The silent dying of choice

Women in the Philippines are running out of options as common contraceptives are silently, steadily disappearing from the market—even as there is no way to replenish them just yet, thus limiting women’s choices for themselves and their families. Yet, the “drought” is allowed to persist.

This began in June 2015 when the Supreme Court issued a temporary restraining order on the distribution of contraceptive implants in response to a petition filed by a conservative group claiming that implants caused abortions. The following year, the Department of Health filed a motion for the lifting of the TRO, but the Court rejected the motion and expanded instead the TRO’s scope by putting on hold the product registration of other contraceptives.

With product registration or re-certification put on hold, contraceptive brands in the market, once their licenses expire, cannot be sold in the Philippines; and new brands cannot apply for a license either. And existing licenses are now expiring one by one, and the pharmacy stocks of these products are drying up.

Some 31 percent of contraceptive certifications expired last year, estimates the Commission on Population (Popcom). By next year, the expiry rate is expected to reach 91 percent. By 2020, only 2 percent will remain valid. That is if the supply even lasts that long—which, judging from reports around the country, it may not.

Pills, injectables, intrauterine devices, implants and vaginal rings are among the contraceptives that may soon vanish completely from Philippine drugstores—unless the TRO is lifted. If not, the only remaining choices for birth control would be condoms, surgical procedures (such as vasectomy or ligation) and abstinence.

Conservative groups insist that the contraceptives in question have abortifacient qualities, thus preventing the implantation of a fertilized egg. Doctors and scientific scholars have attested that these contraceptives work before fertilization, mainly by preventing the release of the egg in the first place.

The scientific community has repeatedly pointed out that contraceptives are not abortifacients—that is, they don’t cause abortion.

“If your goal is to reduce abortions, then family planning is a solution, not the problem,” says Klaus Beck, Philippine country representative of the United Nations Population Fund.

But sound science is so readily brushed aside in the Philippines such that women’s health, safety and life choices are easily lost in the haze of tradition, superstition and politics.

When it comes to family planning, Filipino women are all too often at the mercy of their partners who still believe that condoms are unnecessary, that withdrawal is reliable, or that having more children makes one more of a man. Combine these ideas with the persistent belief that contraception is a sin, and we have a recipe for millions of unplanned pregnancies among women who are not physically, financially or emotionally ready.

Is it any wonder so many Filipino mothers are at risk during their pregnancy and childbirth?

Popcom projects that the absence of modern contraceptives could result in 800 to 1,000 maternal deaths each year. Young mothers, women with health complications, and women who cannot afford adequate maternal healthcare are some of those who will likely have to put their lives on the line because the option to protect themselves have been severely limited.

“Initially we thought (our courts) could be convinced by scientific evidence,” expressed Dr. Junice Melgar of the nongovernment organization Likhaan Center for Women Health. “Apparently (not).”

This is the most tragic facet of this issue: The facts and evidence are there, clear as day, pointing to the urgent need to lift the TRO, yet the misconception-riddled status quo persists.

President Duterte issued an executive order last January, calling for the accelerated implementation of the Reproductive Health Law. This law would count for little more than an empty promise if, by 2020, Filipino women would run out of contraceptive options. And as choice continues to shrivel for women in the Philippines, so will their chances of being in full control of their health and their life.

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