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Reproductive health bill: Facts, fallacies By Rep.

Edcel Lagman Philippine Daily Inquirer First Posted: 00:46:00 08/03/2008 Date Retrieved: 23:18:50 01/27/2012 URL: http://opinion.inquirer.net/inquireropinion/talkofthetown/view/200 80803-152296/Reproductive-health-bill-Facts-fallacies (Editor's Note: Upon the request of readers, we are running the salient features of the proposed Reproductive Health and Population Development Act of 2008. We asked its principal author in the House of Representatives to present the main points of and misconceptions about the bill. We hope that this issue will help readers reach an informed opinion on the measure.) THE BILL IS NATIONAL IN SCOPE, COMPREHENSIVE, rights-based and provides adequate funding to the population program. It is a departure from the present setup in which the provision for reproductive health services is devolved to local government units, and consequently, subjected to the varying strategies of local government executives and suffers from a dearth of funding. The reproductive health (RH) bill promotes information on and access to both natural and modern family planning methods, which are medically safe and legally permissible. It assures an enabling environment where women and couples have the freedom of informed choice on the mode of family planning they want to adopt based on their needs, personal convictions and religious beliefs. The bill does not have any bias for or against either natural or modern family planning. Both modes are contraceptive methods. Their common purpose is to prevent unwanted pregnancies. The bill will promote sustainable human development. The UN stated in 2002 that ?family planning and reproductive health are essential to reducing poverty.? The Unicef also asserts that ?family planning could bring more benefits to more people at less cost than any other single technology now available to the human race.? Coverage of RH. (1) Information and access to natural and modern family planning (2) Maternal, infant and child health and nutrition (3) Promotion of breast feeding (4) Prevention of abortion and management of post-abortion complications (5) Adolescent and youth health (6) Prevention and management of reproductive tract infections, HIV/AIDS and STDs (7) Elimination of violence against women (8) Counseling on sexuality and sexual and reproductive health (9) Treatment of breast and reproductive tract cancers (10) Male involvement and participation in RH; (11) Prevention and treatment of infertility and (12) RH education for the youth. Strengthening of Popcom. The existing Population Commission shall be reoriented to promote both natural and modern family planning methods. It shall serve as the central planning, coordinating, implementing and monitoring body for the comprehensive and integrated policy on reproductive health and population development. Capability building of community-based volunteer workers. The workers shall undergo additional and updated training on the delivery of reproductive healthcare services and shall receive not less than 10percent increase in honoraria upon successful completion of training. Midwives for skilled birth attendance. Every city and municipality shall endeavor to employ an adequate number of midwives and other skilled attendants. Emergency obstetrics care. Each province and city shall endeavor to ensure the establishment and operation of hospitals with adequate and qualified personnel that provide emergency obstetrics care. Hospital-based family planning. Family planning methods requiring hospital services like ligation, vasectomy and IUD insertion shall be available in all national and local government hospitals. Contraceptives as essential medicines. Reproductive health products shall be considered essential medicines and supplies and shall form

part of the National Drug Formulary considering that family planning reduces the incidence of maternal and infant mortality. Reproductive health education. RH education in an age-appropriate manner shall be taught by adequately trained teachers from Grade 5 to 4th year high school. As proposed in the bill, core subjects include responsible parenthood, natural and modern family planning, proscription and hazards of abortion, reproductive health and sexual rights, abstinence before marriage, and responsible sexuality. Certificate of compliance. No marriage license shall be issued by the Local Civil Registrar unless the applicants present a Certificate of Compliance issued for free by the local Family Planning Office. The document should certify that they had duly received adequate instructions and information on family planning, responsible parenthood, breast feeding and infant nutrition. Ideal family size. The State shall encourage two children as the ideal family size. This is neither mandatory nor compulsory and no punitive action may be imposed on couples having more than two children. Employers? responsibilities. Employers shall respect the reproductive health rights of all their workers. Women shall not be discriminated against in the matter of hiring, regularization of employment status or selection for retrenchment. Employers shall provide free reproductive health services and commodities to workers, whether unionized or unorganized. Multimedia campaign. Popcom shall initiate and sustain an intensified nationwide multimedia campaign to raise the level of public awareness on the urgent need to protect and promote reproductive health and rights. *** Smear offensive Rep. Edcel C. Lagman THERE IS A CONTINUING campaign to discredit the reproductive health bill through misinformation. Straightforward answers to the negative propaganda will help educate and enlighten people on the measure. The bill is not antilife. It is proquality life. It will ensure that children will be blessings for their parents since their births are planned and wanted. It will empower couples with the information and opportunity to plan and space their children. This will not only strengthen the family as a unit but also optimize care for children who will have more opportunities to be educated, healthy and productive. The bill does not interfere with family life. In fact, it enhances family life. The family is more than a natural nucleus; it is a social institution whose protection and development are impressed with public interest. It is not untouchable by legislation. For this reason, the State has enacted the Civil Code on family relations, the Family Code, and the Child and Youth Welfare Code. The bill does not legalize abortion. It expressly provides that ?abortion remains a crime? and ?prevention of abortion? is essential to fully implement the Reproductive Health Care Program. While ?management of post-abortion complications? is provided, this is not to condone abortion but to promote the humane treatment of women in life-threatening situations. It will not lead to the legalization of abortion. It is not true that all countries where contraceptive use is promoted eventually legalize abortion. Many Catholic countries criminalize abortion even as they vigorously promote contraceptive use like Mexico, Panama, Guatemala, Brazil, Chile, Colombia, Dominican Republic, El Salvador, Honduras, Nicaragua, Venezuela, Paraguay and Ireland. The Muslim and Buddhist countries of Indonesia and Laos also promote contraceptive use yet proscribe abortion. According to studies, correct and regular use of contraceptives reduces abortion rates by as much as 85 percent and negates the need to legalize abortion. Contraceptives do not have life-threatening side effects. Medical and scientific evidence shows that all the possible medical risks connected with contraceptives are infinitely lower than the risks of an actual

