Abortion in the Philippines: A National Secret

Reuters) - Minda is a masseuse with a difference. Her caress is used to

abort fetuses.
The 50-year-old grandmother has lost count of the number of pregnancies she has terminated
in this largely Roman Catholic country where abortion is illegal and strictly taboo, but where
about half a million women end their pregnancies every year.
The backstreet abortions performed by healers like Minda may become more common as a
United States government aid program plans to stop distributing contraceptives in the
Philippines in 2008. This will leave birth control up to the government which under the
influence of Catholic bishops advocates unreliable natural birth control methods rather than
the pill and condoms.
Most women who seek abortions are like Remy, married with several children and too poor to
afford another baby.
The petite 44-year old, who declined to give her last name, paid 150 pesos ($3) for a hilot, or
traditional midwife like Minda, to crush her three-month old fetus using rough strokes and
pincer-like grips on her belly.
The procedure, which can also involve pounding the lower abdomen to trigger a miscarriage, is
called a massage.
"I felt guilty but I thought it was better than having another child that will only suffer
because we have no food," she said in an interview in a slum on the outskirts of Manila.
Remy bled for a week after her session with the hilot, passing out with the pain. She refused
to let her husband take her to the hospital because of the shame of what she had done and
because they couldn't afford the medical bills.
"I just prayed to God and asked for forgiveness," she said.
Before her abortion, Remy had no access to artificial family planning. If she had, she says she
wouldn't have become pregnant and resorted to the potentially life-threatening procedure.
Under President Gloria Macapagal Arroyo, a devout Catholic who relies on the support of
politically powerful bishops, the central government promotes natural family planning methods
such as abstinence when the woman is ovulating.
Poor people, who make up the majority of the population, rely largely on the U.S. government
agency USAID, the main supplier of contraceptives in the country for the past 30 years.
But USAID has started phasing out supplies and plans to end the rest of its donation program
in 2008. The agency has said its phase-out is in line with Manila's goal of self-reliance in family
planning.



Alizza Therese S. Anzano BSN-II
DESPERATE SITUATION
Officials says the central government's reluctance to take up where USAID will leave off will
certainly push up the country's rate of abortions, which is already twice as high as in western
Europe, where terminations are legal and easily accessible.
"Supplies (of contraceptives) have already run out in many towns and cities so the situation is
rather desperate," said Dr Alberto Romualdez, a former health secretary under deposed
President Joseph Estrada.
Catholic clerics in the Philippines urge their congregations to use natural family methods
rather than the contraceptive pill.
"The natural family planning method is a good option, not only a good one but an effective one,"
Father Melvin Castro, executive secretary of the Episcopal Commission on Family and Life, told
Reuters.
Over half of women who have had an abortion in the Philippines were not using any family
planning and of those that were, three-quarters were using natural methods advocated by the
government such as rhythm or withdrawal, according to a survey by the U.S.-based.
Guttmacher Institute.
Both methods have high failure rates.
The population, currently estimated at 89 million, is expected to swell to 142 million by 2040
and the rapid arrival of new mouths to feed is already straining the country's creaking
infrastructure and choking efforts to cut poverty."
POLICE SIRENS
Women who abort their fetuses in the Philippines risk a prison sentence of up to six years,
while anyone providing help or assisting faces a similar sentence as well as the loss of any
medical license.
Only one in four women have a surgical procedure according to the Guttmacher Institute. The
4,000-15,000 peso cost, usually in private clinics, is beyond the pockets of most women.
Over 30 percent ingest either cytotec, an anti-ulcer treatment they can buy in pharmacies, or
herbal concoctions, often sold in stalls in front of churches.
Around 20 percent take hormonal drugs, or aspirin, as well as other medications and alcohol.
Some starve themselves or fling themselves down stairs. Most women only succeed in ending
their pregnancy after multiple attempts.
Among poor women seeking abortions, over 20 percent get massages from hilots or insert
catheters in their vaginas.
One mother of three, who had two abortions, said the hilot's touch was agony.
"When she squeezed, it was so painful I wanted to kick her. I bit the blanket. I wanted to cry
but I felt I had to contain myself," said the woman, who declined to be named.
"The pain was worse than childbirth."
The second time she had a surgical procedure in a backstreet clinic without anesthetic.
"The room was so close to the street I could hear cars and police sirens," she said. "I was
afraid I was going to be arrested with my legs wide open."
Alizza Therese S. Anzano BSN-II

Dr Junice Melgar, executive director of Likhaan, a women's health organization, said a lack of
information about artificial contraception and myths about their side-effects was putting some
poor people off using them.
"There is a lot of fear among the women," she said. "You have women choosing abortion before
family planning because of these fears."
Ignorance and rumors, sometimes spread by pro-life groups and members of the clergy, have
led some Filipinos to believe that the contraceptive pill is made from placenta and the tablets
accumulate in the abdomen and cause cancer.

