‘Women come to us crying’

In 2009, before the passage of the Reproductive Health Law, Magdalena “Lina” Bacalando would see 10-22 dead infants a day in their clinic in Tondo. Lina, who heads Pilakk, an organization of urban poor women who are both users and providers of reproductive health services, recalled that the grieving mothers, who more often than not gave birth at home, would rush the babies to the clinic in desperate hope that they could still be revived. Too often, the clinic personnel would shake their heads and say it was too late.

“These women,” said Lina, speaking in Filipino at a recent forum following the launch of the Commission on Human Rights Inquiry Report on the RH Law, “often had three times the number of children they desired, but because they couldn’t afford contraception, or their husbands and family forbade them from practicing family planning, they would get pregnant more times than they wanted.”

After the passage of the RH Law, “I was hopeful that all these unnecessary deaths would come to an end,” said Lina. “Especially after implants were introduced, we saw more and more women coming for the services.” But when the Supreme Court issued its temporary restraining order on the Department of Health’s provision of the implants, personnel in government health centers stopped providing the implants for free.

“Many women came to us crying,” recalled Lina. “They said: Where do we go now?” Since the implants provide protection for up to three years, many of those who had received the devices were filled with anxiety. When they go to health centers for checkups, “many of them are turned away because the center personnel say they are no longer allowed to provide even information or referral,” she said.

“Maraming kumakapit sa patalim (many “clutch the knife’s edge”—act out of desperation), observed Lina. Before the TRO on the insertion of implants, as many as 1,000 patients a month visited their clinic. But with health center personnel refusing to provide follow-up services, the women will now have to go to a private clinic (and pay the fee) or to a public hospital to have the devices removed after three years.

Dr. Esmeraldo Ilem, director of the Jose Fabella Hospital, the country’s main maternity hospital, raised a related problem. With the high demand, he said, the hospital had stepped up the training of service providers on the insertion and removal of implants. But since the TRO, training has ground to a halt, and the number of trained health personnel is falling far short of demand, he said.

He declared: “With this TRO, I foresee an even steeper rise in our maternal mortality ratio.

The problem is highlighted when it comes to teenage mothers. Percy Cendana of the National Youth Commission, who also spoke at the forum, noted that the Philippines is the “gold medalist” in the region when it comes to the number of adolescent pregnancies. The recent Philippine Youth Development Plan found that 31 percent of all young Filipinos engage in sex, while 31 percent want to use contraception but cannot because their preferred methods are not available.

Thus, the number of teen pregnancies has been steadily rising, and the average age has been falling. Even worse, the number of mothers 19 years and younger who gave birth to their second or third babies is rising. The same survey found 12 girls below 15 years who already have three children.

Even before the TRO, it had been difficult for sexually active teens to access contraception, said Cendana. There is the provision (inserted by the Supreme Court) in the RH Law requiring written parental consent before a teen can receive RH services. But even with her parents’ consent, a female teenager still cannot get an implant.

“The three years’ protection provided by an implant is crucial in a teen girl’s life,” Cendana pointed out. “It could mean enabling [her] to finish her education. It could mean giving her much needed time for her body to mature or to develop life skills necessary to be a parent.”

But the TRO condemns girls to a lifetime of serial motherhood and their children to repeat the tragic cycle, he said.