18 arguments on population issue

REPRODUCTIVE health is now the focus of much talk as Congress starts hearings on RH bills. This article scans through the many arguments (pros and cons) of the debate. The sources cited below can be found easily via an Internet search.

ARGUMENT 1: Rapid population growth slows down a nation’s economic rise.

2009 GDP per capita
Country Amount
Singapore $50,180
Malaysia 13,800
Thailand 8,051
Indonesia 4,151
Philippines 3,516
Vietnam 2,942
Timor-Leste 2,522
Laos 2,286
Cambodia 1,993
Burma 1,197

A proxy for a nation’s progress is its citizens’ average income, or per capita income. This is computed as gross domestic product (GDP) divided by the population. The higher this is, the more likely that the people are getting better off. Below is the per capita income of Asean nations in 2009, according to the International Monetary Fund. It is in US dollars, adjusted for differences in prices.

The people of four nations have average incomes higher than those of the Philippines. These countries, with the exception of the Indonesia, also have smaller populations.

Argument 2: The Philippines will be as poor as Somalia by 2050 because of rapid population growth.

Somalia’s GDP per capita was estimated at only $600 in 2009, according to the CIA World Factbook. In the past few years, Somalia’s fastest GDP growth was at 3 percent in 2007. That’s a far cry from the 7 percent of the Philippines in 2007. It’s hard to see how Somalia can overtake the Philippines given its far smaller economy and far slower economic growth.

ARGUMENT 3: Big families tend to be poorer.

2000 Poverty incidence

Family size Percent
1 9.8
2 15.7
3 18.6
4 23.8
5 31.1
6 40.5
7 48.7
8 54.9
9+ 57.3

This is confirmed in a 2002 study by Dr. Aniceto Orbeta writing for the Philippine Institute for Development Studies. Poverty incidence (the percent living below the poverty line) tends to rise the larger the family size. The study contains this table:

ARGUMENT 4: Social services are hard pressed to keep up with population growth.

In a 2007 paper, Representative Edcel Lagman noted the link between population growth and the lack of human development in the Philippines. “The doctor to patient ratio set down by the WHO (World Health Organization) is 1:10,000. In the Philippines it is 1:20,000 and is estimated to even reach 1:30,000.”

He adds that rapid population growth contributes to maternal mortality and births not assisted by doctors, nurses or midwives. Government is also tied down in providing quality education to the youth.

Citing data available at that time, he says, “The student-teacher ratio in the country of 45:1 (DepEd, 2006) is alarming if compared with Singapore, Malaysia and Thailand which all have a ratio of 25 to 30 students per teacher. We have a shortage of 29,321 classrooms; 16,390 teachers; 30.6 million textbooks; and 1.62 million school furniture units (DepEd, 2006).”

ARGUMENT 5: The country is congested.

Population density

Region Density
1 349/sq km
2 108
3 451
4A 707
4B 86
5 282
6 332
7 403
8 168
9 189
10 194
11 204
12 170
13 107
CAR 78
ARMM 129

The argument is often depicted in newspaper pictures and cartoons. Here are the population densities of the various regions, in people per square kilometers, as of 2007. The source is the website of the National Statistical Coordination Board (NSCB).

What is the density of Metro Manila? It is a whopping 18,650. The number is extreme not because of high birth rates in the metropolis, but because people keep flooding in from the provinces. Really striking is the contrast between Metro Manila’s congestion and the wide open spaces of the other regions.

The Philippines is not congested, Metro Manila is. Newspapers should reflect this properly.

ARGUMENT 6: The world is congested.

The world’s population was 6,883,053,726 as of November 22. Suppose they all lived together comfortably, with little congestion, how much land will they occupy?

Metro Manila is congested, and so is Manila alone, with a density of 43,024 people per sq km. They can’t be defined as comfortable. A much lower density can be found in Baguio City, at only 5,251 people per sq km.

Divide the world’s population by the density of Baguio City, and the result is 1,310,833 sq km. That area is slightly larger than Peru and smaller than Mongolia.

Hence, we can fit all the people of the world comfortably in an area about the size of Peru.

ARGUMENT 7: The total fertility rate (TFR) of the Philippines has been falling anyway.

Asean TFR
Country TFR
Philippines 3.23
Laos 3.22
Timor-Leste 3.20
Cambodia 2.90
Malaysia 2.70
Indonesia 2.28
Burma 2.28
Vietnam 1.93
Thailand 1.65
Singapore 1.10

TFR refers to the average number of children born per woman. That is, assuming that all women live to the end of their childbearing years. The Philippines’ TFR has indeed been falling over time.