FEEL THE PAIN
Although abortion is rarely discussed publicly in the Philippines, nearly 80,000 women are
treated in hospitals every year for complications from induced abortion, according to health
reports.
Many are treated roughly by nurses and doctors who abhor what they have done. Painkillers are
sometimes withheld. At least 800 women are estimated to die every year from complications.
"Doctors feel that women need to feel the pain so that they will remember and not do it again,"
said Melgar.
Women who have miscarried sometimes suffer the same ill-treatment because they are
suspected of inducing the loss.
Gemma Apelado, a mother of one, said doctors let her bleed all night when she went to a
hospital in Tondo, a poor area of Manila, after having a miscarriage at four months.
"They were all standing around me and they were saying that I took something to induce an
abortion," she said. "They were telling me I didn't have any conscience."
Minda, the hilot, says her conscience has started to trouble her. The mother of nine
administers pills to induce abortion and uses heavy strokes to push the fetus down.
"I worry about karma," she said. "But I also pity those having to undergo abortions".








Alizza Therese S. Anzano BSN-II

Abortion in the Philippines: Issues on Population Control and
the Ban on the Reproductive Health Bill
Abortion is legally not allowed in the Philippines. Women who induced abortion on their own for their
unplanned or unwanted pregnancy faced up to 6 years in jail. There are no legal abortion clinics or any
abortion or pro-choice centers in Manila. The Catholic Church has a great influence over the law here
and any pro-choice movement would instantly be squashed.
The only abortion allowed in the Philippines is under the medical discretion of an OB-
gynecologist. If the pregnancy will cause the death of the mother or if the fetus is already dead, just a
sac, without a heartbeat or a blighted ovum. A medical miscarriage maybe induced through the use of
Mifepristone, Misoprostol (cytotec) followed possibly by a D&E (dilation and evacuation)
procedure commonly known by Filipinos as "Raspa" (which means to scrape off) to ensure no dead
tissue is left inside the uterus.
Senator Juan Flavier used to have a population control program that offered free condoms and
contraceptives at health centers. With a shift in power and President Arroyo courting the influence of
the Catholic Church to be on her side has stopped the Population control program and the USAID
donations of contraceptives to please the archbishops. Now the Filipino people are on their own. With
the church promoting abstinence as a method to curve the population boom, women now have to
suffer. Only the working class and the rich can afford medical contraception and family planning.
Abortion maybe illegal in the Philippines, but that doesn't mean it doesn't exist. It is talked about,
but never publicly. No woman would ever dare admit to an abortion due to the shame, gossip and
moral outrage of the community.
Still, there are Filipino women often too poor, with no means to buy contraceptives and are raising an
average of 7-10 children that are left to the mercy of hilots (healers or massagers) that is, if they
choose to undergo a backstreet abortion rather than raising another child they are unable to care for.
According to the International Family Planning Perspectives, Filipinas obtain abortionsoften in unsafe
conditionsto avoid unplanned births. In 1994, the estimated abortion rate was 25 per 1,000 women
per year.
Where women go for abortions in the Philippines:
Hilots (healers or massagers) are sought out in communities. The deed is done in backalleys, shanties
or privately rented rooms such as motels and apartelles.
Quiapo Church. Ironically, abortificients such as herbal cocktails and the ulcer drug Misoprostol
(cytotec) are sold by peddlers around the Church area. There are what you call spotters who will ask
women and passerbys if they are interested to avail of the drug. The police conducts annual raids with
the media in tow.
Self-induced or self-injury methods. This ranges from throwing yourself off a flight of stairs, asking to
get punched in the belly, jumping around till you bleed, coathangers, catheters and everything
gruesome. Any possible method to land in a hospital to get a D&E.
Sadly, most who self abort are teenagers and most end up dead due to complications and injury.
I guess what should be promoted by the government is not an abortion or an anti-abortion sentiment,
but rather make safe-sex education and free contraception available to the public.
Alizza Therese S. Anzano BSN-II