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Reproductive Health
REPRODUCTIVE HEALTH IS ABOUT RIGHTS
(Speech delivered by REP. EDCEL C. LAGMAN before the
Philippine Bar Association on 15 October 2008)

I cannot recall having filed a non-controversial bill. Perhaps, bills of genuine national import are controversial ab initio or subsequently become controversial.

Among my highly controversial bills were the comprehensive agrarian reform bill, the debt cap bill which proposed to limit our foreign debt service to 15% of the country’s export receipts, the bill abolishing the death penalty and the bill which modernized the practice of optometry and dismantled the corporate practice of the profession.

Except for the debt cap bill, all of these measures were eventually enacted into law.

My advocacy for the debt cap, agrarian reform and abolition of the death penalty had an enduring partner: the Roman Catholic Church hierarchy, which is still a partner with respect to the pending extension of the land acquisition and distribution (LAD) component of the Comprehensive Agrarian Reform Law (CARL), of which I am the principal author and sponsor.

However, many Catholic bishops vilify the reproductive health bill because it challenges the orthodoxy of the Church on family life and the procreative function of marriage.

The Catholic hierarchy must abandon its antediluvian doctrines or suffer isolation from the mainstream of Philippine society. It must heed the faithful who are overwhelmingly in favor of reproductive health and family planning.

Considering that I speak before fellow lawyers, I shall underscore the relevance of reproductive health to the protection and promotion of people’s rights as well as the constitutional validity of the bill.

Reproductive health and family planning
are basic universal human rights.

Reproductive health is a fundamental human right and was affirmed as such in the Proclamation of Tehran, International Conference on Human Rights 40 years ago in 1968.

The right to reproductive health and family planning was subsequently reiterated in numerous other UN Conventions of which the Philippines is likewise a signatory.

The Philippines is also committed to achieving the Millennium Development Goals, among which are the reduction of infant mortality and the improvement of maternal health. The MDGs were recently amended to underscore that family planning is indispensable to the attainment of these two goals.

Freedom of Informed Choice

Central to the RH bill is the freedom of informed choice. An enabling environment shall be created to allow women and couples to freely choose the method of family planning from the natural to the modern that they wish to adopt consistent with their personal needs and individual consciences.

The government shall conduct a massive information campaign on the benefits of family planning without any bias for or against any method. The only limitation is that the entire menu of family planning methods must be legal and medically-safe.

The government shall afford acceptors access to the family planning supplies of their choice which shall be given free to the poor and marginalized.

A sustained information campaign shall be undertaken because freedom of choice will not be meaningful if there is no prior complete and accurate information. This includes the possible side-effects and failure rates of the various methods of family planning.

It is in this sensitive campaign of giving factual and truthful information that the misinformation being peddled by the oppositors of the bill should be exposed and rebutted, like the following:

1. It is false and malicious to claim that the RH bill legalizes abortion. It does not. The measure repeatedly provides to the point of superfluity that abortion is illegal, criminal and punishable, and is not part of the menu of legally permissible and medically safe family planning methods.

2. It is likewise misleading and inaccurate to claim that the use of contraceptives will eventually lead to the legalization of abortion. Catholic and Muslim countries which have liberalized the use of contraceptives still continue to criminalize abortion. Moreover, there is 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.

3. It is utterly unchristian and grossly inhuman to assert that medical care should not be extended to women suffering from post-abortion complications because to do so would condone and encourage abortion. Like a wounded rebel in an encounter with government forces, women in distress must not be deprived of medical help.

4. The proposition that the use of 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 wherein the country’s population will continue to grow even if the population growth rate is increasingly reduced to below replacement levels.

The importance of policymaking is that policies are never cast on stone. They are flexible and reversible. Given the experiences of countries like Singapore, South Korea and Japan where there is a thinning young population and there is need to accelerate PGR, the Philippines can anticipate well in advance these eventualities without forfeiting the vast opportunity of economic growth by currently mitigating population expansion.

5. Commending labor migration as the beneficent result of “population power” is a misplaced accolade to inordinate fertility. Dollar remittances from OFWs should not blind us to the incalculable social and economic costs of labor migration.

Moreover, the so-called “population power” has just exploded in our faces as the bleak scenario unfolds with OFWs returning home because there is a depressed market for overseas employment as a consequence of the collapse of Wall Street.

6. The issue on population is not a simple matter of “population density” but more importantly, it is a question of sustainable human development. Concededly, there are still vast unpopulated areas of the country but these are places hostile to human development because there are no infrastructures in place, no schools, no hospitals, and no visible means of livelihood and employment.

Certainly, we can place the entire world’s population of 6.5 billion people in an area the size of the State of Texas. But they would end up eating each other’s sewage!

7. 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 and could not afford to buy reproductive health supplies.

8.  It is grossly medically unfounded to allege that all contraceptives are life threatening and contraceptive use results to fatal diseases. This misinformation is negated by the data of medical authorities. For example, experts report that the risk of dying within a year (not actual death) is: one out of two hundred thousand (200,000) pill users; one out of one million (1,000,000) who have undergone vasectomy; one out of ten million (10,000,000) users of IUD; and zero (0) for condom users. This is compared to one out of 5,900 motor vehicle travelers and one out of ten thousand (10,000) non-high risk pregnancies.

The RH Bill is Constitutional

An inordinately huge population impacts negatively on all indicators of human development such as quality education, adequate medical care, food security, availability of employment, sufficient mass housing and a healthy ecology.

Invariably, all the more populous countries in the world rank low in human development. The Philippines, which is the 12th most populous country in the world with 88.4 million people is 84th in the 2006 UN-measured Human Development Index.

The salutary constitutional provisions on the right to quality education (Sec. 1, Article XIV); right to health (Sec. 15, Art. II); right to a family living wage and income (Sec. 3(2), Art. XV); right to a balanced and healthful ecology (Sec. 16, Art. II); and the right of children to proper care and nutrition and protection from all forms of neglect, abuse, cruelty, exploitation and other conditions prejudicial to their development, will all be illusory if the government is unable to promote reproductive health and family planning as indispensable tools to manage population growth and achieve sustainable human development.

The RH bill accords fealty to these constitutional rights and mandates.

House Bill No. 5043 is being faulted for being violative of the Section 12, Article II of the Constitution which reads:

“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.” (underscoring supplied).

The constitutional challenge is baseless for the following overriding reasons:

1. The RH bill does not violate or intrude on the “sanctity of family life”. On the contrary, it discharges the obligation of the State to protect and strengthen the family.

The family is more than a natural unit. It is a social institution whose well-being is impressed with public interest and concern.

Verily, it is not immune from legislation. It has to be amenable to the State’s exercise of police power for its protection and development. Hence, there are relevant laws like the Civil Code of the Philippines; Family Code of the Philippines (EO 209); the Child and Youth Welfare Code (PD 603); and the Special Protection of Filipino Children Against Child Abuse, Exploitation and Discrimination Act (RA 7610), among others.

The RH bill aims to protect the family from poverty and want by helping women and couples achieve their fertility goals.

