A long-awaited reproductive health law in the Catholic-majority Philippines that took effect a year ago is still facing challenges. Health service providers are dealing with a new Supreme Court order curbing some free contraception for the poor.
The delivery ward at the Philippines’ largest public maternity hospital is filled by rows of beds with mothers in hospital gowns. Some women breastfeed while others try to calm crying newborns. At the Joseph Fabella Memorial Hospital in Manila, these women will be out in a day and counselors have little time to let them know about family planning.
Dr. Esmeraldo Ilem heads comprehensive family planning services at Fabella, which includes options from natural methods of birth control to artificial contraception. He says most of the mothers here are poor and have five children on average. A few say they have opted for some form of contraception after giving birth.
Free contraceptives for poor
Ilem says the new law that provides for free contraceptives to the poor has been a great help.
“For the one year that the law was passed we were able to procure a lot of commodities and they were all distributed to the health centers and made available to the clients needing them,” he said.
Ilem says before the 2012 law, government health facilities did not have the money to dispense contraceptives for free and they relied on donations from other countries. For years versions of the law were shot down by lawmakers who took the view of the Catholic Church, that contraception unnaturally ends life before it can begin.
Constitutional challenges
Immediately after it was signed into law, the Responsible Parenthood and Reproductive Health Act of 2012 was put on hold. It faced nearly a dozen challenges to its constitutionality. Last year, the Philippine Supreme Court struck down eight provisions, but left the rest alone, including the arrangements for free contraceptives for the poor.
But this June, the Court placed a temporary restraining order on government distribution of certain implant contraceptives, while it looks into a petition that claims they cause abortions. Ilem says the implant is the most popular form of birth control. The long thin progesterone capsules are embedded under a woman’s skin and prevent pregnancy for three years.
At the non-government Likhaan Center for Women’s Health, Mary Jane Jurilla does community outreach. She says since the government health clinics are not dispensing implants, it is hard for women to save enough for bus fare to Likhaan.
She says, “What about the really poor women who can not afford the fare? They should just leave us women to decide for ourselves what kind of family planning we want. But of course we need the government to provide it for free.”
Jurilla worries Likhaan could be in the same position it was in some years back when no government sanctioned free contraception, even if donated, was available to the poorest of the poor, and buying it from drug stores was well beyond their budgets.
Conscientious objectors
Early this year, Sorsogon Mayor Sally Lee, who calls herself a devout Catholic, declared her city “prolife,” using a clause stipulated by the Supreme Court that conscientious objectors are not compelled to dispense artificial contraceptives.
"It is all about my conscience. It is all about living in harmony with nature. It is all about God. I do not have any [argument] with those things. I do not need to argue. It is just my commitment to God, to people and myself,” said Lee.
Lee says the city’s public health centers promote the Catholic-sanctioned “natural family planning” and no longer provide free artificial contraception.
Dr. Gina Pardilla with the Manila City health office says the city had already started to broaden its family planning options before the law was passed last year, but it allowed the city for the first time to set aside funding for free artificial birth control for the needy.
“Once you talk to me I will tell you, ‘This is because of your health.’ Then you can change your mind without me attacking your sense of values or your sense of religion or even your morals. I will just center on your health,” she said.
Fabella’s Dr. Esmeraldo Ilem says while the temporary hold on certain birth control is in place, health officials continue to travel