pregnancy and everyday activities. The risk of dying within a year of riding a car is 1 in 5,900. The risk of dying within a year of using pills is 1 in 200,000. The risk of dying from a vasectomy is 1 in 1 million and the risk of dying from using an IUD is 1 in 10 million. The probability of dying from condom use is absolutely zero. But the risk of dying from a pregnancy is 1 in 10,000. The bill will not promote contraceptive mentality. The bill does not prohibit pregnancy. Critics are mistaken in claiming that because contraceptives would be readily available, people would prefer to have no children at all. Couples will not stop wanting children simply because contraceptives are available. Contraceptives are used to prevent unwanted pregnancies but not to stop pregnancies altogether. Timed pregnancies are assured. The bill does not impose a two-child policy. It does not promote a compulsory policy strictly limiting a family to two children and no punitive action shall be imposed on parents with more than two children. This number is not an imposition or is it arbitrary because results of the 2003 National Demographic and Health Survey show that the ideal of two children approximates the desired fertility of women. Sexuality education will neither spawn ?a generation of sex maniacs? nor breed a culture of promiscuity. Age-appropriate RH education promotes correct sexual values. It will not only instill consciousness of freedom of choice but also responsible exercise of one?s rights. The UN and countries which have youth sexuality education document its beneficial results: understanding of proper sexual values is promoted; early initiation into sexual relations is delayed; abstinence before marriage is encouraged; multiple-sex partners is avoided; and spread of sexually transmitted diseases is prevented. It does not claim that family planning is the panacea for poverty. It simply recognizes the verifiable link between a huge population and poverty. Unbridled population growth stunts socioeconomic development and aggravates poverty. The connection between population and development is well-documented and empirically established. UN Human Development Reports show that countries with higher population growth invariably score lower in human development. The Asian Development Bank in 2004 also listed a large population as one of the major causes of poverty in the country. The National Statistics Office affirms that large families are prone to poverty with 57.3 percent of families with seven children mired in poverty while only 23.8 percent of families with two children are poor. Recent studies also show that large family size is a significant factor in keeping families poor across generations. Family planning will not lead to a demographic winter. UP economics professors in their paper ?Population and Poverty: The Real Score? declared that the threat of a so-called demographic winter in the Philippines is ?greatly exaggerated, and using it as an argument against a sensible population policy is a plain and simple scare tactic.? The National Statistical Coordinating Board projected that a replacement fertility of 2.1 children per couple could be reached only by 2040. Moreover, despite a reduced population growth rate, the effects of population momentum would continue for another 60 years by which time our total population would be 240 million. Humanae Vitae is not an infallible doctrine. In 1963, Pope John XXIII created the Papal Commission on Birth Control to study questions on population and family planning. The Commission included ranking prelates and theologians. Voting 69 to 10, it strongly recommended that the Church change its teaching on contraception as it concluded that ?the regulation of conception appears necessary for many couples who wish to achieve a responsible, open and reasonable parenthood in today?s circumstances.? However, it was the minority report that Pope Paul VI eventually supported and which became the basis of Humanae Vitae. Even 40 years ago when the encyclical was issued, theologians did not generally think that it was infallible. Monsignor Fernando

Lambruschini, spokesperson of the Vatican at the time of its release, said ?attentive reading of the encyclical Humanae Vitae does not suggest the theological note of infallibility? It is not infallible.? Five days after the issuance of the encyclical, a statement against it was signed by 87 Catholic theologians. It asserted that ?Catholics may dissent from ? noninfallible Church doctrine? and that ?Catholic spouses could responsibly decide in some circumstances to use artificial contraception.? (Rep. Edcel C. Lagman of Albay is the principal author of the proposed Reproductive Health and Population Development Act of 2008.)

THE REPRODUCTIVE HEALTH BILL: LOGIC 101 Date Retrieved: 01-27-2012 URL: http://miriam.com.ph/newsblog/?p=465 Author: Miriam Defensor-Santiago

(Speech at the inter-university forum on 15 September 2011 sponsored by the UP Law Center Human Rights Institute at the UP College of Law Malcolm Theatre) Reproductive Rights as Part of Human Rights Our topic is the nature of reproductive rights as part of the greater sum of human rights. In legal terms, human rights form the totality of the freedoms, immunities, and benefits that, according to modern values specially at an international level all human beings should be able to claim as a matter of right in the society in which they live. In international law, the basic document is the non-binding but authoritative Universal Declaration of Human Rights, accompanied by the binding documents known as the International Covenant on Civil and Political Rights, and the International Covenant on Economic, Social, and Cultural Rights. In national or domestic law, the basic document is the Philippine Constitution, particularly Article 2 on Declaration of State Policies, and Article 3 on the Bill of Rights. Our Constitution, Art. 2 Sec. 15 specifically provides: The State shall protect and promote the right to health of the people and instill health consciousness among them. This right to health is now viewed as including the right to reproductive health. Reproductive rights constitute the totality of a persons constitutionally protected rights relating to the control of his or her procreative activities. Specifically, reproductive rights refer to the cluster of civil liberties relating to pregnancy, abortion, and sterilization, specially the personal bodily rights of a woman in her decision whether to become pregnant or bear a child. The phrase reproductive rights includes the idea of being able to make reproductive decisions free from discrimination, coercion, or violence. Human-rights scholars increasingly consider many reproductive rights to be protected by international human rights law. When we speak of Philippine internal laws and politics, we are speaking of the so-called horizontal strand of the human rights movement. But as constitutionalism spreads among states, we now speak of the so-called vertical strand of the new international law, that is meant to bind states and that is implemented by the new international institutions. Filipino politicians seem to be aware only of the horizontal but not of the vertical dimension of the human rights movement.1 But the truly novel developments of the last half century have involved primarily the vertical dimension. Thus, contrary to the misimpression of many of our politicians, the national debate on reproductive health is not only limited to the Constitution, but necessarily include Philippine obligations under the legally binding obligations of the International Covenant on Economic, Social, and Cultural Rights, as well as other treaties to which the Philippines is a state party. The urgency of enforcing reproductive rights in our country was raised at the 1993 Vienna World Conference, when the UN Committee on Economic, Social, and Cultural Rights2 drew attention to: The shocking reality . . . that States and the international community as a whole continue to tolerate all too often breaches of economic social and cultural rights which . . . would provoke horror and outrage and would lead to concerted calls for immediate remedial action. In the human rights movement, the mechanisms and processes for the delivery of health services are themselves morally compelling. Evaluation of health programs emphasizes distribution in outcomes, not only averages. We are concerned about the entire distribution, because reproductive rights theories take seriously the idea that every human being is worthy of respect.