Back in 1967-72, the TFR in the Philippines was 5.89 children. This has been dropping steadily over the years, reaching 3.23 children in 2010.

The counterargument for this is that the TFR has not been falling fast enough; other nations already have low TFR. The following are Asean TFRs for 2010 (CIA World Factbook).

ARGUMENT 8: Aging or populations that lack working youth are a real problem.

The commonly sought number for TFR is the replacement rate of 2.2 children. The 2 children will be just enough to replace the parents when they pass away. The 0.2 takes into account childless women.

When the number of children is lower than this, there will not be enough working adults to support the retired elderly. Pension problems result from TFRs below 2.2. The elderly will see their pensions slashed. The working youth also know that their pensions in the future will suffer even larger cuts. Last October, France erupted into riots across the nation over pension reforms pushed by her unpopular president.

Aging is rampant in Japan, South Korea, Russia, France, the United Kingdom, Canada, Spain and Italy.

In her October 28 column, Ceres Doyo cites a study by the East-West Center in the United States on the deep fall of fertility in Asia. The paper is, “Very Low Fertility in Asia: Is There a Problem? Can It Be Solved?” by Sidney B. Westley, Minja Kim Choe and Robert D. Retherford.

She quotes the summary: “Then the birth rates began to fall in several countries more steeply than anyone had anticipated. This unexpected trend has now raised concerns about the social and economic impact of extremely low fertility … (T)hese societies have expanding elderly populations and a shrinking workforce to pay for social services and drive economic growth.”

Given present conditions, the Philippines will sink to a TFR of 2.07 by 2035-2040, according to the NSCB.

The counterargument for this is that the Filipino population is still young today; aging is a problem many years away.

Argument 9: Family planning is a popular demand among the people.

The National Demographic and Health Survey of 2008 compared the number of children that couples wanted and the actual number they had. It found, among others, that the poorest fifth of women wanted an average of 3.3 children. But they actually got 5.2.

Demand for family planning has been confirmed repeatedly by many surveys of Social Weather Stations (SWS). For example, the SWS poll in January found 68 percent agreeing with the test statement that the government health service should provide all legal means of family planning that a family might choose. Only 10 percent disagreed with this. Agreement reached 78 percent in Metro Manila and 75 percent within the rich and middle class ABC.

While surveys of public opinion can’t dictate policy, at least they must be listened to.

ARGUMENT 10: Family planning methods must not induce abortion.

The issue is not only moral but is also legal, for abortion is banned by the 1987 Philippine Constitution. Laws that promote abortion will therefore be met by constitutional challenges.

Article II Section 12 says, “The State recognizes the sanctity of family life and shall protect and strengthen the family as a basic autonomous social institution. It shall equally protect the life of the mother and the life of the unborn from conception.”

The 1986 Constitutional Commission understood conception as fertilization, the moment when the sperm enters the egg cell. At fertilization, the 23 chromosomes of the father unite with the 23 of the mother to form a new individual with 46 chromosomes.

It is interesting that nations that pushed artificial contraception changed the definition of the beginning of life. Instead of fertilization, they chose the implantation of the fertilized egg into the uterus as the start, or 7-10 days after fertilization.

ARGUMENT 11: The IUD may cause abortion.

The primary effect of the intrauterine device or IUD is to prevent fertilization of the egg by the sperm. However, there are secondary effects after fertilization.

The American Journal of Obstetrics and Gynecology reported that for the IUD, “the major postfertilization effect is destruction of the early embryo in the fallopian tube.” See Joseph B. Stanford and Rafael T. Mikolajczyk (2005). “Mechanisms of action of intrauterine devices: Update and estimation of postfertilization effects.” American Journal of Obstetrics and Gynecology (W.B. Saunders Comp) 187 (6): 1699-1708.

ARGUMENT 12: The birth control pill may cause abortion.

This angle is particularly controversial.

Planned Parenthood is among the largest family planning organizations in the world. On its website it explains that most birth-control pills are a combination of estrogen and progestin. These hormones keep the ovaries from releasing eggs. They also thicken a woman’s cervical mucus. Hence, the sperm can’t swim toward the egg.

