

Formal education on RH and sexuality is necessary because of the parental default at home where conversations on sex is traditionally taboo.

Moreover, an SWS survey released only last month shows that 76% of Filipinos approve of the teaching of family planning to the youth. Family planning encompasses reproductive health and sexuality education.

EMPLOYERS’ RESPONSIBILITIES - Employers shall respect the reproductive health rights of all their workers. Women shall not be discriminated against in the matter of hiring, regularization of employment status or selection for retrenchment. Employers shall provide free reproductive health services and commodities to workers, whether unionized or unorganized.

These are all restatements and improvements of existing provisions of the Labor Code and prevailing Collective Bargaining Agreements (CBAs).

CAPABILITY BUILDING OF COMMUNITY-BASED VOLUNTEER WORKERS - Community-based workers shall undergo additional and updated training on the delivery of reproductive health care services and shall receive not less than 10% increase in honoraria upon successful completion of training. This will improve the ability of our barangay health workers to deliver relevant RH information and services.

CERTIFICATE OF COMPLIANCE - No marriage license shall be issued by the Local Civil Registrar unless the applicants present a Certificate of Compliance issued for free by the local Family Planning Office certifying that they had received adequate instructions and information on family planning, responsible parenthood, breastfeeding and infant nutrition.

PROHIBITED ACTS – The following persons, and no one else, shall be held liable for prohibited acts, as follows:

1. Public and private health care providers who:    

(a) Knowingly (with malicious intent) withhold or impede the dissemination of information about the programs and services provided for in this Act or intentionally give out incorrect information;

(b) Refuse to perform voluntary ligation and vasectomy and other legal and medically-safe reproductive health care services on any person of legal age on the ground of lack of spousal consent or authorization;

(c) Refuse to provide reproductive health care services to an abused minor and/or an abused pregnant minor, whose condition is certified to by an authorized DSWD official or personnel, even without parental consent which is not necessary when the parent concerned is the perpetrator;

(d) Fail to provide, either deliberately or through gross or inexcusable negligence, reproductive health care services as mandated under this Act; and

(e) Refuse to extend reproductive health care services and information on account of the patient’s civil status, gender or sexual orientation, age, religion, personal circumstances, and nature of work: Provided, That all conscientious objections of health care service providers based on religious grounds shall be respected: Provided, further, That the conscientious objector shall immediately refer the person seeking such care and services to another health care service provider within the same facility or one which is conveniently accessible: Provided, finally, That the patient is not in an emergency or serious case as defined in RA 8344 penalizing the refusal of hospitals and medical clinics to administer appropriate initial medical treatment and support in emergency and serious cases.

2. Any public official who prohibits or restricts personally or through a subordinate the delivery of legal and medically-safe reproductive health care services, including family planning (inaction is not culpable).

3. Any employer who shall fail to comply with his obligation under Section 17 of this Act or an employer who requires a female applicant or employee, as a condition for employment or continued employment, to involuntarily undergo sterilization, tubal ligation or any other form of contraceptive method.

4. Any person who shall falsify a certificate of compliance as required in Section 14 of this Act.

5. Any person who maliciously engages in disinformation about the intent or provisions of this Act.

Now that I have discussed the most relevant provisions of the RH bill, I would like to clarify some of the misconceptions about the measure.

THE BILL IS NOT ANTI-LIFE. It is pro-quality life. It will ensure that children will be blessings to their parents since their births are planned and wanted. It will empower couples with the information and opportunity to plan and space their children. This will not only strengthen the family as a unit, it will optimize care for fewer children who will have more opportunities to be educated, healthy and productive.

It must be repeatedly underscored that the bill is not against the birth of children. It does not advocate that women and couples stop having children. What it aims to do is to help women and couples achieve their fertility goals.

If they want two children, then family planning will help them have two children. If they want three, family planning, whether natural or modern, will help ensure that they have only three. If a couple wants eight children, they have all the right to have eight if they so desire. But without family planning, they would more likely have nine, or 10 or 11 children, not the eight they originally wanted.

THE BILL DOES NOT FAVOR MODERN FAMILY PLANNING METHODS OVER NFP. Both natural and modern family planning techniques are contraceptive methods. Their common purpose is to prevent unwanted pregnancies and the bill does not impose a bias for either method. Section 3(a) of the bill unmistakably provides: “In the promotion of reproductive health, there should be no bias for either modern or natural methods of family planning.”

The bias of the government is actually for natural family planning methods because currently, the POPCOM is promoting only NFP even though only 27% of women employ NFP and traditional methods compared to the 73% who use modern methods.

It is actually this present policy that should elicit the outcry that is directed towards HB 5043. Because the bill in fact democratizes family planning because it will make available to couples all possible family planning methods and not just NFP methods preferred by the Catholic Church.

Central to the bill is freedom of informed choice. Limiting the choice of family planning method to either only modern or natural will negate this fundamental freedom. This is why authors of the bill insist that they will not allow “killer amendments” to the measure that will remove contraceptives from the menu of family planning options.