Advocates of human rights pay particular attention to disaggregated data among women and the poor, because they are particularly liable to practices and prejudices that weaken their agency and the social basis of their self-esteem. Finally, reproductive rights approaches accommodate adoptive preferences. Many poor women do not receive information on how to receive reproductive health care. In addition, our underprivileged women have to accept standards lower than what they need, want, or deserve. This is the reason why we hold forums like these to raise consciousness, provide political education, and take measures in civil society to expand the imagination and the demands of the excluded group of women who belong to the poorest of the poor.3 Why the RH Bill is Controversial The two most controversial provisions of the RH bill are: Sec. 7. Access to Family Planning. All accredited public and private health facilities shall provide a full range of modern family planning methods, except in specialty hospitals which may render such services on an optional basis. No person shall be denied information and access to family planning services. Sec. 8. Maternal Death Review. Sec. 9. Family Planning Supplies as Essential Medicines. The National Drug Formulary shall include hormonal contraceptives, intrauterine devices, injectables and other safe, legal and effective family planning products and supplies in accordance (with FDA guidelines). These products and supplies shall also be included in the regular purchase of essential medicines and supplies of all national and local hospitals, provincial, city, and municipal health offices, including rural health units. In brief, the RH bill merely wants to empower a woman from the poorest economic class to march to the nearest facility operated by the Department of Health or the local government unit, to demand information on a family planning product or supply of her choice. The bill, at the simplest level, wants to give an indigent married woman the freedom of informed choice concerning her reproductive rights. If the bill is highly controversial, it is not because it is dangerous to humans or to the planet. It is not subversive of the political order. It is not a fascist diktat of a totalitarian power structure. The reason this bill is emotionally charged is because of the fervent opposition of the Catholic church in the Philippines and those who wish to be perceived as its champions. Every year that a new Congress is convened, an RH bill is filed, provokes heated debate, consumes tons of newsprint, and then it lapses into a coma. There it remains, until it is resurrected at the next Congress, only to go through the same rigmarole of passion, flailing arms, doomsday scenarios, threats of Armaggedon, and an implicit competition among its champions for canonization as defender of the faith. And yet the rest of the Catholic world is unimpressed by the implicit threat that if the Congress passes the RH bill, an asteroid will dive straight into planet earth and obliterate the entire human race, particularly those who are pro-RH. In fact, the very opposite has happened. The majority of Catholic countries have passed reproductive health laws, led by Italy, where the Vatican is located. The other Catholic but pro-RH countries are: Spain, Portugal, Paraguay, Mexico, Guatemala, Ecuador, Colombia and Argentina. Of 48 Catholic countries profiled by the UN Population Fund, only six countries did not have an RH law. The Philippines is among these six stragglers. Apart from the Catholic church, all other major religions in our country support RH, namely: Iglesia ni Cristo, National Council of Churches in the Philippines, Philippine Council of Evangelical Churches, the Interfaith Partnership for the Promotion of Responsible Parenthood, and the Assembly of Darul-Ifta of the Autonomous Region in Muslim Mindanao. It is inaccurate to employ the term Catholic church in describing the anti-RH group. The more accurate term is Catholic Bishops Conference of the Philippines, because the CBCP is not the entirety of

the Catholic church. Under the more enlightened philosophy of Vatican 2, the Church is not the pope or the bishops or the priests. These Church officials are not a privileged caste; they are not necessarily superior to the entire faith community. The Church is the whole people of God, and there are many Catholics who adhere to the teaching of liberation theology that the Catholic church should observe a preferential option for the poor. Before we seek salvation, we must seek liberation for the poor from poverty, disease, and untimely death. The Filipino people, regardless of religion, have already voted in favor of RH. According to the survey conducted just this June 2011 by Social Weather Stations, 73 percent want information on legal methods available from the government, while 82 percent say family planning method is a personal choice. This is the will of the Filipino people; it is the democratic expression of what the public wants from government. The anti-RH groups are mute on this ineluctable fact. The inflexibility of the traditional Catholics is anchored on the encyclical entitled Humanae Vitae issued in 1966 by Pope Paul 6. In paragraph 11, he wrote: The Church . . . teaches that each and every marriage must remain open to the transmission of life. In applying natural law, the encyclical relies on the rhythm method, or the restriction of marital relations to sterile periods of the month. Thus, the basis of the encyclical is merely biological. I have to emphasize that the encyclical is NOT a so-called non-infallible statement of the Church. This encyclical is fallible. Humanae Vitae caused a worldwide tempest. It created a backlash that eventually resulted in placing limits on Catholic teaching authority on moral issues. This backlash has taken the form of the doctrine of primacy of conscience. This doctrine is based on the document entitled Declaration on Religious Freedom issued by Vatican Council 2. In Note 3, it declares that we are bound to follow our conscience faithfully in all our activity, and that no one is to be forced to act in a manner contrary to ones conscience. Nor, on the other hand, is one to be restrained from acting in accordance with ones conscience, especially in matters religious. Now let me surprise you, and shock the CBCP, by giving you the ultimate word. The present Pope Benedict 16 used to be known as Fr. Joseph Ratzinger. As a young man in 1968, he served as Chair of dogmatic theology at the University of Tubingen. In this capacity, he wrote a commentary on the encyclical Gaudium et Spes or the Church in the Modern World. He said: Above the pope . . . stands ones own conscience, which has to be obeyed first of all, if need be, against the demands of church authority. 4 Thus, in effect, the pope himself teaches that there is a basic right for RH advocates to observe the primacy of conscience. Why the RH Bill is Urgently Necessary We should urge Congress that in both chambers, the debates should conclude and legislators should come to a vote, in order that this recurrent issue can stop hogging the national agenda every time a new Congress is convened. Let the Filipino people know the principled stand of every legislator, so that in the coming 2013 elections, the electorate, in whom reposes the sovereign might of the state, will know whom to reward and whom to punish. There is an urgent need for an RH law, because 11 mothers die everyday from childbirth- and pregnancy-related complications. According to the 2008 National Demographic and Health Survey by the National Statistics Office: 11 MOTHERS DIE EVERYDAY! 3,000 to 5,000 mothers die every year 162 mothers out of 100,000 live births die 11% of all deaths among women of reproductive age in the Philippines are maternal deaths 23 million (from 15 to 49 years old) are of reproductive age 15 million are at risk of pregnancy Thus, ladies and gentlemen, the statistics in favor of an RH law are overwhelming, while the sophistic procrastination of politicians are underwhelming.

