Philippine Reproductive health bill: Facts, fallacies
(Philippine Daily Inquirer Editor’s Note: Upon the request of readers, we are running the salient features of the proposed Reproductive Health and Population Development Act of 2008. We asked its principal author in the House of Representatives to present the main points of and misconceptions about the bill*. We hope that this issue will help readers reach an informed opinion on the measure.)
The bill is national in scope, comprehensive, rights-based and provides adequate funding to the population program. It is a departure from the present setup in which the provision for reproductive health services is devolved to local government units, and consequently, subjected to the varying strategies of local government executives and suffers from a dearth of funding.
The reproductive health (RH) bill promotes information on and access to both natural and modern family planning methods, which are medically safe and legally permissible. It 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.
The bill does not have any bias for or against either natural or modern family planning. Both modes are contraceptive methods. Their common purpose is to prevent unwanted pregnancies.
The bill will promote sustainable human development. The UN stated in 2002 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.”
Coverage of RH. (1) Information and access to natural and modern family planning (2) Maternal, infant and child health and nutrition (3) Promotion of breast feeding (4) Prevention of abortion and management of post-abortion complications (5) Adolescent and youth health (6) Prevention and management of reproductive tract infections, HIV/AIDS and STDs (7) Elimination of violence against women (8) Counseling on sexuality and sexual and reproductive health (9) Treatment of breast and reproductive tract cancers (10) Male involvement and participation in RH; (11) Prevention and treatment of infertility and (12) RH education for the youth.
Strengthening of Popcom. The existing Population Commission shall be reoriented to promote both natural and modern family planning methods. It shall serve as the central planning, coordinating, implementing and monitoring body for the comprehensive and integrated policy on reproductive health and population development.
Capability building of community-based volunteer workers. The workers shall undergo additional and updated training on the delivery of reproductive healthcare services and shall receive not less than 10-percent increase in honoraria upon successful completion of training.
Midwives for skilled birth attendance. Every city and municipality shall endeavor to employ an adequate number of midwives and other skilled attendants.
Emergency obstetrics care. Each province and city shall endeavor to ensure the establishment and operation of hospitals with adequate and qualified personnel that provide emergency obstetrics care.
Hospital-based family planning. Family planning methods requiring hospital services like ligation, vasectomy and IUD insertion shall be available in all national and local government hospitals.
Contraceptives as essential medicines. Reproductive health products shall be considered essential medicines and supplies and shall form part of the National Drug Formulary considering that family planning reduces the incidence of maternal and infant mortality.
Reproductive health education. RH education in an age-appropriate manner shall be taught by adequately trained teachers from Grade 5 to 4th year high school. As proposed in the bill, core subjects include responsible parenthood, natural and modern family planning, proscription and hazards of abortion, reproductive health and sexual rights, abstinence before marriage, and responsible sexuality.
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. The document should certify that they had duly received adequate instructions and information on family planning, responsible parenthood, breast feeding and infant nutrition.
Ideal family size. The State shall encourage two children as the ideal family size. This is neither mandatory nor compulsory and no punitive action may be imposed on couples having more than two children.
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.
Multimedia campaign. Popcom shall initiate and sustain an intensified nationwide multimedia campaign to raise the level of public awareness on the urgent need to protect and promote reproductive health and rights.
There is a continuing campaign to discredit the reproductive health bill through misinformation. Straightforward answers to the negative propaganda will help educate and enlighten people on the measure.
The bill is not antilife. It is proquality life. It will ensure that children will be blessings for 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 but also optimize care for children who will have more opportunities to be educated, healthy and productive.
The bill does not interfere with family life. In fact, it enhances family life. The family is more than a natural nucleus; it is a social institution whose protection and development are impressed with public interest. It is not untouchable by legislation. For this reason, the State has enacted the Civil Code on family relations, the Family Code, and the Child and Youth Welfare Code.