Empirical studies consistently document that larger families are almost invariably poorer than smaller families. Moreover, large family size perpetuates poverty across generations.

According to the UN State of the World Population Report 2002, “family planning and reproductive health are essential to reducing poverty.” The report declares that “countries that invest in reproductive health and family planning and in women’s development register lower population growth and faster economic growth.”

In a recent study of poverty and its causes in the Philippines, the Asian Development Bank listed an expanding population as one of the major causes of poverty in the country.

2. The bill does not supplant the primary right of parents in the “… development of moral character” of the youth even as it proposes the mandatory teaching of age-appropriate reproductive health and sexuality education in all schools from Grade 5 to Fourth Year High School.

This is giving support, as required by the Constitution, to parents, particularly to the vast majority who have defaulted in imparting reproductive health and sexuality education to their children simply because discussing sex at home is generally taboo.

Consequently, the young get their information on sexuality from polluted and inaccurate sources – peer groups, entertainment media and the internet.

Verily, there is critical need for formal reproductive health and sexuality education in schools.

The fear that sex education would breed youthful “sex maniacs” and develop a culture of promiscuity is grossly unfounded.

Studies by the UN and progressive countries reveal the beneficent results of reproductive health and sexuality education among the young. These are:

(a)    Inculcation of correct and relevant sexual values and norms in the young which disabuses their minds of preconceived myths on sex and responsibly addresses their curiosity so much so that experimenting is foreclosed;
(b)    Initiation into sexual activity is delayed;
(c)    Multiple sexual partners are avoided;
(d)    Abstinence before marriage is encouraged; and
(e)    Spread of HIV-AIDS and sexually transmitted diseases is prevented.

3. The use of legal and medically-safe contraceptives, which are not abortifacients, and which are tested and registered by the Bureau of Food and Drugs (BFAD), does not violate the constitutional provision on the obligation of the State “to equally protect the life of the mother and the life of the unborn from conception.”

The genesis of this provision in the Constitutional Commission establishes the following:

(a) The purpose of this provision is to preempt the Congress and the Supreme Court from legalizing abortion. This bill definitely does not legalize abortion.

The anti-abortion intent of this provision is admitted both by its principal proponent, Commissioner Bernardo Villegas, and Commissioner Joaquin Bernas who initially proposed a similar provision as Section I of the Bill of Rights which read: “The right to life extends to the fertilized ovum.” (underscoring supplied).

This Bernas proposal did not materialize. Its non-adoption unmistakably manifests that the concept that life begins at fertilization was not constitutionalized for lack of concurrence from the Commissioners.

After the deletion of the Bernas proposal in the Bill of Rights, another formulation was included in Article II on the Declaration of Principles which originally read: “The State shall protect human life from the moment of conception.”

It is important to note that under the foregoing draft, it is suggested that human life begins “from the moment of conception”, not anymore from the fertilization of the ovum.

This also confirms the thinking of the Commissioners that the “fertilization of the ovum” is not the same or synonymous to “conception”. The two refer to different stages of the reproductive process.

(b) As finally adopted, it is provided that the State “… shall equally protect the life of the mother and the life of the unborn from conception.”

There were two amendments in the approved final provision: (1) the phrase “the moment of” preceding “conception” was deleted; and (2) the phrase “the life of the mother” was included. These two amendments are very significant.

The deletion of the phrase “the moment of” was the result of the Commissioners’ uncertainty as to the precise beginning of conception. Hence, they decided to defer to medical science and subsequent legislation the determination of the start of conception.

The international scientific community and numerous medical dictionaries and textbooks define the beginning of pregnancy or conception as the moment the fertilized ovum attaches itself to the lining of the uterus. Pregnancy, therefore, starts one to two weeks after fertilization.

The American College of Obstetricians and Gynecologists defines conception as “the implantation of the blastocyst. It is not synonymous with fertilization.” The National Institute of Health/Food and Drug Administration states that “Pregnancy encompasses the period of time from confirmation of implantation until expulsion or extraction of the fetus.”

Verily, the fertilized egg has no sustainable viability outside of the uterine wall. It has to implant in the uterus to have sustainable life and for gestation to progress or for pregnancy to begin.

Consequently, the International Federation of Gynecologists and Obstetrics (FIGO) defines abortion as “the termination of pregnancy after implantation and before the conceptus has become independently viable.”

It is important to note that this international medical organization expressly states that for an act to be considered an abortion, the fertilized egg must already be implanted in the uterus.

Verily, the bill does not offend the constitutional intent proscribing abortion. In fact, it repeatedly reiterates the national policy against abortion. Moreover, the RH bill is even an anti-abortion measure because it respects the option of women and couples to use legal and medically-safe contraceptives which reduces abortion rates by 85%.

In the Philippines, it has been established that majority of those who undergo induced abortion are not teenagers or single women. They are married Catholic women with ages ranging from 21 to 29 who do not want another pregnancy or could not afford another child because of poverty or lack of resources. (State of the Philippine Population Report, 2001).

(c) The proceedings of the Constitutional Commission show that there was no intention to ban contraceptives which are not abortifacient.

Contraceptives like pills and injectables which prevent a woman from ovulating are not abortifacients because in the first place, no egg is released for fertilization. Similarly, contraceptives which weaken the sperm to incapacitate it from fertilizing an egg cannot be considered abortifacient because there is no fertilized egg for implantation in the uterine wall.

In the same token, IUDs which principally slow down the sperm to prevent them from reaching the egg are also not abortifacients. The primary action of IUDs is to “release copper ions which are toxic to sperm.”

The notion that contraceptives prevent implantation has been debunked by the UNDP, UNFPA and WHO. In their joint position paper submitted to the House of Representatives, they stated unequivocally that there is “no scientific evidence supporting this possibility. Therefore contraceptives cannot be labeled as abortifacients.” (underscoring supplied).

True to its nomenclature, a contraceptive is an antidote to conception or anti-conception. Hence, contraceptive use prevents conception. In the absence of conception, there is no life of the unborn to be protected.

(d) The importance of the second amendment which included the protection of “the life of the mother” is lost because of the undue emphasis on protecting “the life of the unborn from conception.”

The Constitution mandates the equal protection of the life of the mother and the life of the unborn.

In fact, when both the lives of the mother and the unborn are imperiled, the invariable option is to save the life of the mother if both lives could not be saved. The doctor’s primary obligation is to the mother because it is she who is the patient.

Family planning, as a vital component of reproductive health, does not only ensure the health of mothers and children. Family planning saves lives. The WHO, UNFPA and the medical journal Lancet are unanimous in declaring that the use of reliable contraceptives decreases maternal mortality by one-third. Close to 200,000 maternal deaths worldwide could be avoided annually if women use contraception.

The body of a woman needs at least three years to fully recuperate from pregnancy and childbirth. The use of contraceptives prevents unremitting pregnancies which endanger the lives of mothers and infants.

It is indubitable that based on the foregoing discussion, HB 5043 is constitutional and actualizes the people’s rights related to reproductive health and family planning.