This is a killer amendment not because the bill is anchored on the distribution of modern contraceptives but because such an amendment will dilute the right of women and couples to make informed family planning decisions if they will be ultimately compelled to choose NFP for lack of other choices.

THE BILL DOES NOT LEGALIZE ABORTION AND WILL NOT LEAD TO ITS LEGALIZATION. The measure repeatedly underscores that abortion is illegal, criminal and punishable, and is not part of the menu of legally permissible and medically safe family planning methods.

Moreover, the use of contraceptives will not lead to the legalization of abortion. Catholic countries like Panama, Guatemala, Brazil, Chile, Columbia, Dominican Republic, El Salvador, Honduras, Nicaragua, Venezuela, Paraguay and Ireland all prohibit abortion as a family planning method even as they vigorously promote contraceptive use. Muslim and Buddhist countries like Indonesia and Laos have likewise liberalized the use of contraceptives but still continue to criminalize abortion.

There is also an inverse correlation between contraceptive use and abortion. The regular and correct use of contraceptives drastically reduces abortion rates since unplanned and unwanted pregnancies are avoided. Consequently, women do not have to resort to abortion and the State will find no need to legalize abortion.

IT DOES NOT ENDORSE ABORTIFACIENTS. Hormonal contraceptives are BFAD-approved, medically safe and legal. They do not cause a “medical abortion” or “hidden abortion” as claimed by critics of the bill.

The primary mechanism of pills and injectables is to suppress ovulation. If no egg is released, how can there be an abortion? They also prevent the sperm from reaching the egg. If fertilization is avoided, how can there be a fetus to abort? Articles in peer-reviewed medical journals testify that IUDs do not cause abortions because they stop fertilization. A recent study revealed that not a single fertilized egg was recovered from the fallopian tubes of women using IUDs proving that they are amazingly successful in preventing fertilization.

The UNDP, UNFPA and WHO have submitted to the House of Representatives an expert opinion on the mechanisms of modern contraceptives and they state that contraceptives “cannot be labeled as abortifacients” as none of these methods have been shown to cause abortions.

The bill is truly anti-abortion. It will tremendously reduce the incidence of abortion in the country which in 2002 has been recorded to be about 470,000. Data also show that it is not single women and teenagers but poor, married, Catholic women in their 20s who most often undergo abortions because they cannot afford another child.

CONTRACEPTIVES DO NOT HAVE LIFE THREATENING SIDE-EFFECTS. Medical and scientific evidence show that all the possible medical risks connected with contraceptives are infinitely lower than the risks of an actual pregnancy and everyday activities. The risk of dying within a year of riding a car is 1 in 5,900. The risk of dying within a year of using pills is 1 in 200,000. The risk of dying from a vasectomy is 1 in 1 million and the risk of dying from using an IUD is 1 in 10 million. The probability of dying from condom use is absolutely zero. But the risk of dying from a pregnancy is 1 in 10,000.

Although pregnancy is not a disease, it is fraught with risks, especially for women who have too many children or unremitting pregnancies or those who are more than 35 years old or younger than 18 years. Persistently high maternal mortality is a violation of women’s right to health and life.

THE BILL WILL NOT PROMOTE CONTRACEPTIVE MENTALITY. The bill does not prohibit pregnancy. Critics are mistaken in claiming that because contraceptives would be readily accessible, people would prefer to have no children at all. Couples will not stop wanting children simply because contraceptives are available. Contraceptives are used to prevent unplanned pregnancies but not to stop pregnancies altogether. Timely pregnancies are assured.

Human beings have the primal desire to reproduce and propagate their genes. This bill cannot undo millions of years of evolution. People will not stop wanting children of their own just because they can avail themselves of family planning services.

It is erroneous to conclude that HB 5043 aims to promote a “contraceptive mentality” that would give rise to abhorrence for children. On the contrary, it is precisely the high value the authors of the bill place on the lives of children and the recognition of the importance of ensuring that they are born healthy and wanted that spurs me and my colleagues to push for the passage of this measure.

SEXUALITY EDUCATION WILL NOT PROMOTE PROMISCUITY. Age-appropriate RH education promotes correct sexual values. It will not only instill consciousness of freedom of choice but responsible exercise of one’s rights. The UN and countries which have youth sexuality education document its beneficial results like understanding of proper sexual values; initiation to sexual relations is delayed; abstinence before marriage is encouraged; multiple sex partners is avoided; and spread of sexually transmitted diseases is prevented.

Parents who do not allow their children to attend RH and sexuality education classes will not be prosecuted and jailed. The provision on Prohibited Acts does not include parents who raise objections.

THE BILL DOES NOT CLAIM THAT FAMILY PLANNING IS THE PANACEA TO POVERTY. It simply recognizes the verifiable link between a huge population and poverty. Unbridled population growth stunts socio-economic development and aggravates poverty. The connection between population and development is well-documented and empirically established.

