The ‘A’ word

The quickest way to kill support for reproductive health initiatives, we told RH advocates recently, was to mention abortion.

Sure enough, even supporters of the RH bill in Congress have found themselves in agreement with opponents of the measure in rejecting calls for the legalization of abortion.

What two members of the New York-based Center for Reproductive Rights (CRR) in fact proposed was the decriminalization of abortion. There is a difference. In decriminalization, non-penal sanctions can still be imposed on the abortionist, the woman, or both of them. As in the proposal to decriminalize libel, civil liability is not extinguished; journalists or media organizations can still be made to pay damages to the aggrieved party. But anyone found guilty can no longer be sent to prison.

Payal Shah and Melissa Upreti of the CRR, together with Dr. Florence Macagba-Tadiar of the Institute for Social Studies and Action (ISSA), pointed out that criminalizing abortion has not stopped Filipino women from undergoing the risky procedure.

What criminalization has done, they said, is to drive women underground, into the hands of midwives, herbalists and other people who are not qualified to perform the surgery.

What it has also done is give health centers a reason to reject women who need treatment for post-abortion complications, even if it could mean the woman’s death from serious infection or hemorrhage.

Among those who were accepted for treatment in the Philippines, the CRR documented cases wherein the women were humiliated or discriminated against.

One woman was tied down to the operating table and scolded. She found a sign with the word “abortion” written on it displayed at the foot of her bed.

Decriminalizing abortion will stop such human rights violations.

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Many women who undergo abortion lack knowledge of or access to contraceptives and reproductive health services, so it’s understandable that the abortion debate becomes linked to RH and birth control.

The CRR and ISSA place the number of induced abortions in the Philippines in 2008 at 560,000. The actual figure is likely to be higher because many cases go unrecorded due to women’s fear of landing in prison for a criminal act. About 90,000 sought treatment for post-abortion complications and 1,000 died. Teenagers account for about 17 percent of unsafe abortions in this country, according to the two organizations.

I personally know girls in their teenage years or early 20s terminating their pregnancies by taking herbs from Quiapo or drugs recommended by friends who have themselves undergone abortions. I know someone who drank an infusion of the herbs and then jumped down from a coconut tree, just to help the process along.

In the tough neighborhood where I grew up in the city of Manila, there was a house that the entire neighborhood knew was an abortion clinic. It was run by a gynecologist who lived in Quezon City and who told patients that he paid off police and military officers every month to keep his clinic open. He regaled patients with stories of his residence being so nice it was used for a TV advertisement. The doctor was old and must be dead by now.

The line of patients inside his clinic was like those snaking lines for rice during the crisis last year. The doctor offered socialized pricing: lower for teenage students, and higher for the well-heeled socialites who pretended they were there for a minor consultation.

Three of my young friends underwent abortions; one in that clinic, and two at the hands of midwives. A college classmate also went to the gynecologist. The two who went to the real doctor recovered quickly; my college classmate went dancing in a disco just hours later.

The two who went to midwives suffered serious complications. One was given a piece of wire like the one for clothes hangers to scrape out the fetus herself. She later collapsed while taking a shower and nearly died from excessive bleeding and infection, but was treated in a hospital.

Would sex education have prevented the pregnancies? We didn’t have sex education back then in our Catholic high school (some private schools teach it in fourth grade these days). What we knew we learned from tiny books crudely printed and sold openly in Manila’s University Belt as well as movies and videotapes. And porn materials don’t teach you about birth control.

I don’t know if my friends ever became part of official statistics on abortion, but I know their stories to be true, plus those of many others over the years who didn’t know or didn’t care that undergoing abortion meant breaking the law.

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That law, according to the CRR and ISSA, constitutes a total ban on abortion and is one of the most restrictive in the world.

Shah and Upreti, who both have legal backgrounds, point out that the absolute ban leads to violations of women’s rights and is in defiance of Philippine obligations under international law.

The CRR has prepared a report on the problem in the Philippines, which aims to shed light “on the dilemmas and challenges many healthcare providers face as they are caught between the criminal ban, which prescribes penalties for providers of abortion, and their professional obligation to treat their patients with compassion and respect.”

The two groups point out that several United Nations committees have expressed concern about the situation in the Philippines. These are the UN Committee on Economic, Social and Cultural Rights; the Committee on Elimination of Discrimination Against Women; and the Committee on the Rights of the Child.

The UN bodies have noted that Filipino women are being driven to undergo unsafe abortions due to the lack of information on RH and access to contraceptive methods.

Under the Millennium Development Goals, the Philippines has committed to reduce the current ratio of 230 maternal deaths per 100,000 live births to just 52 by 2012.

I’m not sure how concerned the Aquino administration is about the country’s international commitments. But the bottom line in this debate is saving women’s lives. Legalizing abortion is out of the question in our society at this time, but treatment of women for post-abortion complications is something else.

Doctors and other health professionals are sworn to save lives. Even those of their enemies, or those who do not share their religious beliefs.

*      *      * –Ana Marie Pamintuan (The Philippine Star)