Popular support to the RH Bill


Vox populi, vox Dei (the voice of the people is the voice of God) and vox populi est suprema lex (the voice of the people is the supreme law) are truisms most relevant to the RH campaign. Consider the following popular survey results for almost two decades:

•    96% of Catholics say it is important to have the ability to control their fertility and most approve of the use of contraceptives expressly forbidden by the Church (SWS, July 1991).

•    Pulse Asia has conducted regular surveys (1995, 2001, 2004 and 2007) on family planning and the results have consistently revealed that Filipinos believe in the importance of family planning. The 2007 results reveal:

    92% of all Filipinos believe that it is important to have the ability to control one’s fertility and plan one’s family.
    93% of all Roman Catholics surveyed said that family planning is important. This is an even higher percentage than the national average of 92%.
    89% of all Filipinos support government funding for modern methods of family planning.
    90% of all Roman Catholics surveyed agreed that government should allocate funding to modern FP methods. Again, this is an even higher percentage than the national average of 89%.
    The top three ethnic groups which support public funding for contraceptives are: Bicolanos (96%), Pangasinenses (96%) and Kapangpangans (95%).
    75% of Filipinos will support candidates who are in favor of a government budget for family planning.
    76% of Filipinos consider it important that a candidate includes family planning in his or her program of action.
    77% of Roman Catholics surveyed say that it is important that family planning be included in a candidate’s program of action. Again, this is even higher than the national average of 76%.

House Bill No. 5043 or the “Reproductive Health, Responsible Parenthood and Population Management Act of 2008” has strong support inside and outside the House of Representatives. To date, 113 members of the House have coauthored the bill even as tremendous multi-sectoral support continues to increase.

This bill has the longest gestation in Congress with precursor measures dating back to the 8th Congress (1987-1992).

Now, it has irreversibly reached the period of plenary debates. Its eventual approval is almost a certainty because it is necessary, beneficial and practicable.

And, it is also rights-based and constitutional.

National
THE CONCEPT OF ODIOUS DEBT IN THE
PHILIPPINE SETTING
(Keynote Speech of REP. EDCEL C. LAGMAN during the Forum on “Odious Debt in Public International Law”
on 24 February 2008, Malcolm Hall Theater, University of the Philippines College of Law, Diliman, Quezon City)


My advocacy for the reduction of the country’s huge debt service, particularly on foreign loans, antedates my crusade for the enactment of a law on reproductive health, family planning and population development and my campaign for the abolition of the death penalty. The latter has succeeded almost three years ago. The RH bill has bright and encouraging prospects of passage within the year.

But the crusade for debt reduction still hangs on the balance more than two decades after I have filed the first of a series of debt cap bills pegging the country’s debt service to a percentage of our export receipts.

Although there is yet to be a universally accepted definition of “odious debt”, paraphrasing various authorities and commentaries could evolve a definition suitable to the Philippine setting in this wise:

An odious debt is one contracted and utilized by a despotic, corrupt and/or profligate regime against the interest of the people or as personal availment of the leader or ruling clique, without the consent of the people, and with the complicity or awareness of the creditor, thus rendering the debt unenforceable or subject to repudiation.

From the foregoing definition, an odious debt has the following essential elements:

(a)    The debt was contracted by a tyrannical, profligate and/or corrupt regime;
(b)    The proceeds of the loan were used against the interest of the people or principally utilized as a private availment of the leader or clique of the contracting regime;
(c)    A new leadership or succeeding regime repudiates the loan as odious and unenforceable; and
(d)    The creditor was aware or could have been aware of the corrupt and/or tyrannical regime and the errant or fraudulent utilization of the loan.

The confluence of these elements fits to a “T” the transition from martial rule under the late President Ferdinand Marcos to the new administration under former President Corazon Aquino after the EDSA People Power Revolution in 1986 which could have justified the repudiation of patently odious loans. The classic example is the 2.2 billion U.S. dollar Bataan Nuclear Power Plant loan which was attended by corruption and bribery even as the secondhand nuclear facility was installed with 4,000 defects atop a volcano and proximate to an active fault.

After President Aquino addressed the United States Congress and proclaimed that “never again shall we kneel before the altar of foreign finance”, the Philippines, invoking the Spanish dictum of palabra de honor (word of honor), continued to pay all foreign loans, including the tainted and odious Bataan Nuclear Power Plant loan which we have now fully paid to the tune of 64.794 billion pesos, a religious repayment spanning four administrations from the Aquino, Ramos, Estrada and Arroyo regimes. It should be underscored that the nuclear power plant also known as the “Monster of Morong” had been mothballed since 1986 and has not produced even a single kilowatt of electricity.

And now there is a pending bill in the House of Representatives projecting the immediate rehabilitation, commissioning and commercial operation of the BNPP without even an updated feasibility study addressing its technical, safety, economic, financial and ecological aspects. Perforce, we must reject this improvident bill and let the BNPP remain a stark monument of official corruption and greed, and culpable private complicity.

The payment by the Philippines of odious loans is assured and facilitated by two factors:

(1) The continuing implementation of the mechanism of automatic appropriation of debt service, a martial law edict under Presidential Decree No. 1177, which has been conveniently incorporated in the Revised Administrative Code during the remaining few months of the Aquino Revolutionary Government and ratified by the Eighth Congress in 1987.

I am informed that it is very possible that no other country in the world has a similar statute on automatic appropriation of debt service.

(2) Absence of a public, thorough and transparent audit of foreign debt in order to validate, among others, the existence of odious loans.

Congressional efforts to deal with aforesaid twin problems are not lacking. Since the Eighth Congress and early in every Congress up to the present Fourteenth Congress, bills and resolutions have been filed repealing or calling for the abrogation of automatic appropriation of debt service. These measures are inexorably and invariably destined to and subsequently found in the archives after the end of each Congress.

This Fourteenth Congress I have filed again the bill on the repeal of automatic appropriation under House Bill No. 329.

Unfortunately, the Supreme Court has refused to strike down as unconstitutional the statute on automatic appropriation of debt service. The High Court has recommended instead that a repealing law should be enacted by Congress. Hence, the periodic, almost Sisyphean, attempts to obliterate from the statute books the sinister mechanism on automatic appropriation.

In the Thirteenth Congress, Joint Resolution No. 2 was filed by freedom from debt advocates in the House of Representatives calling for the creation of a Congressional Commission to “review and assess the debt policies, strategies and programs of the Philippines; conduct a public audit of all loans acquired including assumed and contingent liabilities; validate the utilization of loan proceeds and the payments made thereon; and recommend policies and strategies to reduce debt service.”

This was the first measure of national significance approved by the House of Representatives in the Thirteenth Congress. Unfortunately, the Senate failed to act on the said Joint Resolution which would have had the force and effect of a law if approved by the President.

Joint Resolution No. 4, which is of similar import as Joint Resolution No. 2, was filed again in the present Fourteenth Congress. It is still languishing in the Committee on Rules and we intend to transform it to a simple House Resolution so that it does not have to go to the Senate.

