Philippines: New study shows Manila's ban on contraceptives leads to health crisis

Interviews with women, health-care workers, government officials and community groups reveal the devastating impact the ban has had on women and their families. Essential family planning services, including supplies of condoms and birth control pills, have disappeared from city health centers and hospitals that are subject to the order. Providers have refused to provide women basic information about family planning. And doctors—silenced into compliance—are unable to exercise their best medical judgment in advising women, endangering their lives and health.

“Manila has grossly violated women’s fundamental human rights under constitutional and international laws unfettered for nearly a decade,” said Elizabeth A. Pangalangan of ReproCen, a reproductive rights and health organization based in the University of the Philippines in Manila.

“This is one of the most devastating policies against women that we have seen in fifteen years of reproductive rights law reform,” said Luisa Cabal, Director of the International Legal Program at the Center for Reproductive Rights, a legal advocacy group based in New York. “This report sends a clear message to policymakers: you cannot violate women’s basic human rights without being held accountable. The global community is watching.”

Former Manila mayor Jose Atienza issued the ban in 2000, under the influence of the Vatican teachings. A new mayor Alfredo S. Lim took office in July of this year and Likhaan, ReproCen, and the Center for Reproductive Rights have called on him to revoke the ban. Because most Filipinos rely on public facilities for contraceptive services, the ban has produced long-term and irreversible effects on women’s well-being and quality of life, in areas ranging from their health to their economic status to their relationships. The ban has had a particularly harmful effect on poor women.

Tina Montales, 36, has eight children. When she wanted to have a tubal ligation after her fourth pregnancy, she couldn’t because the local hospital no longer offered the service. She worries about feeding her children on an income that’s already barely enough to meet basic needs: “Our daily income is 150 pesos (3.28 USD/2.40 EUR) from scavenging…We make do with soy sauce or salt if we can’t afford to buy ten pesos' (0.22 USD/0.16 EUR) cooked vegetable for lunch or dried fish for dinner.”

One woman on her eighth pregnancy said her life was put at risk during one delivery. She had a breech pregnancy and her doctor advised her not to get pregnant or she might die. Although her doctor very much wanted her to have a ligation, she was powerless to perform the surgery, despite serious concerns about the woman’s health. Since neither contraception nor sterilization is available to her, she said, “I get nervous with every pregnancy. I think that the moment I give birth will be the time I will die.”

Some women interviewed try to refuse sex with their partners as a way to avoid pregnancy, but many describe how this puts strains on their relationships and in some cases, even leads to sexual violence: “Sometimes when there’s no money to buy condoms and I don’t want to have sex with my husband, he gets angry and forces me. I tell him, ‘Aren’t you ashamed of yourself? You’ve got so many kids already and we don’t have privacy.’ Our house is very small; we sleep together with the kids. Only a thin wall separates us from the neighbors and I don’t want them to hear us arguing so I just give in to what my husband wants.”

“Religious ideology has trumped concerns for public health and women’s well-being for far too long in Manila. We are hopeful that the new mayor recognizes that women should be able to decide whether they want to use contraceptives, and to have full access to the contraceptive method of their choice,” said Dr. Junice Lirza Demeterio-Melgar, Executive Director of Likhaan, a women’s health organization based in Quezon City, Philippines.

13 August 2007