The bill does not legalize abortion. It expressly provides that “abortion remains a crime” and “prevention of abortion” is essential to fully implement the Reproductive Health Care Program. While “management of post-abortion complications” is provided, this is not to condone abortion but to promote the humane treatment of women in life-threatening situations.
It will not lead to the legalization of abortion. It is not true that all countries where contraceptive use is promoted eventually legalize abortion. Many Catholic countries criminalize abortion even as they vigorously promote contraceptive use like Mexico, Panama, Guatemala, Brazil, Chile, Colombia, Dominican Republic, El Salvador, Honduras, Nicaragua, Venezuela, Paraguay and Ireland. The Muslim and Buddhist countries of Indonesia and Laos also promote contraceptive use yet proscribe abortion. According to studies, correct and regular use of contraceptives reduces abortion rates by as much as 85 percent and negates the need to legalize abortion.
Contraceptives do not have life-threatening side effects. Medical and scientific evidence shows 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.
The bill will not promote contraceptive mentality. The bill does not prohibit pregnancy. Critics are mistaken in claiming that because contraceptives would be readily available, 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 unwanted pregnancies but not to stop pregnancies altogether. Timed pregnancies are assured.
The bill does not impose a two-child policy. It does not promote a compulsory policy strictly limiting a family to two children and no punitive action shall be imposed on parents with more than two children. This number is not an imposition or is it arbitrary because results of the 2003 National Demographic and Health Survey show that the ideal of two children approximates the desired fertility of women.
Sexuality education will neither spawn “a generation of sex maniacs” nor breed a culture of promiscuity. Age-appropriate RH education promotes correct sexual values. It will not only instill consciousness of freedom of choice but also responsible exercise of one’s rights. The UN and countries which have youth sexuality education document its beneficial results: understanding of proper sexual values is promoted; early initiation into sexual relations is delayed; abstinence before marriage is encouraged; multiple-sex partners is avoided; and spread of sexually transmitted diseases is prevented.
It does not claim that family planning is the panacea for poverty. It simply recognizes the verifiable link between a huge population and poverty. Unbridled population growth stunts socioeconomic 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. The Asian Development Bank in 2004 also listed a large population as one of the major causes of poverty in the country.
The National Statistics Office affirms that large families are prone to poverty with 57.3 percent of families with seven children mired in poverty while only 23.8 percent of families with two children are poor. Recent studies also show that large family size is a significant factor in keeping families poor across generations.
Family planning will not lead to a demographic winter. UP economics professors in their paper “Population and Poverty: The Real Score” declared that the threat of a so-called demographic winter in the Philippines is “greatly exaggerated, and using it as an argument against a sensible population policy is a plain and simple scare tactic.”
The National Statistical Coordinating Board projected that a replacement fertility of 2.1 children per couple could be reached only by 2040. Moreover, despite a reduced population growth rate, the effects of population momentum would continue for another 60 years by which time our total population would be 240 million.
Humanae Vitae is not an infallible doctrine. In 1963, Pope John XXIII created the Papal Commission on Birth Control to study questions on population and family planning. The Commission included ranking prelates and theologians.
Voting 69 to 10, it strongly recommended that the Church change its teaching on contraception as it concluded that “the regulation of conception appears necessary for many couples who wish to achieve a responsible, open and reasonable parenthood in today’s circumstances.”
However, it was the minority report that Pope Paul VI eventually supported and which became the basis of Humanae Vitae.
Even 40 years ago when the encyclical was issued, theologians did not generally think that it was infallible. Monsignor Fernando Lambruschini, spokesperson of the Vatican at the time of its release, said “attentive reading of the encyclical Humanae Vitae does not suggest the theological note of infallibility… It is not infallible.”
Five days after the issuance of the encyclical, a statement against it was signed by 87 Catholic theologians. It asserted that “Catholics may dissent from … noninfallible Church doctrine” and that “Catholic spouses could responsibly decide in some circumstances to use artificial contraception.”
* Rep. Edcel Lagman of Albay is the principal author of the proposed Reproductive Health and Population Development Act of 2008.