Identification of Need - Women's Health

     Identification of Need - Women's Health

  While many health issues affect the people of  the Philippines, one of the most cited is the lack of contraceptive, reproductive and women's health services within the country.  Many of the significant health problems in the Philippines are related to poverty and natural disasters - but the problem of inadequate contraceptive and reproductive health is largely an ideological one.     

       Approximately 83% of Filipinos identify themselves as Catholic and within the religious belief system of the Catholic Church is the teaching that intercourse should only occur between husband and wife and couples "should never act to suppress or curtail the life-giving power given by God that is an integral part of what they pledged to each other in their marriage vows" (United States Conference of Catholic Bishops, 2015).  While adherence to this particular doctrine within the church varies worldwide, in countries such as the Philippines where the large majority of citizens identify as Catholic, contraceptive availability is lower (Center for Reproductive Rights, 2015).  This influence has resulted in restrictive laws regarding contraceptive and reproductive health service availability.  There are significant social stigmas regarding sex outside of marriage (for women) and towards women who do not marry and have children.

       In May, 2015 the United Nations Committee on the Elimination of Discrimination Against Women (U.N.CEDAW) called upon the Filipino government to guarantee access to modern contraceptives and decriminalize abortion.  The committee criticized the government for placing women's human rights behind religious ideology and cultural stereotypes.  These practices lead to discrimination and decreased access to services.  The report also called for the decriminalization of abortion in cases of rape, incest, when the health or life of the woman is at risk, and in cases of severe fetal impairment (Center for Reproductive Rights, 2015).

       Despite passage of the Reproductive Health Law in 2012 (which expanded access to contraception and women's health services) a contradictory law entitled Executive Order 003 within Manila City bans women's access to modern contraception.  Although the Executive Order is for Manila City specifically, it is considered accepted practice throughout most of the country as well.  Latest data indicates there were an estimated 610,000 illegal abortions within the country in 2013 (Center for Reproductive Rights, 2015).

       The U.N. report emphasized that the consequences of such policies result in in unplanned pregnancies, unsafe abortions and unnecessary and preventable maternal deaths. Economically disadvantaged women, adolescent girls and women in abusive relationships are most likely to be affected by these policies. Data obtained from a 2008 Guttmacher Institute report indicated there were 1.9 million unintended pregnancies in the Philippines, resulting in two main outcomes - unplanned births and unsafe abortions (Guttmacher Institute, 2008).

As these graphs indicate, approximately 37% of

births were completely unplanned with 20% being mistimed and 16% unwanted.  Furthermore, it is women in the poorest classes who had the most disparity between desired fertility rates and actual births.
Despite the image many Filipinos
wish to promote, abortion is fairly common and those seeking abortion services are typically married Catholic women with other children.  Due to the secretive nature of abortions, unsafe methods such as home abortion, herbal remedies and black market drugs are often utilized. Although post abortion care is legal in the Philippines, the social stigma of seeking it out is such that many women do not - putting their health and lives at risk and sometimes leaving existing children motherless (Guttmacher Institute, 2013).

Perhaps some of the most challenging aspects to data such as this are less-measurable sequelae. For example, how would general standards of living improve if families had fewer children to care for? Is postpartum depression under reported as well?  Do unwanted children suffer greater neglect or abuse? Does guilt over seeking an abortion lead to women neglecting other health issues for themselves?  The list of questions leads to many other health and wellness issues.