14th August 2010
By ANNE MARXZE D. UMIL
MANILA — In the Philippines, it’s not enough that women who wish to terminate their pregnancies do not have legal and safe means to do it. In many hospitals and clinics across the country, Filipinas who undergo abortion and then seek medical treatment because of complications are routinely harassed and violated by health-care providers.
There are among the findings of a study done by the Center for Reproductive Rights, a New York-based advocacy group. It concluded that because of the criminal ban on abortion in the Philippines, a dire human-rights crisis has emerged, which it blamed on the Philippine government and the powerful Roman Catholic Church.
One of the case studies in its report, titled Forsaken Lives: The Impact of the Criminal Ban on Abortion in the Philippines, is about a woman named Lisa, who went to a hospital to seek post-abortion care. According to Lisa, she experienced verbal abuse, the procedure was delayed despite her severe bleeding, and she was humiliated by hospital whose nurses put sign on her bed that says hers was an abortion-related case.
“I just wish that the doctors would stop threatening women like me who had an abortion,” the report quoted Lisa as saying. “They do not know the whole story, the women’s experience in life that led to abortion…. Some women, instead of going to the hospital to seek medical care, would rather not out of fear of being imprisoned. That is why there are numerous cases of death and infection.”
In the study, the CRR says that the criminal ban did not stop abortion in the Philippines. The ban merely pushed it underground, where women who terminate their pregnancies do so in unsafe conditions.
According to the Guttmacher Institute, another US group that has done aborton studies in the Philippines, an estimated 560,000 induced abortions tookl place in the Philippines in 2008. Out of that, 90,000 women sought treatment for complications and 1,000 women died.
“These tragic and preventable deaths are a direct consequence of the nation’s restrictive abortion law and an indirect consequence of the lack of adequate information about and access to effective modern contraceptives in the Philippines, especially in Manila City,” the report said.
The Philippines, CRR said, is one of the few countries in the world that criminalized abortion in all circumstances with no clear exceptions, even if the life of the mother is in danger.
The study argues that the Philippine government has committed violations of human rights by criminalizing abortion regardless of circumstance. CRR said that the government has failed to fulfill its international obligation to protect women’s health and human rights. The human rights violated by the criminal ban include the rights to life; health; freedom from cruel, inhuman, and degrading treatment; equality and nondiscrimination; and privacy.
All of these rights are guaranteed by major international treaties that have been signed and ratified by the Philippines, including the International Covenant on Civil and Political Rights (ICCPR), the International Covenant on Economic, Social, and Cultural Rights (ICESCR), the Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW), the Convention against Torture (CAT), the Convention on the Rights of the Child (CRC), and the Convention on the Elimination of Racial Discrimination (CERD).
The continuing implementation of the restrictive abortion law further shows the Philippines’ noncompliance with official recommendations of United Nations treaty monitoring bodies (UN TMBs), which have repeatedly urged the government to address the problem of unsafe abortion in the Philippines through law reform, the report said.
In its conclusion, CRR asserts that “there is an urgent need for legal and policy reform and accountability measures to address unsafe abortion and related abuses of women’s human rights in the Philippines.”
Because the Catholic Church remains dominant in the Philippines, efforts to at least provide exceptions have been met with stiff resistance. Not only that, the Church actively campaigns against measures, such as Reproductive Health Bill, to educate Filipinos about sex and the contraceptive options available.
In 2000, the regime of Gloria Macapagal Arroyo supported the call of the Catholic Church for natural planning method, the only method the Church approves of. Then Manila City Mayor Lito Atienza even implemented in his city Executive Order 003 that prohibits modern contraceptives in public health clinics funded by the local government and mandates instead the promotion of natural methods of family planning.
As a result of the EO 003, women in Manila have been deprived access to reproductive-health services such as pills and condoms. Not surprisingly, according to the CRR, Manila has the highest number of abortion cases in the Philippines. The prohibition of modern contraceptives resulted in unplanned pregnancies and eventually led to higher cases of unsafe abortion.