Smokescreen: The Logical Fallacies in the RH Debate There is no idea as powerful as an idea whose time has come. Politicians seeking to earn the favor of the Catholic hierarchy pose and preen on the national stage. But for every single day that we consume in nitpicking debate resulting in logical fallacies, the clock ticks and every single day 11 women die from childbirth complications. Before this day is over, 11 Filipinas from the poorest section in society will breathe their last. But look at what the politicians are doing. Devoid of any substantial argument on the merits, they engage in what any college class on Logic would immediately recognize as a logical fallacy. Let me give you just a few examples. The Abortion Fallacy. Abortion is an artificially induced termination of pregnancy for the purpose of destroying an embryo or fetus. Contraception is the prevention of pregnancy from being a consequence of sexual intercourse. Therefore, if there is no pregnancy, there can be no abortion. But anti-RH groups keep chanting the mantra of abortion or abortifacient. This is the fallacy of the red herring, because it uses irrelevant material to prevent a conclusion being reached in its absence. The Fallacy of the Beginning of Life. Identification of the precise time when life begins is recklessly claimed by some people who can only be called delusional. The truth is that there is no accepted, authoritative finding accepted by the medical and scientific professions on when life begins, much less on when the soul begins. The Constitution Article 2 Sec. 12 provides that the state shall equally protect the life of the mother and the life of the unborn from conception. Conception is the act of becoming pregnant or of creating a child in the womb. It could be defined as the process by which a set of human cells becomes human with characteristics defined as human life. Conception is not an exact scientific term. The issue is whether conception begins at fertilization or at implantation. Fertilization is the process of penetration of the egg cell by the sperm cell, and the combination of this genetic material to form the fertilized egg or zygote. Implantation is the attachment of a fertilized ovum on the wall of the uterus. According to the statement issued in August 2011 by the Universal Health Care Study Group, which is a part of the National Institutes of Health in UP Manila: No one equates conception with fertilization. Moreover: All contraceptives, including hormonal contraceptives and IUDs, have been demonstrated by laboratory and clinical studies, to act primarily prior to fertilization. To summarize, conception begins only after fertilization, but there is no precise scientific definition of the precise moment when the set of cells can be called human. Delimiting a specific time frame is simply not realistic at this time. This is the logical fallacy of affirming the consequent, meaning it affirms the consequent in order to prove the antecedent. It is also the fallacy of amphiboly, meaning the fallacy of ambiguous construction. The Fallacy of Population Imperialism. It is claimed that the US needs widespread access to the mineral resources of less developed countries like the Philippines. But population pressure and the anti-imperialist attitudes of the youth stand in the way of the American hegemony. Therefore, births in certain countries in the Philippines should be limited, and the RH bill is just a form of US imperialism. This scenario is highly likely, and I would not put it past the US to develop this strategy. However, family planning is not only an advocacy of the US, but also of the entire United Nations. In addition, the best economists of the country, who just happen to be UP professors, issued in 2008 a paper entitled Population, Poverty, Politics, and the RH bill. It supports an RH law as an integral part of the strategy for development and poverty reduction. The Economics 27 said categorically: A rapidly growing population has a negative impact on economic development. And they noted: Contraceptive use

remains extremely low among poor couples, because they lack information about, and access, to them. To demonize lower population growth because the U.S. advocates family planning for developing countries is a logical fallacy. This is the fallacy of argumentum ad populum, appealing to popular antiAmerican prejudice instead of presenting relevant material. The Argument that Pro-RH Advocates are Sinful or Stupid. Anti-RH groups use various personal insults against us, as if name-calling will suffice to stop or even reduce maternal mortality. This is the fallacy of argumentum ad hominem, or undermining an opponents argument by insults calculated to substitute personal traits for arguments on the merits. I will stop here, but I have just shown you that the RH debate in Congress is a long-winded theater art on how to trivialize an important national policy. I suspect that the debate will not end by the time budget season begins, and all pending bills will be shelved. If we allow the critics to have their way, RH will be a work in progress, until climate change brings about another global flood and obliterates all of human civilization, including those who think that a few mothers dying everyday from childbirth complications is a mere negligible factor in the grander scheme of things, like the coming 2013 elections. Enough! Send an email to every single senator and congressman, tell him you are watching, and that you will not vote for him forevermore if he is anti-RH. Not only that: campaign actively against anti-RH creatures. Take our campaign to Facebook, Twitter, Google, blogs, and every form of social media. If any of the news media purposely fail to present a balanced presentation of the RH debate, email the editor and appeal to the ethics of the journalism profession. Today we mark the centennial of the great UP college of law. At one time, I earned a gold medal here as Best Debater. In commemoration, Sen. Pia Cayetano and I challenge any UP law graduate in the Senate to a debate on RH, in any neutral public forum to be shown on TV, before a university audience. Let the young people decide the social legislation of this country. There is a mother of seven in a hovel in a squatters area near you. She is old beyond her years, her eyes are dimmed by despair. She is undernourished, and so are her children. Her husband is an itinerant manual worker, and cannot always afford to put food on the table, never mind buying medicines or paying for school. The government health worker has warned the couple that another pregnancy might pose a risk to the life of mother and child. But the couple do not know how to prevent pregnancy. Will you leave mother and child to die, because of mere ignorance? I do not want this mother to die nine months from today. I refuse to allow it! I might never see her, but as a Filipina, I lift her hand, and pray with her: Out of the night that covers me, Black as the Pit from pole to pole, I thank whatever gods may be For my unconquerable soul.

