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Women's Feature Service

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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)

 

Philippines: Crime - Abortion - Punishment - Suffering

 

By Perla Aragon-Choudhury - Women's Feature Service

 

Manila, The Philippines - WFS - "Before my third abortion, I consulted a private doctor on what drug to take.... She said it is against their profession... I told her I had this condition [severe hypertension]; I had a reason. She firmly said she would not give me a drug..." - Haydee, 32, a mother of one, diagnosed with severe hypertension, a condition that can make pregnancy fatal.

 

"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 Philippines is one of the few countries in the world that has criminalised abortion in all circumstances with no clear exceptions.

 

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 Philippines; 90,000 women sought treatment for related complications and 1,000 women died. These tragic and preventable deaths were a direct consequence of the nation's restrictive abortion law and an indirect consequence of the lack of adequate information about, and access to, effective modern contraceptives. This eye opening data was recently released as part of the New York-based Centre For Reproduction Right's (CRR) latest study, 'Forsaken Lives: The Harmful Impact of the Philippine Criminal Abortion Ban'.

 

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 Philippines, reveals the study, is the unavailability of a full range of family planning services and information. In 2008, an estimated 1.9 million pregnancies were unplanned, higher than a 2006 study which revealed that 1.43 million unplanned pregnancies occurred each year.

 

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."