UN Human Development Reports show that countries with higher population growth invariably score lower in human development. Last year, the Philippines, as the 12th most populous country, ranked No. 84 out 171 countries in the Human Development Index rankings made annually by the United Nations. This year, we are down to No. 90. We went down by six points, making the Philippines the worst performer among Southeast Asian countries.

The Asian Development Bank in 2004 also listed a large population as one of the major causes of poverty in the country. Recent studies also show that large family size is a significant factor in keeping families poor across generations.

However, the authors of the bill do claim that the bill will help promote sustainable human development. The UN has stated that “family planning and reproductive health are essential to reducing poverty” The UNICEF also asserts that “family planning could bring more benefits to more people at less cost than any other single technology now available to the human race.”

FAMILY PLANNING WILL NOT LEAD TO A DEMOGRAPHIC WINTER. The proposition that modern family planning will wipe off the Filipino race in a catastrophic “demographic winter” is a scare tactic which fails to comprehend the dynamics of population momentum or the continuous increase in population even though replacement levels have been reached.

UP Economics professors in their paper entitled “Population and Poverty: The Real Score” state that a so-called demographic winter will not happen in the country for “at least another 100 years”.

According to the projections of the National Statistics Coordination Board, replacement fertility of 2.1 children will be achieved only by 2040. However, the effects of “population momentum” will go on for another 60 years by which time the population of the country would have reached 240 million.

AN RH LAW WILL NOT BE SUPERFLUOUS. It is a myopic view that since contraceptives are available in the market, there is no need to enact a law on reproductive health and family planning. This contention overlooks that availability does not mean access, particularly to those who are uninformed or could not afford to buy reproductive health supplies. Availability does not assure adequate and accurate information on family planning and reproductive health which are basic universal human rights.

There are 12.86 million currently married women of reproductive age in the country. But we have a contraceptive prevalence rate of only 49.3% (2006 Family Planning Survey).

For those who are using any form of contraception, 72% use modern methods with 53% using supply methods like condoms, pills and IUDs and 19% using permanent methods like ligation and vasectomy. Twenty-seven percent of women use traditional methods such as withdrawal and calendar-rhythm and only 0.4% use modern natural family planning like Standard Days, Billings Ovulation and Lactational Amenorrhea Methods.

Critics of the bill claim that instead of allocating billions to reproductive health and family planning, more government funds should be appropriated to help curb heart disease, malaria, tuberculosis and other causes of mortality among women. But if we divide the amount allocated to RH and family planning in the 2008 budget among the 12 million plus women of reproductive age in the country, it would translate to 42 centavos per woman per day. This is hardy extravagant.

Moreover, the WHO emphasizes that 15% of all pregnant women experience potentially fatal complications. Twenty-five% of all maternal deaths is caused by “indirect causes”, followed by severe bleeding (21%), eclampsia (13%) and obstructed labor and infection (8% each). But it is important to underscore that heart disease, anemia and malaria are the diseases included under “indirect causes” of maternal death. Therefore, these common diseases among women are aggravated by pregnancy and childbirth so there is ample reason to appropriate funds for RH and family planning.

Additionally, women suffer more from maternal morbidities (illness) than any other illness. The DOH estimates that at 400,000 cases for 2005 alone, maternal morbidities are on the very top of the list of the ten most common causes of morbidity for women in the Philippines.

But more than half of the cases involving maternal morbidity could be prevented through effective family planning according to the UNICEF, WHO and UNFPA.

A law that will help prevent 200,000 pregnancy and childbirth related illnesses and countless maternal deaths is definitely not superfluous.

Moreover, proper birth spacing reduces the risk of death in infants by half. This means that almost 8,000 infant deaths each year could be prevented through family planning.

We need to enact HB 5043 because it promotes and protects the right to health, the right to informed choice, the right to reproductive self-determination, and the right to sustainable human development.

The bottom line is if women are given the chance to make responsible family planning decisions, they almost always decide to have smaller families and their children will invariably be healthier, better-educated and have at least a fighting chance at living full and dignified lives. Without this ability, most women will often find it more difficult – some may find it even impossible – to finish their education, find remunerative work or have a say in their own future.

The authors of HB 5043 are counting on Soroptimists to support this measure because it is genuinely pro-women, pro-poor and pro-life. We are counting on you because you know for a fact that RH is essential to women’s overall health and if it is neglected, primary aspects of women’s general welfare and wellbeing will be irrevocably compromised. We are counting on you because most of you have exercised the right to family planning and we know that you would not wish to deprive your less fortunate sisters of the same right.

But ultimately, we are counting on you not only because based on your website the word “soroptimist” means “best for women” and Soroptimist International is an organization of women who help make other women’s lives better. We are counting on your support because the RH bill will be truly best for women and will help them become empowered, educated, healthy and self-reliant; live productive lives; and contribute meaningfully to nation building – the very objectives of Soroptimist International.