2. UN Doc. E/1993/22 Annex 3, para 5 and 7. 3. Varon Gauri, Social Rights and Economics: Claims to Health Care and Education in Developing Countries, in Philip Alston and Mary Robinson (eds.), Human Rights and Development Towards Mutual Reinforcement (2005) at 65. 4. Vorgrimler, Herbert, (ed.) Bums and Oates, Commentary on the Documents of Vatican 2 (1959) at 134.

It matters not how strait the gate How charged with punishments the scroll, I am the master of my fate; I am the captain of my soul. -o0oENDNOTES 1. Henry Steiner, Philip Alston, Ryan Goodman, International Human Rights in Context 3d ed. (2008) at 59.

source: http://jlp-law.com/blog/full-text-oft-act-of-2008/ HOUSE BILL NO. 5043 AN ACT PROVIDING FOR A NATIONAL POLICY ON REPRODUCTIVE HEALTH, RESPONSIBLE PARENTHOOD AND POPULATION DEVELOPMENT, AND FOR OTHER PURPOSES Be it enacted by the Senate and the House of Representatives of the Philippines in Congress assembled: SECTION 1. Short Title. This Act shall be known as the Reproductive Health and Population Development Act of 2008. SEC. 2. Declaration of Policy. The State upholds and promotes responsible parenthood, informed choice, birth spacing and respect for life in conformity with internationally recognized human rights standards. The State shall uphold the right of the people, particularly women and their organizations, to effective and reasonable participation in the formulation and implementation of the declared policy. This policy is anchored on the rationale that sustainable human development is better assured with a manageable population of healthy, educated and productive citizens. The State likewise guarantees universal access to medically-safe, legal, affordable and quality reproductive health care services, methods, devices, supplies and relevant information thereon even as it prioritizes the needs of women and children,among other underprivileged sectors. SEC. 3. Guiding Principles. This Act declares the following as basic guiding principles: a. In the promotion of reproductive health, there should be no bias for either modern or natural methods of family planning; b. Reproductive health goes beyond a demographic target because it is principally about health and rights; c. Gender equality and women empowerment are central elements of reproductive health and population development; d. Since manpower is the principal asset of every country, effective reproductive health care services must be given primacy to ensure the birth and care of healthy children and to promote responsible parenting; e. The limited resources of the country cannot be suffered to, be spread so thinly to service a burgeoning multitude that makes the allocations grossly inadequate and effectively meaningless; f. Freedom of informed choice, which is central to the exercise of any right, must be fully guaranteed by the State like the right itself; g. While the number and spacing of children are left to the sound judgment of parents and couples based on their personal conviction and religious beliefs, such concerned parents and couples, including unmarried individuals, should be afforded free and full access to relevant, adequate and correct information on reproductive health and human sexuality and should be guided by qualified State workers and professional private practitioners; h. Reproductive health, including the promotion of breastfeeding, must be the joint concern of the National Government and Local Government Units(LGUs); i. Protection and promotion of gender equality, women empowerment and human rights, including reproductive health rights, are imperative; j. Development is a multi-faceted process that calls for the coordination and integration of policies, plans, programs and projects that seek to uplift the quality of life of the people, more particularly the poor, the needy and the marginalized;

k. Active participation by and thorough consultation with concerned non-government organizations (NGOs), peoples organizations (POs) and communities are imperative to ensure that basic policies, plans, programs and projects address the priority needs of stakeholders; l. Respect for, protection and fulfillment of reproductive health rights seek to promote not only the rights and welfare of adult individuals and couples but those of adolescents and childrens as well; and m. While nothing in this Act changes the law on abortion, as abortion remains a crime and is punishable, the government shall ensure that women seeking care for post-abortion complications shall be treated and counseled in a humane, non-judgmental and compassionate manner. SEC. 4. Definition of Terms. For purposes of this Act, the following terms shall be defined as follows: a. Responsible Parenthood refers to the will, ability and cornmitTrient of parents to respond to the needs and aspirations of the family and children more particularly through family planning; b. Family Planning refers to a program which enables couple, and individuals to decide freely and responsibly the number and spacing of their children and to have the information and means to carry out their decisions, and to have informed choice and access to a full range of safe, legal and effective family planning methods, techniques and devices. c. Reproductive Health -refers to the state of physical, mental and social well-being and not merely the absence of disease or infirmity, in all matters relating to the reproductive system and to its funcitions and processes. This implies that people are able to have a satisfying and safe sex life, that they have the capability to reproduce and the freedom to decide if, when and how often to do so, provided that these are not against the law. This further implies that women and men are afforded equal status in matters related to sexual relations and reproduction. d. Reproductive Health Rights refers to the rights of individuals and couples do decide freely and responsibly the number, spacing and timing of their children; to make other decisions concerning reproduction free of discrimination, coercion and violence; to have the information and means to carry out their decisions; and to attain the highest standard of sexual and reproductive health. e. Gender Equality refers to the absence of discrimination on the basis of a persons sex, in opportunities, allocation of resources and benefits, and access to services. f. Gender Equity refers to fairness and justice in the distribution of benefits and responsibilities between women and men, and often requires. women-specific projects and programs to eliminate existing inequalities, inequities, policies and practices unfavorable too women. g. Reproductive Health Care refers to the availability of and access to a full range of methods, techniques, supplies and services that contribute to reproductive and sexual health and well-being by preventing and solving reproductive health-related problems in order to achieve enhancement of life and personal relations. The elements of reproductive health care include: 1. Maternal, infant and child health and nutrition; 2. Promotion of breastfeeding; 3. Family planning information end services; 4. Prevention of abortion and management of post-abortion complications; 5. Adolescent and youth health; 6. Prevention and management of reproductive tract infections (RTIs), HIV/AIDS and other sexually transmittable infections (STIs); 7. Elimination ofviolence against women;

