Poor women speak on RH; is anyone listening?

In the seemingly endless agonizing of religious officials and associated lay followers over when life begins, whether some contraceptives are abortifacient, or which contributes more to poverty—inequitable resource distribution or population increase—almost totally ignored are the voices of those who bear and care for more children than they want—our poor women.

How ironic that the women most affected by the decisions of political and religious leaders about their wombs and sexual behavior, are accorded the least say on their expressed need for reproductive health services. Although it is their lives that hang in the balance, celibate males and conservative Catholic laity unabashedly speak for them in these matters. Let us for a change listen to poor women’s voices, as articulated in empirical studies like Likhaan’s “Imposing Misery: The Impact of Manila’s Ban on Contraception.” (2007) It details some of the effects of former Mayor Lito Atienza’s Executive Order 003 passed in 2000 declaring total commitment and support only to natural family planning methods.

Rosario (fictitious name to protect her identify) speaks: “I feel anxious and fearful of the chance of getting pregnant if I don’t have money to buy pills, unlike before when I used to get injectables for free, which were very convenient and effective for months …. I got depressed when the mayor banned family planning. It was a big loss for many mothers…”

Laarni, already in her eighth pregnancy, explains, “My life was put at risk when I gave birth to my fifth child … The doctor … said that this should be my last pregnancy or else my children would suffer if I die…. The doctor really wanted me to have a ligation but she couldn’t do anything since it was banned in the hospital.”

Lita expresses her anxieties, “Bawat pagbubuntis ko, kabado ako. Iniisip ko pag nanganak na ’ko at mailabas ang bata, doon ako mawala.” (I get nervous with every pregnancy. I think that the moment I give birth will be the time I will die.)

Socorro reflects, “The mayor’s policy has made it more difficult for women like me. He does not understand how it is to be poor.”

Asked to comment, a City Hall official replies, “In Manila, we are pro-life. We take care of our women.”

The presence of half a million women of child-bearing age in Manila’s slum settlements deprived of modern contraceptive services affirms the urgent need for a reproductive health law that is national in scope. No local mayor, governor or barangay captain should have the power to restrict access sought by their constituents. Being poor, those women suddenly denied free pills, injectables, IUDs, male condoms and ligation from government centers were faced with four choices: buy food or buy expensive contraceptive pills in drug stores, seek RH services in adjacent Metro Manila cities, risk another pregnancy, or go for an unsafe abortion.

In 2010 the Commission on Human Rights called on the City of Manila to revoke EO 003 “and ensure that artificial birth control devices … be made available to all adult citizens who are residents within its jurisdiction, in health centers and hospitals….” Further, stated the CHR, the City of Manila should issue an apology to all women and men denied access to facilities and services as a result of the EO, and to the children of the families affected. Although the ban appears to have been relaxed in practice under current Mayor Alfredo Lim, EO 003 apparently remains on the books.

Likhaan’s “Very Intimate Stories; Accounts of Women Who Had Abortion” (2003), revealed that of 30 poor women with 165 pregnancies, there were 66 attempted abortions of which 51 succeeded. Sixteen women had undergone from 2 to 5 abortions. Their reasons? Losing their livelihoods or living in extreme poverty worsened by a fire or demolition. Most hid the abortion decision from family members and the community, confiding in only one or two relatives or friends. Secrecy was imperative because abortion was illegal, the subject of neighborhood gossip and condemned by the Catholic Church.

“Oo nga, kasalanan sa Diyos ’yan. Pero siguro hindi mo naman gagawin ’yan kung walang dahilan. Kasi para sa akin, mas kasalanan kung halimbawa bubuhayin mo siya na maghihirap din siya.” (Yes, this is a sin against God. But after all, one wouldn’t do this if there were no reason. In my view, it’s more sinful to give life to a child who will be poor.)

“… Pero siguro maiintindihan din ’yon ng Diyos kasi hindi ko totally kasalanan ang nangyari sa akin. Kumbaga biktima lang ako ng karahasan, ng rape.” (…but I guess God will understand this because what happened was not totally my fault. As a matter of fact, I was simply a victim of rape.)

Women who opt for abortions anticipate the pain and suffering—maybe even death—that lie ahead. Yet, their faith sustains them. “Bahala na lang makaintindi sa akin ang nasa itaas.” (I’ll just leave it to The Being Up There to understand my situation.) If the 473,400 women who in the year 2000 underwent induced abortions had availed themselves of modern family planning, the 9 percent who died as a result might have been saved. What of the thousands of Filipinas who entered their reproductive years in the intervening decade? And the more than 4,000 women this year—or 11 per day—who still face death or disability for lack of life-saving reproductive health services? What indeed does society say to the masses of children deprived of their mothers’ loving care?

And so, despite the universal right to health, thousands of our women will continue to die because crucial services remain beyond their reach. Facing another pregnancy, many will conclude that they have no option but abortion. Given this tragic reality, RH advocates are simply but firmly urging moral leaders to re-examine their stance that by opposing contraceptive services, they are protecting women. Thousands of poor women are telling them otherwise.

Mary Racelis teaches social anthropology at the Ateneo de Manila University and the University of the Philippines.