After 14 years, the controversial Reproductive Health bill is now law. Without fanfare, President Benigno Aquino III on December 21 signed “The Responsible Parenthood and Reproductive Health Act of 2012.”
Most Filipinos welcome the passage of the RH law–71 percent favor its passage, according to a Social Weather Station survey, and 78 percent support “sex education” in public schools.
The law does not only lay the groundwork for RH services, but it also has become a symbol of the primacy of conscience over some church teachings, the importance of reason and choice and the enhanced dignity that comes with exercising control over one’s reproductive life.
But the Catholic Bishops’ Conference of the Philippines and Catholic Church groups like Pro Life Philippines and Couples for Christ, as well as conservative legislators, opposed the bill intensely. From their perspective, it is an evil that would destroy families, kill the “unborn,” entice adolescents to sexual promiscuity and open the gates to divorce, abortion and same-sex marriage.
Opposition continues to this day. Lay groups, supported by the clergy, recently launched the “One Million Red Ribbons for Life and Family Movement” throughout the country, urging Catholics to hang red ribbons everywhere in protest against the RH law. Bishops have vowed to challenge its constitutionality in the Supreme Court.
A careful reading of the RH law, however, shows it is a basically reasonable piece of legislation that intends to make sure women and men have access to reproductive health care.
Framed within the 1987 Constitution, the law is based on human rights principles, particularly the right to reproductive health and to a safe and satisfying sex life. Its salient features are the provision of
- information and free natural and artificial contraceptives in public health facilities;
- life-saving emergency obstetric and newborn care in public health facilities;
- reproductive health education to young people between the ages of 10 and 19 in public schools; and
- maximum benefits by PhilHealth, the country’s social health insurance system, to women and men with reproductive health conditions such as obstetric emergencies, breast and reproductive tract cancers, and HIV/AIDS.
These provisions are a response to significant reproductive health problems that confront the Philippines today, which neighboring countries such as Malaysia, Thailand and Vietnam have already successfully dealt with.
Maternal and newborn deaths
Many Filipino women continue to die during pregnancy and childbirth because they lack access to emergency obstetric services. From 1990 to 2010, some 4,300 women died every year due to complications related to pregnancy and childbirth.
When a woman dies, the prospects for her babies are dim. A study showed that when mothers died during labor, their newborns died within a year of their birth. Another study found that the risk of death for children under five years old is doubled if their mothers die in childbirth.
Emergency obstetric and newborn care and social health insurance, as articulated in the RH law, would effectively prevent maternal and newborn deaths.
Unmet contraceptive needs
In 2011, the National Statistics Office conducted a survey and showed that the unmet contraceptive needs of married women in the 15 to 49 age group have increased from 15.7 percent in 2006 to 19.3 percent in 2011. Unmet need is highest among poor women (25.8 percent), adolescent girls (37 percent), women with no education (29.2 percent), and women in the Autonomous Region of Muslim Mindanao (35.8 percent).
This same survey showed that the most commonly cited reasons for not using any contraceptive was that women “want to have children” (20.8 percent), followed by difficulty of access to family planning methods (16.2 percent) and fear of side effects (15.5 percent). Only 2.2 percent of women surveyed pointed to “religious prohibition” for not using contraceptives.
Provision of information and free services on the various family planning methods would help women and men control their fertility and decide the number of children they desire to have.
The National Statistics Office estimates that fertility rate for the 15 to 19 age group increased from 39/1000 in 2006 to 54/1000 in 2011. At 54/100,000, the Philippines has one of the highest teenage pregnancy rates in ASEAN, next to Laos and East Timor.
According to the UN Population Fund, the number of teenage pregnancies–from 15 to 19–has increased by 70 percent, from 114,205 in 1999 to 195,662 in 2009.
Reproductive health education – from physiology and sexuality to women’s rights – has been shown to delay initiation into sexual activities, prevent early marriages, protect couples from HIV and other sexually transmitted infections.
Men having sex with men is the main mode of transmission of HIV in the country. The total number of reported cases, according to the DOH, is 10,514–a 587 percent increase since 1984 when the first case of HIV was reported.
While the incidence of HIV is less than one percent of the 93 million Filipinos, DOH says that HIV cases are increasing: At least nine new cases were reported every day in 2012. In 2000, only one new case was reported every three days. If this trend continues, DOH projects 37,000 new cases of HIV in 2015.
Provision of information and condoms as well as the inclusion of HIV in the social health insurance system would have a positive impact on HIV prevention in the country.
The RH law has other noteworthy provisions, such as making persons with disabilities gain access to sexual and reproductive health programs, encouraging private service providers to work pro bono for indigent women and strengthening the capacities of frontline health workers in providing and promoting reproductive health.
It is a breakthrough in health and civil rights legislation in the Philippines although it still has to pass through the grueling process of implementation. But its chances for success are buoyed by the broad enthusiasm that greeted its passage.
Marilen J. Danguilan, a medical doctor, is the author of Making Choices in Good Faith: A Challenge to the Catholic Church’s Teachings on Sexuality and Contraception and Women in Brackets: A Chronicle of Vatican Power and Control.