When I was Chair of the Committee on Appropriations during the First Regular Session of the current Congress, I successfully sponsored the reduction by 25.904 billion pesos of the debt service allocation as contained in the President’s National Expenditure Program. This cut was approved by the House of Representatives and the Senate in the 2008 General Appropriations Bill and the amount of 25.904 billion pesos was reallocated to social services.

Of this total amount of debt service reduction, (a) 15.904 billion pesos corresponded to debt service savings as a consequence of the appreciation of the Philippine peso to the US dollar at that time; (b) 5.0 billion pesos corresponded to premature allocation of interest payments for contingent loans; and (c) another 5.0 billion pesos corresponded to loans challenged as fraudulent, wasteful and/or useless, pending their renegotiation and/or condonation, like the following:

(1)    Austrian Medical Waste Project;
(2)    Small Coconut Farms Development Project;
(3)    Social Expenditure Management Program 2;
(4)    Secondary Education Development and Improvement Project;
(5)    Philippine Merchant Marine Academy Modernization Project;
(6)    Telepono sa Barangay Project;
(7)    Power Sector Restructuring Program;
(8)    Power Sector Development Program;
(9)    Angat Water Supply Optimization Project;
(10)    Procurement of Search and Rescue Vessel Project; and
(11)    Pampanga Delta Development Project.

The foregoing challenged loans were identified by the Freedom from Debt Coalition (FDC) who had difficulty in documenting the fraudulent and wasteful loans because of the absence of a public debt audit and the scarcity of verifiable documents.

Many of the controverted loans can qualify as odious loans either at the time they were secured and/or at the time of their respective, flawed and corrupt project implementations.

As expected, the Executive vetoed Special Provision No. 1 on the “Use of the Fund” and Special Provision No. 2 on “Reporting Requirement” covered under the heading “Debt Service-Interest Payment”. However, the reallocations of the debt service cuts to basic social services were spared, as we have designed.

The presidential veto was justified on the following grounds: (1) automatic appropriation for debt service is allowed by law and has been declared constitutional; (2) the prohibition on disbursement of funds for interest payments on loans challenged as fraudulent, wasteful and/or useless is an encroachment on the constitutional guarantee of non-impairment of contracts; and (3) the government’s credit standing needs to be preserved and protected.

It is clearly manifest that Congress does not have the requisite extraordinary number of votes to override the President’s veto. Suffice it to say that the constitutional guarantee on non-impairment of contracts only protects valid and legitimate contractual obligations. Moreover, the repudiation of odious, fraudulent and wasteful loans would not detract from the government’s credit standing as we do not default on our lawful and aboveboard indebtedness.

The crusade for debt reduction has been long and arduous. But neither I nor my likeminded colleagues will give up a good fight.  We therefore truly appreciate the holding of this forum on odious debt as it would be instructive on the strategies we will have to pursue in identifying and repudiating Philippine odious debts.

The debt campaign may have been protracted and difficult but this will only make our eventual victory more rewarding and the battle even more worthwhile.

Reproductive Health

SETTING THE RECORD STRAIGHT ON THE RH BILL
(Speech delivered by REP. EDCEL C. LAGMAN on 17 February 2009
at the University of Makati)

People still continue to ask why I am tirelessly advocating the passage of the reproductive health bill to the extent of my having given up the Chairmanship of the powerful Committee on Appropriations in order to devote more time to the enactment of this controversial measure.

Some ask to confirm what they already know. Others ask to resolve their doubts. And not a few ask to test or contest my premises.

I always encourage people to ask. And this forum is a way of also asking.

We have a very serious problem of a huge population growth rate (PGR) of 2.04%, the highest in Southeast Asia after the small countries of Brunei and Laos.

Our population today is more than 90 million. It is projected to reach 94.3 million in 2010. It will balloon to 141 million in 2040 if will allow our PGR to remain high.

We have finite resources which are rapidly being depleted. Our food production hardly copes with the growth in population. Poverty alleviation or reduction is a dream. It may soon become a nightmare. 

The global economic crisis has a greater toll on more populous countries. The more the people, the heavier is the burden on government in seeking relief from the worldwide meltdown.

The RH bill gives Filipino women and couples the opportunity and option to meet their fertility goals, plan their families, space the birth of their children, avoid high-risk pregnancies, improve maternal health, reduce infant mortality, and achieve a more comfortable life and better wellbeing.

In other words, this bill offers a solution, without compulsion, to reduce the huge population growth rate; to alleviate the grinding poverty across generations; to minimize unremitting pregnancies which contribute to high infant mortality and morbidity; to ease the perennial problems of overcrowded classrooms, lack of textbook and teachers, scarcity of jobs and food supply, absence of quality medical care, shortage in mass housing and despoliation of the environment. 

And the solution provided for by the RH bill will not cost the government the mega millions invested in some government projects.

The UNICEF underscores that “family planning could bring more benefits to more people at less cost than any other single technology now available to the human race.”

I.    RH is HR: Reproductive Health is a Human Right

A.    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.

B.    International Conference on Human Rights in the Proclamation of Teheran: “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.

C.    But the fundamental human right to RH remains illusory for millions of Filipinos.

1.    2.6 million Filipino women would like to plan their families but lack information and access to do so.
2.    Poorest Filipinas are still having an average of 6 children (this is almost 3x their desired number of children and equivalent to the Total Fertility Rate in 1973).
3.    44% of the pregnancies of the poorest Filipinas are unwanted.
4.    Maternal deaths comprise 11% of all deaths in women aged 15-49.

II.    There is more to RH than simply family planning and contraceptive use – it is about health, rights and sustainable human development.

III.    Salient Features of House Bill 5043 or the proposed “Reproductive Health, Responsible Parenthood and Population Development Act
of 2008”.

A.    Family planning is only one element of RH. Reproductive health has 11 essential elements:

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.

B.    Midwives for skilled attendance.

1.    Only 57% of Filipino women give birth with the assistance of a trained medical professional.
2.    Bill mandates that every city and municipality shall endeavor to employ an adequate number of midwives and other skilled attendants.
3.    Skilled attendance at birth will help prevent maternal and infant mortality.

C.    Emergency Obstetric Care.

1.    Each province and city shall endeavor to ensure the establishment and operation of hospitals with adequate and qualified personnel that provide emergency obstetric care.
2.    The miracle of life should not mean death for 11 mothers daily.
3.    Importance of facilities that can provide life saving services to pregnant women cannot be overemphasized.

D.    Hospital-based family planning.

1.    Family planning methods requiring hospital services like ligation, vasectomy and IUD placement shall be available in all government hospitals.
2.    Maternal and infant mortality and morbidity are public health concerns.
3.    FP methods like ligation and vasectomy must be readily available in government hospitals – the health facilities the poor and marginalized regularly utilize.

