WUNRN
Women's Feature Service
Forsaken Lives - The Harmful Impact
of the Philippines Criminal Abortion Ban
'Forsaken Lives: The Harmful Impact of the Philippine
Criminal Abortion Ban' brings the voices of women who have suffered
the adverse consequences of abortion law in the Philippines.
(Courtesy: CRR\WFS)
By Perla
Aragon-Choudhury - Women's Feature Service
"Many women
would come to my clinic telling me they needed help. But I could not help them.
So they would go away very sad. Of course, there were also many times when the
hospital staff would wake me up in the middle of the night saying that a woman
who had come to my clinic after undergoing an unsafe abortion was doing badly.
It's during those times that I felt that I was pushing these women to have
unsafe abortions" - Dr Florence Tadiar, a doctor and a women's health
activist.
Why did Haydee's
doctor refuse to even consider her request for abortion and why did Dr Florence
Tadiar go through a moral dilemma each time she turned away a patient? Because
the
Under Article 256 of
the Revised Penal Code of 1930, a person who intentionally causes an abortion
may be jailed for two to 20 years, depending on whether the abortion was caused
by violence and on whether the pregnant woman consented to the procedure. The
Article 259 jails physicians and midwives, who directly cause or assist in an
abortion, for a period of 20 years.
But despite the
criminal ban, in 2008 alone, an estimated 560,000 induced abortions took place
in the
The CRR, which uses
the law to advance reproductive freedom as a fundamental human right, has
chronicled the negative experiences of women and documented the impact of the
ban on health care providers. The law, it says, leaves health care workers
unable to fulfill their ethical obligations to their patients, making them
"an accessory to women's suffering".
The study was done
with the support of women health activists like Dr Tadiar, who is the chief
executive officer of the Institute for Social Studies and Action (ISSA), an
advocacy and resource centre founded in 1983.
While there is a
criminal ban on abortion, what has added to the confusion is the stand that
health workers can take with regard to abortions in Section 12 of the Article
II of the 1987 Constitution. This Article protects the lives of the mother and
the unborn and says that there is no obligation to report a woman suspected of
inducing an abortion or the person suspected of giving it.
The ground reality,
however, has been spelt out by the Philippine Obstetrical and Gynecological
Society (POGS), which has made it clear that pregnancy may be terminated only
if consistent with the Roman Catholic Church's principle called the double
effect. In 'Ethical Issues in Fetomaternal Care', POGS has stated that giving
medicines or treatment that will most likely end pregnancy is acceptable only
when the intended effect is not to cause an abortion but to treat another
medical condition - as, for instance, removing a women's fallopian tubes to
treat ectopic pregnancy or giving chemotherapy to treat certain cancers.
But, according to the
CRR study, although the POGS recognises ectopic pregnancy as possible medical
grounds for abortion, its guidelines reveal a strong bias toward the foetus by
prohibiting the use of medical options that may perceivably directly impact the
foetus, even at the risk of threatening a woman's life.
The guidelines reinforce
this approach through another provision that establishes that the foetus must
be "regarded as a patient from the time of conception". There is no
recognition of rape and incest as a ground for abortion, although FIGO [the
international body on obstetrics and gynecology] recognises that "most
people would consider [abortion] to be justified in cases of incest or rape on
ethical grounds".
One of the main
reasons behind the high rates of abortions in the
Government policy
combined with binding religious rules has only added to the dismal state of
women's reproductive rights. So what's the way out for these "forsaken
women"? The study has some important recommendations. First, medical
schools and teaching hospitals should formally train students and residents to
manage abortion complications, and to respect and counsel women seeking illegal
abortion. Second, the Department of Health (DOH) should resume training of
service providers on the prevention and management of abortion and its
complications or PMAC - specifically, on techniques in post-abortion care,
gender sensitivity and awareness of professional and ethical obligations.
Third, the government should increase the amount of - and upgrade the quality
of - lifesaving drugs, supplies and equipment for PMAC. It could give more
manual vacuum aspirators (MVA) for post-abortion care, plus the supplies needed
(cannulas, and so on) for this procedure.
While these
suggestions could significantly make a difference to the lives of women, the
CRR study appears to have split reproductive health workers into two camps. One
is pushing for a law on legal abortion; the other is rooting for the
reproductive health bill, which was nearly passed in the last Congress and has
been re-filed.
"How do we
prevent [the] discrimination and violation of human rights?" asks lawyer
Clara Rita Padilla, executive director of EnGendeRights, and adds, "By
passing a comprehensive reproductive health law and implement it to the full
extent. At the same time, provide access to safe and legal abortion either on
certain grounds (rape, danger to the health and life of the women, foetal
impairment) or on broader grounds to do away with judicial and medical
interpretation."
Dr Junice Melgar,
executive director of Likhaan, a centre that advocates women's health and
empowers grassroots women, has a different take. She feels that
"widespread and effective contraception can reduce abortion by several
folds." As she puts it, "A national consensus on reproductive health
has already [been] achieved after over a decade of research, debate and mass
actions by Filipinos from different sectors of society. Surveys time and again
show a consensus for a bill that does not legalise abortion but reduces its
incidence with support for modern family planning and sex education and
[training], which guarantees humane post-abortion care."
Be it a law or a
bill, what women like Imelda, 30 - a mother of four and whose family has no
steady income - need is a choice. Putting things in perspective she says,
"Why should a woman bring a child into this world just to suffer? ... If
only the government would see women's situation, then there would be no need
for secrecy and untimely deaths. It is the fear of stigma and lack of knowledge
that are stopping women from seeking help even if they are actually bleeding to
death. If it is legal, then hospitals will provide a safe service to all the
women who need it."