8. Education and counseling on sexuality and sexual and reproductive health; 9. Treatment of breast and reproductive tract cancers and other gynecological conditions; 10. Male involvement and participation in reproductive health;, 11. Prevention and treatmentof infertility and sexual dysfunction; and 12. Reproductive health education for the youth. h. Reproductive Health Education refers to the process of acquiring complete, accurate and relevant information on all matters relating to the reproductive system, its functions and processes and human sexuality; and forming attitudes and beliefs about sex, sexual identity, interpersonal relationships, affection, intimacy and gender roles. It also includes developing the necessary skills do be able to distinguish between facts and myths on sex and sexuality; and critically evaluate. and discuss the moral, religious, social and cultural dimensions of related sensitive issues such as contraception and abortion. i. Male involvement and participation refers to the involvement, participation, commitment and joint responsibility of men with women in all areas of sexual and reproductive health, as well as reproductive health concerns specific to men. j. Reproductive tract infection (RTI) refers do sexually transmitted infections, sexually transmitted diseases and other types of-infections affecting the reproductive system. k. Basic Emergency Obstetric Care refers to lifesaving services for maternal complication being provided by a health facility or professional which must include the following six signal functions: administration of parenteral antibiotics; administration of parrenteral oxyttocic drugs; administration of parenteral anticonvulsants for preeclampsia and iampsia; manual removal of placenta; and assisted vaginal delivery. l. Comprehensive Emergency Obstetric Care refers to basic emergency obstetric care plus two other signal functions: performance of caesarean section and blood transfusion. m. Maternal Death Review refers to a qualitative and in-depth study of the causes of maternal death with the primary purpose of preventing future deaths through changes or additions to programs, plans and policies. n. Skilled Attendant refers to an accredited health professional such as a licensed midwife, doctor or nurse who has adequate proficiency and the skills to manage normal (uncomplicated) pregnancies, childbirth and the immediate postnatal period, and in the identification, management and referral of complication in women and newborns. o. Skilled Attendance refers to childbirth managed by a skilled attendant under the enabling conditions of a functional emergencyobstetric care and referral system. p. Development refers to a multi-dimensional process involving major changes in social structures, popular attitudes, and national institutions as well as the acceleration of economic growth, the reduction of inequality and the eradication of widespread poverty. q. Sustainable Human Development refers to the totality of the process of expending human choices by enabling people to enjoy long, healthy and productive lives, affording them access to resources needed for a decent standard of living and assuring continuity and acceleration of development by achieving a balance between and among a manageable population, adequate resources and a healthy environment. r. Population Development refers to a program that aims to: (1) help couples and parents achieve their desired family size; (2) improve reproductive health of individuals by addressing reproductive health problems; (3) contribute to decreased maternal and infant mortality rates and early child mortality; (4) reduce incidence of teenage

pregnancy; and (5) enable government to achieve a balanced population distribution. SEC. 5. The Commission on Population (POPC0NI). Pursuant to the herein declared policy, the Commission on Population (POPCOM) shall serve as the central planning, coordinating, implementing and monitoring body for the comprehensive and integrated policy on reproductive health and population development. In the implementation of this policy, POPCOM, which shall be an attached agency of the Department of Health (DOH) shall have the following functions: a. To create an enabling environment for women and couples to make an informed choice regarding the family planning method that is best suited to their needs and personal convictions; b. To integrate on a continuing basis the interrelated reproductive health and population development agenda into a national policy, taking into account regional and local concerns; c. To provide the mechanism to ensure active and full participation of the private sector and the citizenry through their organizations in the planning and implementation of reproductive health care and population development programs and projects; d. To ensure peoples access to medically safe, legal, quality and affordable reproductive health goods and services; e. To facilitate the involvement and participation of non-government organizations and the private sector in reproductive health care service delivery and in the production, distribution and delivery of quality reproductive: health and family planning supplies and commodities to make them accessible and affordable to ordinary citizens; f. To fully implement the Reproductive Health Care Program with the following components: (1) Reproductive health education including but not limited to counseling on the full range of legal and medically-safe family planning methods including surgical methods; (2) Maternal, pen-natal and post-natal education, care and services; (3) Promotion of breastfeeding; (4) Promotion of male involvement, participation and responsibility in reproductive health as well as other reproductive health concerns of men; (5) Prevention of abortion and management of post-abortion complications; and (6) Provision of information and services addressing the reproductive health needs of the poor, senior citizens, women in prostitution, differently-abled persons, and women and children in war AND crisis situations. g. To ensure that reproductive health services are delivered with a full range of supplies, facilities and equipment and that service providers are adequately trained for reproductive health care; h. To endeavor to furnish local Family Planning Offices with appropriate information and resources to keep the latter updated on current studies and research relating to family planning, responsible parenthood, breastfeeding and infant nutrition; i. To direct all public hospitals to make available to indigent mothers who deliver their children in these government hospitals, upon the mothers request, the procedure of ligation without cost to her; j. To recommend the enactment of legislation and adoption of executive measures that will strengthen and enhance the national policy on reproductive health and population development; k. To ensure a massive and sustained information drive on responsible parenthood and on all methods and techniques to prevent unwanted, unplanned and mistimed pregnancies, it shall release information bulletins on the same for nationwide circulation to all government