E.    Contraceptives as essential medicines.

1.    RH products shall be considered essential medicines and supplies and shall form part of the National Drug Formulary.
2.    This will help the poorest of our women avoid unplanned pregnancies and maternal death.
3.    Both the WHO and UNFPA have declared that contraceptive use can prevent 1/3 of all maternal deaths.
4.    RP’s maternal mortality rate: 162 deaths out of every 10,000 live births. (FPS 2006)
5.    Filipino women have a 1 in 100 chance of dying from maternal causes in their lifetime. (FPS 2006)
6.    Modern contraceptives are included in the World Health Organization Model List of Essential Medicines.

F.    RH and Sexuality Education

1.    RH education in an age-appropriate manner shall be taught by adequately trained teachers from Grade 5 up to 4th Year High School. Subjects include:

(a)    Values formation;
(b)    Prevention and avoidance of sexual advances and molestation from acquaintances and strangers;
(c)    Parts and functions of the reproductive system;
(d)    Responsible parenthood;
(e)    Natural and modern family planning;
(f)    Proscription and hazards of abortion;
(g)    Reproductive health and sexual rights;
(h)    Abstinence before marriage; and
(i)    Responsible sexuality.

2.    Sexuality education = positive view of sexuality; information and skills about taking care of one’s sexual health; and sound decisions.

3.    Sexuality education makes adolescents more sexually responsible and adds a level of maturity to their attitudes towards sexual relations.

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

5.    The SWS survey released in October 2008 shows that 76% of Filipinos approve of the teaching of family planning to the youth.

IV.    Clarifying misconceptions about the RH bill.

A.    Misconception 1: the bill is anti-life.

1.    It is pro-quality life. It will ensure that children will be blessings to their parents since their births are planned and wanted.

2.    It will empower couples with the information and opportunity to plan and space their children.

3.    This strengthens the family as a unit and optimizes care for fewer children who will have more opportunities to be educated, healthy and productive.

4.    The capacity of people to make full use of their potentials is imperiled and impaired by a ballooning population and resultant poverty.

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

B.    Misconception 2: Bill is biased for modern methods of FP

1.    Section 3(a) of the bill provides: “In the promotion of reproductive health, there should be no bias for either modern or natural methods of family planning.”

2.    Government’s bias is actually for NFP because POPCOM has been promoting purely NFP even though only 27% of all women using family planning employ NFP and traditional methods compared to the 73% who use modern contraceptive methods. (FPS 2006)

3.    The bill in fact democratizes family planning because it will make available to couples all possible family planning methods and not just NFP which is preferred by the Catholic Church.

C.    Misconception 3: Bill legalizes abortion.

1.    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.

2.    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.

3.    Muslim and Buddhist countries like Indonesia and Laos have likewise liberalized the use of contraceptives but still continue to criminalize abortion.

4.    Contraceptive use and abortion have an inverse correlation: regular and correct use of contraceptives reduces abortion rates since unplanned and unwanted pregnancies are avoided.

D.    Misconception 4: Bill endorses abortifacients.

1.    Pills and IUDs are BFAD-approved, medically safe and legal.

2.    Primary mechanism 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?

3.    IUDs do not cause abortions because they stop fertilization.

4.    UNDP, UNFPA and WHO  Expert Opinion on the Mechanisms of Modern Contraceptives: contraceptives “cannot be labeled as abortifacients”.

E.    Misconception 5: Contraceptives kill.

1.    The WHO emphasizes that 15% of all pregnant women experience potentially fatal complications. Preventing pregnancy in high risk women through contraception significantly reduces maternal death.

2.     Medical risks connected with contraceptives are infinitely lower than the risks of an actual pregnancy and everyday activities.

(a)    Risk of dying within a year of riding a car is 1 in 5,900.
(b)    Risk of dying within a year of using pills is 1 in 200,000.
(c)    Risk of dying from a vasectomy is 1 in 1 million.
(d)    Risk of dying from using an IUD is 1 in 10 million.
(e)    Risk of dying from condom use is absolutely zero.
(f)    But the worldwide risk of dying from a pregnancy is 1 in 10,000.
(g)    In the Philippines, the lifetime risk of dying from maternal causes is an alarming 1 in 100.

F.    Misconception 6: Bill will promote contraceptive mentality.

1.    The bill does not prohibit pregnancy.

2.    Couples will not stop wanting children simply because contraceptives are available.

3.    Contraceptives are used to prevent unplanned pregnancies but not to stop pregnancies altogether.

4.    Human beings have the primal desire to reproduce and propagate their genes. This bill cannot undo millions of years of evolution.

5.    The bill’s authors recognize the importance of ensuring that children are born healthy and wanted.

G.    Misconception 7: Sexuality education will promote promiscuity.

1.    Age-appropriate RH education promotes correct sexual values.

2.    Benefits of sexuality education: (1) under-standing of proper sexual values; (2) initiation to sexual relations is delayed; (3) abstinence before marriage is encouraged; (4) multiple sex partners is avoided; and (5) spread of sexually transmitted diseases is prevented.

3.    Parents who do not allow their children to attend RH and sexuality education classes will not be prosecuted and jailed.

H.    Misconception 8: Bill claims to be panacea to poverty.

1.    The authors of HB 5043 have never claimed that the bill will be a cure-all for poverty and underdevelopment in the country. The bill simply recognizes the verifiable link between a huge population and poverty.

2.    Unbridled population growth stunts socio-economic development and aggravates poverty.

(a)    UN Human Development Reports show that countries with higher population growth invariably score lower in human development.
(b)    Philippines is the 12th most populous country in the world and ranked 102nd out 179 countries in the United Nations Human Development Index 2008.
(c)    Asian Development Bank: a large population is one of the major causes of poverty in the country.
(d)    Large family size is a significant factor in keeping families poor across generations. (Phil. Institute for Development Studies)

3.    UN: “family planning and reproductive health are essential to reducing poverty”.

I.    Misconception 9: The bill will lead to a demographic winter.

1.    A “demographic winter” or a zero population growth rate is the marked decrease in the number of births in a country and this aging of the population is being experienced in varying degrees by some highly industrialized nations.

2.    Given the excruciatingly slow decrease in our Total Fertility Rate, demographers and other experts assert that a so-called “demographic winter” is a scare tactic which fails to comprehend the dynamics of population momentum.

(a)    UP Economics professors have declared in a paper entitled “Population and Poverty: The Real Score” that a so-called demographic winter will not happen in the country for “at least another 100 years”.
(b)    National Statistics Coordination Board, replacement fertility of 2.1 children will be achieved only by 2040 but effects of “population momentum” or the continuous increase in population will go on for another 60 years by which time the population of the country would have reached 240 million.

J.    Misconception 10: We don’t need an RH law.

1.    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.

(a)    Availability of contraceptives does not mean access.
(b)    Availability does not assure adequate and accurate information.

2.    There are 12.86 million currently married women of reproductive age in the country but contraceptive prevalence rate is only 50.6% (2006 Family Planning Survey).    

3.    Critics claim that instead of allocating billions to RH and family planning, more government funds should be appropriated to help curb heart disease, malaria, TB and other causes of mortality among women.

4.    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, it would translate to 42 centavos per woman per day. This is hardy extravagant.

5.    Maternal deaths and infant mortality continue to be alarming and these are public health issues that deserve immediate action from government.