Unsafe abortion methods include painful abdominal massages by traditional midwives, inserting a catheter into the uterus, medically unsupervised consumption of Cytotec (the local brand name for a drug containing misoprostol) to induce uterine contractions, and ingestion of herbs and other concoctions sold by street vendors. Complications caused by unsafe abortion are hemorrhage, sepsis, perforation of the uterus, damage to other internal organs, and death.
“Unsafe abortion is a notable cause of death and disability for women and adolescent girls worldwide,” the CRR said. “Almost 70,000 women and girls die due to unsafe abortion each year, and close to five million suffer short-term or permanent disabilities.”
Unsafe abortion is also one of five internationally recognized “obstetric emergencies” that account for most maternal deaths in the world. In the Philippines, according to the World Health Organization (WHO), abortion complications is among the Top 10 causes of hospitalization of women each year.
The WHO had said the legality of abortion is a key determinant of unsafe abortion mortality and morbidity. But because it is illegal in the Philippines, women — especially those who belong to the poor — are left with no choice but to seek unsafe abortion, the CRR said.
Ana, 35, a domestic violence survivor and a mother of seven children, said in the CRR report that she had fears on the legal consequences of abortion, but people should learn to understand why some women have to undergo such underground procedure. “The law did not stop me since I was thinking of providing a better life for my existing children. It would have been easier if you could openly ask a doctor about pregnancy options and the cost would be cheaper or affordable for poor people.”
“Before my third abortion, I consulted with a private doctor on what drug to take,” said Haydee, 32. She was diagnosed with severe hypertension, a condition that can make pregnancy fatal. “The doctor said it is against their profession because it is the taking of life. She would never prescribe a drug to induce an abortion. I told her I had this condition [severe hypertension]; I had a reason. She firmly said she would not give a drug because she would [be] commit[ting] a sin.”
If women who seek unsafe abortion had complications, they also have no choice but to seek medical attention in hospitals whose staff view abortion as a crime. Instead of giving post-abortion care, they are “frequently harassed, intimidated, abused, and threatened with criminal prosecution by health service providers.”
According to the study, post-abortion care is legal in the Philippines but because abortion was criminalized, it became highly stigmatized in the medical community, with the women bearing the brunt. “Despite the fact that post-abortion care is legal, women who seek treatment for complications arising from illegal and unsafe abortions are often viewed as criminals and denied compassionate and lifesaving care,” the study said.
One case study in the CRR report was of Maricel. She was 18 and already a mother. She died of a severe infection after a self-induced abortion.
“Maricel’s mother was employed as a domestic worker abroad and wanted Maricel to have the same opportunity. Maricel applied for, and had just been granted, a visa permitting her to work abroad when she found out she was pregnant. She was still breastfeeding her first child and had thought that she was adequately protected from becoming pregnant again. Afraid that the pregnancy would mean she would lose the employment opportunity, Maricel attempted to induce an abortion.
“Desperate, Maricel tried several means of abortion. She first attempted to end her pregnancy herself by taking Cytotec. After two weeks of not experiencing any bleeding, Maricel went to a hilot for an abdominal massage. Three days later, still not experiencing any bleeding, she sought the help of a neighbor, who directed her to a woman who performed “catheterizations,” meaning that she inserted catheters into the uterus for women as a method of abortion. By that time, Maricel was in her third month of pregnancy. For two weeks following the catheterization, Maricel was bleeding vaginally and feverish. She delayed going to a hospital because she was scared of what would happen to her since she had illegally induced an abortion, but finally sought medical treatment when her fever and bleeding persisted.
“Maricel arrived at Fabella Memorial Hospital pale, bleeding, and running a high fever. The doctors tried to treat Maricel with antibiotics and decided to perform a dilation and curettage (D&C) to complete the abortion but it was too late: Maricel died on the operating table as a result of the sepsis caused by the unsafe abortion.”
Unknown to many, under internationally recognized ethical norms, women have right to abortion. In Italy where the Apostolic Palace stood in the city of Vatican, abortion is legal. Italian women are allowed to request an abortion for health, economic or social reasons, including the circumstances under which conception occurred. It is free of charge in public hospitals or in private clinics authorized by the regional health authorities.
In some countries where the Catholic Church is dominant, abortion is also legal, like in Portugal and Spain as well as in Hungary and Colombia.