departments, agencies and instrumentalities, non-government organizations and the private sector, schools, public and private libraries, tri-media outlets, workplaces, hospitals and concerned health institutions; l. To strengthen the capacities of health regulatory agencies to ensure safe, high-quality, accessible, and affordable reproductive health services and commodities with the concurrent strengthening and enforcement of regulatory mandates and mechanisms; m. To take active steps to expand the coverage of the National Health Insurance Program (NHIP), especially among poor and marginalized women, to include the full range of reproductive health services and supplies as health insurance benefits; and n. To perform such other functions necessary to attain the purposes of this Act. The membership of the Board of Commissioners of POPCOM shall consist of the heads of the following AGENCIES: 1. National Economic DevelopmentAuthority (VEDA) 2. Department of Health (DOH) 3. Department of Social Welfare and Development (DSWD) 4. Department of Labor and Employment (DOLE) 5. Department of Agriculture (DA) 6. Department of the Interior and Local Government (DILG) 7. Department of Education (DepEd) 8. Department of Environment and Natural Resources (DENR) 9. Commission on Higher Education (CHED) 10. University of the Philippines Population Institute (UPPI) 11. Union of Local Authorities of the Philippines (ULAFI) 12. National Anti-Poverty Commission (NAPQ 13. National Commission on the Role of Filipino Women (NCRFW) 14. National Youth Commission (NYC) In addition to the aforementioned, members, there shall be three private sector representatives to the Board of Commissioners of POPCOM who shall come from NGOs. There shall be one (1) representative each from women, youth and health sectors who have a proven track record of involvement in the promotion of reproductive health. These representatives shall be nominated in a process determined by the above-mentioned sectors, and to be appointed by the President for a term of three (3)years. SEC. 6. Midwives for Skilled Attendance. -Every city and municipality shall endeavor to employ adequate number of midwives or other skilled attendants to achieve a minimum ratio of one (1)for every one hundred fifty (150) deliveries per year, to be based on the average annual number of actual deliveries or live births for the past two years. SEC. 7. Emergency Obstetric Care. Each province. and city shall endeavor to ensure the establishment and operation of hospitals with adequate and qualified personnel that provide emergency obstetric care. For every 500,000 population, there shall be at least one (1) hospital for comprehensive emergency obstetric care and four (4) hospitals for basic emergency obstetric care. SEC. 8. Maternal Death Review. All LGUs, national and local government hospitals, and other public health units shall conduct maternal death review in accordance with the guidelines to be issued by the DOH in consultation with the POPCOM. SEC. 9. Hospital-Based Family Planning. -Tubal ligation, vasectomy, intrauterine device insertion and other family planning methods requiring hospital services shall be available in all national and local government hospitals, except: in specialty hospitals which may render such services on an optional basis. For indigent patients, such services shall be fully covered by PhilHealth insurance and/or government financial assistance. SEC. 10. Contraceptives as Essential Medicines. Hormonal contraceptives, intrauterine devices, injectables and other allied reproductive health products and supplies shall be considered under the category of essential medicines and supplies which shall form part of the National Drug Formulary and the same shall be included in the regular purchase of essential medicines and supplies of all national and lord hospitals and other government health units.

SEC. 11. Mobile Health Care Service. -Each Congressional District shall be provided with a van to be known as the Mobile Health Care Service (MHOS) to deliver health care goods and services to its constituents, more particularly to the poor and needy, as well as disseminate knowledge and information on reproductive health: Provided, That reproductive health education shall be conducted by competent and adequately trained persons preferably reproductive health care providers: Provided, further, That the full range of family planning methods, both natural and modern, shall be promoted. The acquisition, operation and maintenance of the MRCS shall be funded from the Priority Development Assistance Fund (PDAF) of each Congressional District. The MHCS shall be adequately equipped with a wide range of reproductive health care materials and information dissemination devices and equipment, the latter including but not limited to, a television set for audio-visual presentation. SEC. 12. Mandatory Age-Appropriate Reproductive Health Education. Recognizing the importance of reproductive health rights in empowering the youth and developing them into responsible adults, Reproductive Health Education in an age-appropriate manner shall be taught by adequately trained teachers starting from Grade 5 up to Fourth Year High School. In order to assure the prior training of teachers on reproductive health, the implementation of Reproductive Health Education shall commence at the start of the school year one year following the effectivity of this Act. The POPCOM, in coordination with the Department of Education, shall formulate the Reproductive Health Education curriculum, which shall be common to both public and private schools and shall include related population and development concepts in addition to the following subjects and standards: a. Reproductive health and sexual rights; b. Reproductive health care and services; c. Attitudes, beliefs and values on sexual development, sexual behavior and sexual health; d. Proscription and hazards of abortion and management of postabortion complications; e. Responsible parenthood. f. Use and application of natural and modern family planning methods to promote reproductive health, achieve desired family size and prevent unwanted, unplanned and mistimed pregnancies; g. Abstinence before marriage; h. Prevention and treatment of HIV/AIDS and other, STIs/STDs, prostate cancer, breast cancer, cervical cancer and other gynecological disorders; i. Responsible sexuality; and j. Maternal, peri-natal and post-natal education, care and services. In support of the natural, and primary right of parents in the rearing of the youth, the POPCOM shall provide concerned parents with adequate and relevant scientific materials on the age-appropriate topics and manner of teaching reproductive health education to their children. In the elementary level, reproductive health education shall focus, among others, on values formation. Non-formal education programs shall likewise include the abovementioned reproductive Health Education. SEC. 13. Additional Duty of Family Planning 0ffice. Each local Family Planning Office shall furnish for free instructions and information on family planning, responsible parenthood, breastfeeding and infant nutrition to all applicants for marriage license.