(a)    DOH: 400,000 cases of maternal morbidities in 2005. It is the most common cause of illness for women in RP.
(b)    But more than half of the cases involving maternal morbidity could be prevented through effective family planning (UNICEF, WHO and UNFPA).
(c)    Proper birth spacing reduces the risk of death in infants by half.
(d)    Around 8,000 infant deaths each year could be prevented through family planning.

K.    Misconception 11: The bill is unconstitutional.

1.    House Bill No. 5043 is being faulted for being violative of the Section 12, Article II of the Constitution which reads:

“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.” (underscoring supplied).

2.    The constitutional challenge is baseless for the following overriding reasons:

(a)    Bill does not violate or intrude on the “sanctity of family life”. On the contrary, it discharges the obligation of the State to protect and strengthen the family.

•    The family is more than a natural unit. It is a social institution whose well-being is impressed with public interest and concern. It is not immune from legislation. It has to be amenable to the State’s exercise of police power for its protection and development.
•    Hence, there are relevant laws like the Civil Code of the Philippines; Family Code of the Philippines (EO 209); the Child and Youth Welfare Code (PD 603); and the Special Protection of Filipino Children Against Child Abuse, Exploitation and Discrimination Act (RA 7610), among others.

(b)    The bill does not supplant the primary right of parents in the “… development of moral character” of the youth even as it proposes the mandatory teaching of age-appropriate reproductive health and sexuality education in all schools from Grade 5 to Fourth Year High School.

•    This gives support, as required by the Constitution, to parents, particularly to the vast majority who have defaulted in imparting reproductive health and sexuality education to their children simply because discussing sex at home is generally taboo.
•    Consequently, the young get their information on sexuality from polluted and inaccurate sources – peer groups, entertainment media and the internet. Therefore, there is critical need for formal reproductive health and sexuality education in schools.

(c)    The use of legal and medically-safe contraceptives, which are not abortifacients, and which are tested and registered by the Bureau of Food and Drugs (BFAD), does not violate the constitutional provision on the obligation of the State “to equally protect the life of the mother and the life of the unborn from conception.”

•    The purpose of this provision is to preempt the Congress and the Supreme Court from legalizing abortion. This bill definitely does not legalize abortion.
•    The proceedings of the Constitutional Commission show that there was no intention to ban contraceptives which are not abortifacient.

V.    The people have spoken – they favor family planning and want the RH bill passed.

A.    SWS:
1.    71% of Filipinos are in favor of the RH bill.

2.    76% of Filipinos agree that there should be a law requiring government to teach family planning to the youth.

3.    68% believe that there should be a law requiring government to distribute legal contraceptives like condoms, pills and IUDs

B.    PULSE ASIA:

1.    93% of Filipinos consider it important to have the ability to plan their families.

2.    82% of Filipinos believe government should teach couples about all methods of family planning.

3.    Another 82% of Filipinos say that it is the government’s duty to provide the people with knowledge, services, and materials on all methods of family planning.

4.    A considerable majority of Filipinos (63%) want the RH bill to be passed into law with only 8% expressing opposition to the measure.

VI.    Catholics have spoken – they support the use of contraceptives and the enactment of the RH bill.

A.    68% of Catholics believe that government should distribute free contraceptives to those who want them (SWS).

B.    76% of Catholics agree that there should be a law requiring government to teach family planning to the youth (SWS).

C.    71% of Catholics favor the passage of the RH bill versus only 68% of non-Catholics who endorse the bill (SWS).

D.    Religion ranks 9th out of 10 reasons why women do not use contraception (FPS 2006).

VII.    We have to enact HB 5043 because it promotes and protects:

A.    The right to health.

B.    The right to informed choice.

C.    The right to reproductive self-determination.

D.    The right to sustainable human development.

VIII.    Women must be given the chance to make responsible family planning decisions.

A.    When given the opportunity to plan and space their children, women almost always decide to have smaller families.

B.    They will invariably have children who are healthier, better-educated and have at least a fighting chance at living full and dignified lives.

C.    Without this ability to plan their families, most women will often find it more difficult to finish their education, find remunerative work or have a say in their own future.

IX.    The RH bill is genuinely pro-women, pro-poor and pro-life.

A.    It is essential to the promotion of women’s overall health.

B.    If RH is neglected, primary aspects of women’s general welfare and wellbeing will be irrevocably compromised.

C.    Educated and well-off women have always exercised the right to family planning.

D.    Poor Filipinas should not be deprived of the same right enjoyed by their more prosperous sisters. 

X.    There is no reason for any of us to be afraid of the RH bill.

A.    But there are 4,500 reasons to support the bill - the 4,500 Filipino mothers who die every year from causes related to pregnancy and childbirth.

B.    There are additional 8,000 reasons to fight for reproductive rights – the 8,000 babies who annually do not survive their first month of life.

C.    And another 2.6 million reasons to stand up for the bill – the 2.6 million poor Filipinas who want to plan their families but are unable to do so because they lack information on and access to family planning services.

Clearly, there are more than enough reasons to fight for HB 5043 because family planning indeed saves lives; reproductive health is essential to women’s overall health and its protection and promotion will determine whether or not a woman will have a say in her own future.

National
SHOULD THE “MONSTER OF MORONG” BE
REVIVED TO HAUNT US ONCE AGAIN?
(Statement of Rep. Edcel C. Lagman during the Hearing of the
Appropriations Committee on House Bill No. 4631 on 02 February 2009)

I respect the initiative of Rep. Mark O. Cojuangco in justifying the immediate rehabilitation, commissioning and commercial operation of the Bataan Nuclear Power Plant (BNPP).

However, considering the ignominious past of the BNPP which earned it the moniker of the “Monster of Morong”; the scandal and bribery which surrounded its procurement and construction; the onerous and odious loan of $2.2 billion which financed the erection of the facility; the dubious safety of its location as it is perched on Mt. Natib, a dormant volcano, much like Mt. Pinatubo before its 1991 eruption, and along a fault line; and its subsequent mothballing for some “4,000 defects”, Rep. Cojuangco is correct that one of the reasons for his filing of House Bill No. 4631 is to “start or spark a national debate on the merits and demerits of nuclear power as a viable energy option”.

Reproductive Health
WOMEN: THE CENTRAL FIGURES IN THE RH CAMPAIGN
(Speech delivered by REP. EDCEL C. LAGMAN during the
10th National Summit of the Lady Local Legislator’s League of the Philippines
at the Diamond Hotel on 23 January 2009)

I filed the first version of the reproductive health bill in July 2004 and in the almost five years since then, I am still amazed at the intense and passionate response people have towards the bill. It does not matter if they are for or against the measure – a lukewarm response is not forthcoming when it comes to the issue of RH and family planning. People are almost always either fervently supportive or rabidly opposed to the bill.


But despite the unrelenting protestations and vocal criticisms of some sectors of the Catholic hierarchy and their lay organizations, the reaction of ordinary people to the RH bill has always been overwhelmingly positive. In particular, the support the bill has from women is especially strong.

