Better a carrot than a stick

MANILA, Philippines—Let me make it quite clear: I am pro-life, pro-poor, pro-women. And therefore, like most Filipinos (average of 82 percent according to a Pulse Asia Survey, but ranging from 76 percent to 91 percent across all geographic areas and socio-economic classes), I am in favor of the government providing family planning information and services to those who want to be so informed and/or who want to either space or limit their children.

Why does adopting this stance make me pro-life? Because it will reduce the shockingly high maternal mortality rates as well as infant/child mortality rates (the probability of which increases when the mother dies) in the Philippines. Why shockingly high? Only consider: 4,100 maternal deaths occurred in the Philippines in 2000, as compared to 2,500 for all the developed regions combined (Europe, United States, Canada, Japan, Australia, New Zealand); and 2,740 maternal deaths in Malaysia, Thailand and Vietnam combined, whose total population is twice that of ours. Is that shocking enough?

Why will it reduce the mortality rates? Because of the more than 11 maternal deaths a day (4,100 a year divided by 365 days), it has been found that up to half can be prevented by reducing unintended pregnancies through family planning (the rest by skilled birth attendance and access to emergency obstetric care). Of the 39 infants who die per thousand live births, it has again been calculated that given the 1.71 million live births registered in 2004, at least 7,800 infant deaths a year could be prevented through proper birth spacing.

Is that pro-life enough for the reader?

Next: How does being in favor of access to family planning information and services qualify one to be pro-women? Well, aside from the fact that at least five women’s lives are saved per day, there is the matter of maternal morbidities (illnesses associated with pregnancy and childbirth) which, by the way, are the top cause of female morbidities. The maternal morbidities in the Philippines (circa 2005) were estimated to be 400,000 (compared to, say, the next highest cause of female morbidity—ALRI and pneumonia—of 329,000). And again, it has been estimated that up to 200,000 maternal morbidities could be prevented through effective family planning.

Finally: Where does the pro-poor factor come in? Again, empirical bases. According to the National Health and Demographic Surveys (NHDS—conducted quinquennially) the poor bear the brunt of the maternal and infant mortalities, as well as the maternal morbidities. The poor have the greatest need for family planning services. How can one know this? Per the NHDS, women in the lowest wealth quintile (20 percent) have a total fertility rate of 5.2 as against their wanted fertility rate of 3.3. Compare this to women in the highest wealth quintile whose total fertility rate is 1.9 as compared to their actual fertility rate of 1.6.

Now then, let me also say that I am a practicing Catholic, and I am against abortion, as are most Filipinos; which is again why we are in favor of family planning. We know that a very large percentage of unplanned pregnancies in the Philippines end up in abortion, which in turn contributes to maternal mortality, etc. etc. as discussed above. Better to prevent conception than to having an abortion performed.

So how many Filipino Catholics are in favor of family planning information and services? Let’s do the math: 82 percent of Filipinos (Pulse Asia Survey 2008) are in favor; 19 percent of Filipinos are non-Catholics (2000 Census). Assume that all of the non-Catholics are in favor of family planning. That leaves 63 percent (82 minus 19) of the Filipinos who are in favor of family planning are Catholics. Which means that 78 percent of Filipino Catholics (63 divided by 81) are in favor of family planning.

Now that truly represents a clamor—which should be at least recognized by those in the Catholic hierarchy who are against any form of family planning other than Natural Family Planning (NFP)—and even then, only the so-called Billings Method or mucus method. Unfortunately, that method requires, at least for the poor, much more resources (time, privacy, literacy) than they have—which is why the method has not caught on at all.

But there is an NFP method that was discussed at a forum on the Reproductive Health Bill in our parish (Santuario de San Antonio) yesterday, that impressed me—and one wonders why the Catholic hierarchy (other than Archbishop Tony Ledesma) hasn’t grabbed it and run with it. It is called the Standard Days Method (SDM), and its efficacy rate is reportedly 95.25 percent. Moreover, it works for women whose menstrual cycle is anywhere from 26 to 32 days, which, again reportedly, covers 80 percent of our women.
Milagros Rivera of the Institute for Reproductive Health, who discussed the different NFP methods, showed us the so-called Cyclebeads that is part of the SDM—a rosary-like thing which has a series of brown beads followed by a series of white beads, with one red bead (plus a directional arrow, so you know which way to go), and a movable band. 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.

Instead of trying to prevent Filipinos from using artificial contraceptives, the Church hierarchy should offer an attractive alternative like the SDM. Better a carrot than a stick anytime. –Solita Collas-Monsod, Philippine Daily Inquirer