But a primer in the Planned Parenthood website notes this effect as well: “The hormones also thin the lining of the uterus. In theory, this could prevent pregnancy by keeping a fertilized egg from attaching to the uterus.”

See http://www.plannedparenthood.org/health-topics/birth-con
trol/birth-control-pill-4228.htm accessed on November 29 at 5:30 p.m.

ARGUMENT 13: Birth control injectables or shots may cause abortion.

The Planned Parenthood site explains that the shot releases progestin, which prevents the ovaries from discharging eggs, and which thickens the cervical mucus. It repeats the earlier statement on the abortive effect:

“The hormones also thin the lining of the uterus. In theory, this could prevent pregnancy by keeping a fertilized egg from attaching to the uterus.”

Refer to http://www.plannedparenthood.org/health-topics/birth
-control/birth-control-shot-depo-provera-4242.htm accessed on November 29 at 9 p.m.

ARGUMENT 14: Many would object to saying the said methods may cause abortion.

It comes down to the issue of when life begins.

Before 1965, the medical consensus was that life began at fertilization, or when the sperm penetrated the egg. But in that year, the American College of Obstetrics and Gynecology (Acog) changed the definition to the implantation of the fertilized ovum on the uterus.

Why they did this was suggested by the head of Acog, Dr. Richard Sosnowski, in his 1984 address:

“I do not deem it excellent to play semantic gymnastics in a profession … It is equally troublesome to me that, with no scientific evidence to validate the change, the definition of conception as the successful spermatic penetration of an ovum was redefined as the implantation of a fertilized ovum. It appears to me that the only reason for this was the dilemma produced by the possibility that the intrauterine contraceptive device might function as an abortifacient.”

Refer to Sosnowski Jr. “The pursuit of excellence: Have we apprehended and comprehended it?” Am J Obstet Gynecol 150: 115-9; 1984.

ARGUMENT 15: Condoms promote promiscuity.

The evidence is mixed on the Internet. There are studies which show that condoms do promote promiscuity, while others don’t arrive at that conclusion.

ARGUMENT 16: Natural family planning (NFP) methods protect the family.

That is the Catholic Church argument. In NFP the couple abstains from sex periodically. NFP requires that the husband be familiar with and respect the cycles of his wife. For they are “one flesh.” The woman cannot be just a mere object or outlet of the man. The moral freedom, the stronger will from the discipline of abstinence, helps the couple keep faithful to each other. The man who can abstain a few days with his wife will not likely stray into sex with other women.

See for example, “Spouses should experience pleasure and enjoyment in body and spirit (from sex) … They are no longer two; from now on they form one flesh … These methods respect the bodies of the spouses, encourage tenderness between them and favor the education of an authentic freedom.” (Catechism of the Catholic Church par. 2362, 2364, 2370)

The NFP manual on the Commission on Population’s website puts it as follows:

“The man learns to know the woman in her physical and hormonal changes and the woman appreciates the man’s attention to her individuality and acceptance of her cyclical fertility … When fully integrated into their lives, the methods call for constant dialogue between the couple, thus helping build their relationship.”

ARGUMENT 17: But the rhythm/calendar method does not work.

The calendar method is not being promoted by the State or the Church. It is not among the modern NFP techniques listed in the bill of Lagman.

A better NFP technique is the Billings method which keeps track of the woman’s cycle indicators, like body temperature.

Billings works, but it has been criticized as too taxing for those with little or no education.

ARGUMENT 18: The Standard Days Method (SDM) is much simpler.

Solita Monsod (Inquirer, Oct. 23) cites SDM, writing that she was impressed by it. SDM, like Billings, is mentioned as a modern technique in the Lagman bill.

SDM works for women whose cycles range from 26 to 32 days, which is the big majority. The efficacy rate is reported at 95.25 percent. SDM uses Cyclebeads, similar to a rosary, with a red bead and beads colored white and brown. It includes a movable band. The cyclebeads have been described as “empowering” for the woman.

“On Day 1 of menstruation, you put the band on the red bead. And the band is moved every day. As long as the bead is brown, all systems are go. When the beads are white (Day 8 to Day 19), time out. Etc. Pretty simple—even the husband can keep count,” says Monsod. –Dennis M. Arroyo, Philippine Daily Inquirer

(Dennis M. Arroyo, a fellow of Social Weather Stations and a consultant for the World Bank, is a former director of the National Planning Staff of the National Economic and Development Authority. He was a visiting fellow of Stanford University in 2007-2008.)