The issue of reproductive health and population development are indeed issues close to the hearts of women who bear the brunt not only of pregnancy and childbirth but also of childrearing.  Invariably, women seem to know instinctively that the lack of family planning information and options will have negative effects on their lives.

Being local legislators, I am certain that you have seen firsthand the deleterious outcomes of unremitting pregnancies on the health of both mothers and children in particular and sustainable human development in general.

As women, I am sure that you want concrete and lasting solutions to the problems of maternal and infant mortality and morbidity and better chances for women to lead dignified and meaningful lives.

Poverty in the Philippines Wears a Woman’s Face

The story of ill-health and poverty in the Philippines wears a woman’s face. The feminization of hardship and suffering cannot be denied. Women, who already have significantly less opportunities for remunerative work and quality education, are doubly burdened because they have to bear and give birth to children; feed, bathe, medicate and care for them; manage the family’s finances and do the housework on top of their jobs outside the home. A woman is not only mother and wife. She is also a nurse, cook, maid, laundrywoman, tutor, handyman and accountant rolled into one.

It is no wonder then that Filipino women have expressed tremendous support for the RH bill. They know that it is pro-poor, pro-women and ultimately, pro-life. It will give them and their partners the opportunity to have only the children that they can afford to bring up into healthy, educated and productive citizens.

A ballooning PGR impacts negatively on all
human development indicators

 

But unless women and couples have the opportunity to plan their families and meet their fertility goals, it will be extremely difficult for them to ensure the future wellbeing of their children.

We cannot achieve genuine and sustainable human development if we continue to default in addressing the population problem. It is beyond debate that a huge population growth rate impacts adversely on all indicators of human development such as health, education, shelter, food security, employment and the environment.

Chronic poverty and high population growth rates are inextricably linked. A high PGR all but negates any progress we may achieve in terms of economic growth and cancels out government’s efforts in poverty reduction.
Government can help curb a ballooning population by simply helping women and couples realize their fertility goals. House Bill 5043 on reproductive health, responsible parenthood and population development will help ensure that women and couples will achieve their desired number of children.

The RH Bill = Freedom of Informed Choice

The heart and soul of House Bill 5043 is the creation of an enabling environment wherein women and couples will not only have information on and access to all forms of family planning methods from the modern to the natural but also the opportunity to freely choose which method is best suited to their needs, personal convictions and religious beliefs.

Contrary to the claims of its critics that the bill favors modern methods of family planning over natural methods, 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.

It is important to underscore that 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.

Moreover, neither the Church nor the State can impose its will or preference on couples. Neither are these institutions allowed to intrude into the private bedrooms of women and couples and interfere with their family planning decisions. The final decision rests on the women or couples themselves.

RH and family planning are basic universal human rights

 

Forty years ago, the International Conference on Human Rights in the Proclamation of Teheran articulated unequivocally that “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.

HB 5043 will help protect and fulfill the right of all Filipinos to decide when and how often they want to become parents.

The miracle of life must not mean death for mothers

The persistent negative reports that 11 Filipino women die daily of causes related to pregnancy and childbirth underscore the critical immediacy of enacting the RH bill.

The most recent report comes from the State of the World’s Children 2009 of the UNICEF which emphasizes that “having a child remains one of the biggest health risks for women worldwide.” The report underscores the fact that difference in pregnancy risk between women in developing countries like the Philippines and women in first world nations is “the greatest health divide in the world.”

With approximately 4,500 Filipino mothers dying of complications related to childbirth and pregnancy each year, the Philippines is among the worst performing countries in improving maternal health.

Moreover, based on the UNICEF Report, the lifetime risk of maternal death in the Philippines is 1 in 140, compared to 1 in 8,000 for women in developed countries. According to the report, women in developing countries are 300 times more likely to die in childbirth or from pregnancy-related complications than women in developed countries.

These are not cold statistics but disturbing and distressing figures which demand immediate remedial action from both local and national policymakers.

No woman should die giving life. As local legislators, and more importantly, as women and mothers, your support will be indispensable in the prevention of maternal mortality. The miracle of life should not mean death for so many Filipino mothers.

Family planning saves lives

Studies by the WHO, UNDP and UNFPA validate that correct and consistent use of contraceptives will prevent one-third of all maternal deaths. With 98% of maternal deaths happening in developing countries like the Philippines, it is imperative that women be given access to effective family planning methods as provided for in HB 5043.

Family planning saves lives because it will have a direct effect on maternal mortality by reducing the number of high-risk pregnancies. HB 5043 will help women who are at a higher risk of maternal death avoid unplanned pregnancies.

“Too young, too old, too many, too soon” illustrates the undesirable aspects of unplanned pregnancies and avoiding pregnancies in women who fall under this category will dramatically reduce maternal deaths.

Family planning will not only lead to a decrease in overall pregnancy rates. The WHO emphasizes that with the proper use of contraceptives, “the fall in maternal mortality is likely to be even greater than the fall in the pregnancy rate.” This means that the risk associated with each individual pregnancy had been reduced.

There are several possible ways in which this could happen:

  1. Fewer births to very young women. The bodies of women under 18 years are not yet ready for pregnancy and childbirth and it is for this reason that in the Philippines, 75% of maternal deaths happen to 15 to 19 year old women.
  2. Fewer births to older women. Similarly, women above 35 years are at an increased risk of hemorrhage, pregnancy-induced hypertension and uterine prolapse. Therefore, reducing the proportion of pregnancies among older women would decrease maternal mortality levels.
  3. Fewer high-parity births. Studies show that women who already have four or more children have a substantially increased risk of maternal death. Frequent pregnancies are also often associated with less prenatal care and lower likelihood of supervised delivery.
  4. Fewer short birth intervals. Short birth intervals are also linked to increased risk of an adverse outcome for the mother because studies show that a woman’s body needs no less than three years to recover from pregnancy and childbirth. Thus, the shorter the gap between pregnancies, the greater is the likelihood of maternal death.

 

Family planning prevents abortions

 

It must also be underscored that family planning does not only saves lives, it is directly related to the decrease in abortion rates.

The WHO has unequivocally asserted that family planning is “the most effective intervention to prevent unintended pregnancy and abortion.”

HB 5043 is also very clearly anti-abortion. Its objective is to ensure that women and couples have access to all methods of family planning in order to prevent unplanned pregnancies. According to the 2003 NDHS, 44.3% of all pregnancies in the country are unplanned principally because of the lack of information on and access to family planning services. It is for this reason that the incidence of induced abortion in this country is 500,000 annually.

Contraceptive use and abortion have an inverse correlation. The more women use effective contraception, the less likely they have unwanted pregnancies that will be terminated through abortion. Research by the Gûttmacher Institute also reveals that the use of contraceptives can reduce abortion rates by 85%.

RH and FP are essential to the achievement of key MDGs

The Philippines has committed to achieve the Millennium Development Goals (MDGs) by 2015 of which Goal No. 5 is the improvement of maternal health. MDG Goal No. 5 has recently been amended to include reproductive health. Goal No. 5 now includes the achievement of “universal access to reproductive health”.

