Good question

In the ongoing debate on the reproductive health bill, Senate President Juan Ponce Enrile challenged the figures on induced abortion in the Philippines being cited by proponents of the bill. A good question, since the number of 500,000 or more has echoed from columnist to columnist and activist to activist so often that few stop to ask what was its source.

Actually the number goes back to a study done by an international team using as its empirical base hospital reports from the year 2000 of women treated for the after-effects of abortions.  However, hospitals do not distinguish between induced and spontaneous abortions or miscarriages. Nor do they report the number of women admitted for complications resulting from abortions unless this is one of the 10 most frequent reasons for admission in that hospital. Thus 478 hospitals (out of 2,039) reported about 71,500 admissions for post-abortion complications. These 71,500 are the empirical base for the study, the only “hard fact” that we have.

But how did they get from 71,500 to the overall estimate of 473,400 induced abortions in the year 2000? The researchers built a tall tower of assumptions on that very narrow base: assumptions about the number of women admitted for post-abortion complications in non-reporting hospitals; assumptions about the percentage of women who have abortions but are not admitted to hospitals, either because they have no complications or are treated in private clinics or die without reaching a hospital. From the resulting estimate of women suffering post-abortion complications they subtracted the number of spontaneous abortions which could be expected, given the estimated number of births that year. And “voila,” they had their estimate for the year 2000, which is now projected forward to something over 500,000.

The numbers, in other words, have left behind the 71,500 people on which they were originally based and taken on a life of their own, animated by “heroic assumptions” and supported by repetition.

I do not wish to criticize the researchers, who used a methodology which has been applied elsewhere and apparently did their best with the little hard data available. Neither do I wish to challenge their conclusions, but only to insist that there is wide room for error here. The actual number of abortions may be considerably less or considerably greater than their conclusions indicate. Those who choose to use these figures would do well to use them with caution; those who reject them are free to produce better estimates if they can.

One would have to be blind, however, not to realize that induced abortions are a horrendous reality in the Philippines. This is evident from sample surveys, from reports of abortifacient drugs being sold outside Quiapo church and elsewhere, from accounts of clandestine abortion clinics and stories of hilots who make a business of inducing abortions, from stories of unfortunate women inducing abortion by jumping from high places or by more barbarous methods. The fact that abortion is illegal in the Philippines does not make it any less a national tragedy, calling urgently for a solution.

Part of the solution as proposed by proponents of the RH bill is to make contraceptives more readily available to the poor. Intuitively this makes sense; it seems unlikely that if contraceptives are available women would prefer the risk and pain of abortion.

The objection is made that some of the “contraceptives” now in use are in fact abortifacients, that they prevent a fertilized ovum – a new human being – from being implanted in the womb of the mother and thus bring about its death. This argument opens up a whole can of worms, conceptually and in terms of empirical evidence, and the only practical solution seems to be to stand by the apparent intention of the drafters of the Constitution that life is to be defended from the moment of conception, i.e. from the time when the sperm penetrates the ovum. All pills and devices which can be shown to prevent implantation are therefore illegal.

The argument that contraceptive use and the abortion rate have gone up together in some countries does not seem entirely valid; some of the countries pointed to are those in which abortion has been made legal, and we have little data on those in which it is illegal, as it is and presumably will remain in the Philippines.

In the final analysis, however, contraception is not the solution. We are dealing with values here, not simply technology: the value of life and respect for the sacredness of the act by which a husband and wife cooperate with God in bringing into being a new human person destined for eternity with Him.

For this reason, the comments of Pope Benedict XVI with regard to the use of the condom in the fight against AIDs in Africa seem relevant. In an interview with his biographer Peter Seewald, he cites the “so-called ABC Theory: Abstinence-Be Faithful-Condom, where the condom is used only as a last resort when the other two points fail to work.” In the same interview he recognizes that in some cases –a prostitute, for example – the use of a condom can be “a first step in the direction of moralization, a first assumption of responsibility, on the way to recovering an awareness that not everything is allowed and that one cannot do whatever one wants.” But the real solution must include a “humanization of sexuality” rather than seeing it as “a sort of drug which people administer to themselves.”

In all the clamor over the RH bill, how much real thought and energy is being given, by either side, to the deeper issue of marriage values and how they can be strengthened and supported? And to what the Pope calls the “banalization of sexuality” and its effect on society?

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Comments welcome at jcarroll@ateneo.edu.