SEC. 14. Certificate of Compliance. No marriage license shall be issued by the Local Civil Registrar unless the applicants present a Certificate of Compliance issued for free by the local Family Planning Office certifying that they had duly received adequate instructions and information on family planning, responsible parenthood, breastfeeding and infant nutrition. SEC. 15. Capability Building of Community-Based Volunteer Workers. Community-based volunteer workers, like but not limited to, Barangay Health Workers, shall undergo additional and updated training on the delivery of reproductive health care services and shall receive not less than 10% increase in honoraria upon successful completion of training. The increase in honoraria shall be funded from the Gender and Development (GAD) budget of the National Economic and Development Authority (NEDA), Department of Health (DOH) and the Department of the Interior and Local Government (DILG). SEC. 16. Ideal Family Size. The State shall assist couples, parents and individuals to achieve their desired family size within the context of responsible parenthood for sustainable development and encourage them to have two children as the ideal family size. Attaining the ideal family size is neither mandatory nor compulsory. No punitive action shall be imposed on parents having more than two children. SEC. 17. Employers Responsibilities. Employers shall respect the reproductive health rights of all their workers. Women shall not be discriminated against in the matter of hiring, regularization of employment status or selection for retrenchment. All Collective Bargaining Agreements (CBAs) shall provide for the free delivery by the employer of reasonable quantity of reproductive health care services, supplies and devices to all workers, more particularly women workers. In establishments or enterprises where there are no CBAs or where the employees are unorganized, the employer shall have the same obligation. SEC. 18. Support of Private and Non-government Health Care Service Providers. Pursuant to Section 5(b) hereof, private reproductive health care service providers, including but not limited to gynecologists and obstetricians, are encouraged to join their colleagues in nongovernment organizations in rendering such services free of charge or at reduced professional fee rates to indigent and low income patients. SEC. 19. Multi-Media Campaign. POPCOM shall initiate and sustain an intensified nationwide multi-media campaign to raise the level of public awareness on the urgent need to protect and promote reproductive health and rights. SEC. 20. Reporting Requirements. Before the end of April of each year,the DOH shall submit an annual report to the President of the Philippines, the President of the Senate and the Speaker of the House of Representatives on a definitive and comprehensive assessment of the implementation of this Act and shall make the necessary recommendations for executive and legislative action. The report shall be posted in the website of DOH and printed copies shall be made available to all stakeholders. SEC. 21. Prohibited Acts. The following acts are prohibited: a) Any health care service provider, whether public or private, who shall: 1. Knowingly withhold information or impede the dissemination thereof, and/or intentionally provide incorrect information regarding programs and services on reproductive health including the right to informed choice and access to a full range of legal, medically-safe and effective family planning methods; 2. Refuse to perform voluntary ligation and vasectomy and other legal and medically-safe reproductive health care services on any person of legal age on the ground of lack of spousal consent or authorization. 3. Refuse to provide reproductive health care services to an abused minor, whose abused condition is certified by the proper official or personnel of the Department of Social Welfare and Development (DSWD) or to duly DSWD-certified abused pregnant minor on whose case no parental consent is necessary.

4. Fail to provide, either deliberately or through gross or inexcusable negligence, reproductive health care services as mandated under this Act, the Local Government Code of 1991, the Labor Code, and Presidential Decree 79, as amended; and 5. Refuse to extend reproductive health care services and information on account of the patients civil status, gender or sexual orientation, age, religion, personal circumstances, and nature of work; Provided, That all conscientious objections of health care service providers based on religious grounds shall be respected: Provided, further, That the conscientious objector shall immediately refer the person seeking such care and services to another health care service provider within the same facility or one which is conveniently accessible: Provided, finally, That the patient is not in an emergency or serious case as defined in RA 8344 penalizing the refusal of hospitals and medical clinics to administer appropriate initial medical treatment and support in emergency and serious cases. b) Any public official who prohibits or restricts personally or through a subordinate the delivery of legal and medically-safe reproductive health care services, including family planning; c) Any employer who shall fail to comply with his obligation under Section 17 of this Act or an employer who requires a female applicant or employee, as a condition for employment or continued employment, to involuntarily undergo sterilization, tubal ligation or any other form of contraceptive method; d) Any person who shall falsify a certificate of compliance as required in Section 14 of this Act; and e) Any person who maliciously en ges in disinformation about the intent or provisions of this Act. SEC. 22. Penalties. The proper city or municipal court shall exercise jurisdiction over violations of this Act and the accused who is found guilty shall be sentenced to an imprisonment ranging from one (1) month to six (6) months or a fine ranging from Ten Thousand Pesos (P10,000.00) to Fifty Thousand Pesos (P50,000.00) or both such fine and imprisonment at the discretion of the court. If the offender is a juridical person, the penalty shall be imposed upon the president, treasurer, secretary or any responsible officer. An offender who is an alien shall, after service of sentence, be deported immediately without further proceedings by the Bureau of Immigration. An offender who is a public officer or employee shall suffer the accessory penalty of dismissal from the government service. Violators of this Act shall be civilly liable to the offended party in such amount at the discretion of the proper court. SEC. 23. Appropriations. The amounts appropriated in the current annual General Appropriations Act for reproductive health and family planning under the DOH and POPCOM together with ten percent (10%) of the Gender and Development (GAD) budgets of all government departments, agencies, bureaus, offices and instrumentalities funded in the annual General Appropriations Act in accordance with Republic Act No. 7192 (Women in Development and Nation-building Act) and Executive Order No. 273 (Philippine Plan for Gender Responsive Development 1995-2025) shall be allocated and utilized for the implementation of this Act. Such additional sums as may be necessary for the effective implementation of this Act shall be Included in the subsequent years General Appropriations Acts. SEC. 24. Implementing Rules and Regulations. Within sixty (60) days from the effectivity of this Act, the Department of Health shall promulgate, after thorough consultation with the Commission on Population (POPCOM), the National Economic Development Authority (NEDA), concerned non-government organizations (NGOs) and known reproductive health advocates, the requisite implementing rules and regulations. SEC. 25. Separability Clause. If any part, section or provision of this Act is held invalid or unconstitutional, other provisions not affected thereby shall remain in full force and effect. SEC. 26. Repealing Clause. All laws, decrees, Orders, issuances, rules and regulations contrary to or inconsistent with the provisions of this Act are hereby repealed, amended or modified accordingly.

SEC. 27. Effectivity. This Act shall take effect fifteen (15) days after its publication in at least two (2) newspapers of national circulation.