Consequently, the following are the four new indicators for monitoring MDG No. 5 apart from maternal mortality ratio and proportion of births attended to by a skilled health professional: (1) contraceptive prevalence rate; (2) adolescent birth rate; (3) antenatal care coverage; and (4) unmet need for family planning.

It is important to underscore that six of the eight MDGs are linked to reproductive health and are covered by the elements of RH as enumerated in House Bill 5043.

RH and Goals 4 and 5 on maternal and child health and survival

An important element of reproductive health as provided in HB 5043 is maternal, infant and child health and nutrition. This is crucial to ensuring the health of mothers and infants and in the reduction of maternal and infant mortality under Goals 4 and 5.

Family planning, another vital element of RH, is central to maternal and child health because the WHO states that intervals of six months or shorter between childbirth and an ensuing pregnancy are associated with elevated risks of maternal mortality and intervals of 18 months or shorter are associated with elevated risk of infant mortality, low birth weight and pre-term delivery.

This is why a national policy on RH is crucial in order to drastically lower maternal mortality rates in the country.

RH and Goals 2 and 3 on universal primary education and gender equality

In the Philippines, childcare is still considered primarily the role of mothers and/or older sisters. Therefore, it is not uncommon for girls to drop out of school because they are forced to care for siblings as the family continues to expand. Family planning will help ensure gender parity in school and foreclose this inequity being imposed on girls.

Another element of RH is the elimination of violence against women which will not only promote the basic human right to live a life free of violence but is also central to achieving gender equality.

Moreover, family planning will lead to bigger investments in health and education, improved quality of childcare and more educational and employment opportunities for women. All these will go a long way in achieving Goal 2 on universal primary education and Goal 3 on promoting gender equality.

RH and Goals 6 and 7 on HIV-AIDS and the environment

Still another element of reproductive health is the prevention of HIV-AIDS and other sexually transmitted diseases. Renewed efforts to curb the spread of HIV-AIDS and other STDs as advocated in the RH bill will help government achieve part of Goal No. 6 on combating HIV-AIDS.

Slower population growth through family planning will also relieve the strain that a burgeoning population exerts on an environment increasingly threatened by human activity and will help us attain Goal No. 7 on environmental sustainability.

RH and Goal No. 1 on poverty and hunger

Guaranteeing the right of women and couples to reproductive self-determination will also ultimately help government achieve Goal No. 1 on the eradication of hunger and poverty.

A decline in fertility rates will help open a demographic window of economic opportunity similar to what happened in South Korea, Singapore, Malaysia and Thailand. With fewer dependent children relative to the working-age population, these countries made additional investments on health, education, food security and other basic social services which spurred economic growth and helped reduce poverty.

By promoting and protecting the right to reproductive health, we will clearly have a better chance of achieving the MDGs.

Make every mother and child count

The time has come to put an end to the relegation of women and maternal health to the backburner of the national agenda. We must exert all efforts to make every mother and child count. I am confident that RH advocates in Congress can count on the support of the Lady Local Legislators League of the Philippines to actively and forcefully campaign for the enactment of a national policy on reproductive health, responsible parenthood and population development.

I am truly thankful that many local councils have passed their own versions of the RH bill like those adopted by, among others, the provinces of Aurora, Ifugao and Tawi-Tawi; the cities of Olongapo, Sorsogon and Davao, and the municipalities of Talibon in Bohol, Sagada in the Mountain Province and Lebak in Sultan Kudarat. This is clearly a reflection of the exemplary political will of local leaders.

However, the country still needs a comprehensive, rights-based and adequately funded RH statute that is national in scope.

Passing the buck to LGUs when it comes to the formulation of population policies and implementation of family planning programs is at best, impractical. At worse, it is simply bad governance.

The crafting of population policies and their effective execution cannot be relegated to LGUs for the following reasons: 1) More often than not, local leaders wait for policy directives from the national government; 2) A decrease in population growth will not be an incentive to LGUs because increases in the amount of IRA an LGU receives is directly proportional to the increase in its population; 3) If an LGU provides access to all forms of family planning methods, it can expect a surge of migrants who would want to take advantage of its FP programs to the detriment of actual residents (this is exactly what happened in Quezon City when its health centers were swamped with Manila residents who were deprived of family planning services and supplies for nine years during the incumbency of former Manila Mayor Lito Atienza); 4) The fiscal resources and technical expertise of each LGU differs; and 5) Local executives are more susceptible to the pressures that will be brought to bear by religious institutions in the implementation of RH programs and policies.

The people have spoken: Filipinos want the RH bill passed

 

Survey after survey for the last two decades, document the increasing number of Filipinos, principally Catholics, who favor family planning, including contraceptive use. Consider the results of the latest Pulse Asia survey conducted in October 2008:

  • 93% of Filipinos consider it important to have the ability to plan their families;
  • 82% of Filipinos believe government should teach couples about all methods of family planning;
  • Another 82% of Filipinos say that it is the government’s duty to provide the people with knowledge, services, and materials on all methods of family planning; and
  • A considerable majority of Filipinos (63%) want the RH bill to be passed into law with only 8% expressing opposition to the measure.
The SWS survey conducted in September 2008 shows similar results:
  • 71% of Filipinos are in favor of the RH bill;
  • 76% of Filipinos agree that there should be a law requiring government to teach family planning to the youth; and
  • 68% believe that there should be a law requiring government to distribute legal contraceptives like condoms, pills and IUDs
The SWS survey disaggregated the data to reflect sentiments of Catholics regarding contraception, the inclusion of family planning in school curricula and the RH bill. The results are instructive:
  • 68% of Catholics believe that government should distribute free contraceptives to those who want them;
  • 76% of Catholics agree that there should be a law requiring government to teach family planning to the youth; and
  • 71% of Catholics favor the passage of the RH bill versus only 68% of non-Catholics who endorse the bill.

The people have spoken. They want to be able to plan their families. They want government to give them family planning information and services. They want the RH bill passed. They need the RH bill passed.

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.

A non-coercive measure that will provide accurate and reliable family planning information and services and help people become responsible parents even as it will increase their chances of improving their lives is definitely pro-poor, pro-women and pro-life.

Well-off, educated, accomplished and independent women like you have always exercised their right to responsibly plan their families. Please do not let your less fortunate sisters be deprived of the same right that you enjoy.

There is no reason for any of us to be afraid of the RH bill. But there are 4,500 reasons to support the bill – the 4,500 Filipino mothers who die every year from causes related to pregnancy and childbirth. There are additional 8,000 reasons to fight for reproductive rights – the 8,000 babies who annually do not survive their first month of life. And another 2.6 million reasons to stand up for the bill – the 2.6 million poor Filipinas who want to plan their families but are unable to do so because they lack information on and access to family planning services.

Clearly, there are more than enough reasons to fight for HB 5043 because family planning indeed saves lives; reproductive health is essential to women’s overall health and its protection and promotion will determine whether or not a woman will have a say in her own future.