Reproductive Health Bill: Empowering Couples in Responsible Family Planning

Reproductive Health Bill
The Reproductive Health Bill is a bill pending in the 15th Philippine Congress that seeks to promote on a national level access to information and the availability of natural and artificial contraception. It seeks to empower couples in responsible family planning through education and access to legal and medically safe birth control.
The bill was first filed during the 8th congress in the Corazon Aquino administration and has been refiled in succeeding sessions. It has had an uphill battle due to extreme opposition mainly from the Roman Catholic Church, Pro-Life Philippines, the National Coalition for Family and Life, Abay Pamilya, and Philippine Nurses Association.
Click to read the House of Representatives and Senate versions of the bill.
Despite the strong opposition by the Catholic church, who believes that the said bill will destroy family lives, the Chambers of Congress passed on the third and final reading of the RH Bill on 17 December 2012 13 senators and 133 Congressmen voted in favor of the bill, which will provide the government funds for contraceptives and reproductive health classes in schools.
Senators Edgardo Angara, Joker Arroyo, Alan Peter Cayetano, Pia Cayetano, Miriam Defensor-Santiago, Franklin Drilon, Francis Escudero, Teofisto Guingona III, Panfilo Lacson, Loren Legarda, Ferdinand Marcos, Jr.., Francis Pangilinan and Ralph Recto voted in favor of the bill. Against the bill are Senate President Juan Ponce Enrile, Senate Pro Tempore Jose “Jinggoy” Estrada, Majority Leader Vicente “Tito” Sotto III, Senators Gringo Honasan, Aquilino Pimentel III, Manuel “Manny” Villar, Bong Revilla, and Antonio Trillanes IV.
President Benigno Simeon Aquino III has certified the RH bill as urgent. It was languished at the Congress for 10 years, as legislators avoided to upset bishops that were instrumental in the 1986 People Power revolt.
A pastoral letter was issued by the Catholic Bishops Conference of the Philippines (CBCP), urging the other 64 lawmakers who have not yet cast their votes to vote against it. CBCP vice president Lingayen-Dagupan Archbishop Socrates Villegas said that the bill will lead to more crimes against women and that it “corrupts the soul”.
Main Points
The RH Bill covers a wide range of health-related issues affecting women, and thereby directly affecting all Filipino families. If made into a law, this would be the first Philippine law that directly intends to control the population of the country through aggressive information dissemination on responsible family planning methods.
Contraceptives would be considered essential medicine and hospital-based family planning methods such as IUD insertion, vasectomy and ligation would be made available at government health centers. The ideal family size of two children per family would be encouraged. Through education, the bill proposes the improvement of women’s overall health by lowering the risk of complications from childbirth, unwanted pregnancies, infertility, decreased exposure to abuse and sexually transmitted diseases. Men would also be made responsible for reproductive issues. Children of school age would be taught lessons on family planning, starting at grade 5 to high school. Engaged couples would have to undergo family planning seminars prior to the issuance of their marriage license. Breastfeeding would also be further promoted.
The bill aims to curtail the population to be able to keep up with any economic development. It is created with the masses in mind, as the ones in the lowest income brackets tend to have the most children.
Lagman also said that there are ten to 11 women who die daily while giving birth, and this could be prevented through contraception. He also said that use of contraception will lower the rate of abortions.
According to the proponents of the bill, an effective population control program is instrumental to any economic development plan for it to succeed. Even with the passage of the bill, it will take at least three decades for its effects to be felt because of the strong momentum of the current population growth.
Some definitions used:
Reproductive Health Care - refers to the state of complete 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 functions 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 attain equal relationships in matters related to sexual relations and reproduction.
Reproductive Rights - the rights of individuals and couples to decide freely and responsibly whether or not to have children; 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 do so; and to attain the highest standard of sexual and reproductive health.

Criticism
Doctors and nurses, especially those who belong to the Philippine Nurses Association, say that the bill promotes pills and devices which induce abortion. They refer to the American Journal of Obstetrics and Gynecology (2005). This journal concluded that the IUD brings about the "destruction of the early embryo,"<ref name=stanford2005>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 187: 1699–1708. DOI:10.1067/mob.[phone]. </ref> The scientific journal of the American Medical Association also concluded that the common birth control pill is an abortifacient.<ref name=larimore2000>Larimore WL, Stanford JB (2000). "Postfertilization effects of oral contraceptives and their relationship to informed consent" (PDF). Arch Fam Med 9 (2): 126–33. DOI:10.1001/archfami.9.2.126. PMID 10693729. </ref> The Philippine Medical Association (PMA) announced in December 2010 that human life begins at fertilization, thus agreeing with the stand of the Catholic Church.
Medical practitioners also refer to the World Health Organization announcement that the birth control pill is carcinogenic or cancer-causing,<ref name=whocancer>Template:Cite press release</ref> confers the risk of stroke,<ref name=KemmerenEtAl2002>Jeanet M. Kemmeren, Bea C. Tanis, Maurice A.A.J. van den Bosch, Edward L.E.M. Bollen, Frans M. Helmerhorst, Yolanda van der Graaf, Frits R. Rosendaal, and Ale Algra (2002). "Risk of Arterial Thrombosis in Relation to Oral Contraceptives (RATIO) Study: Oral Contraceptives and the Risk of Ischemic Stroke". Stroke 33: 1202–1208. DOI:10.1161/01.STR.0000015345.61324.3F. PMID 11988591. </ref> and significantly increases the risk of heart attacks.<ref name=BaillargeonMcClishEssahNestler2004>Jean-Patrice Baillargeon, Donna K. McClish, Paulina A. Essah, and John E. Nestler (2005). "Association between the Current Use of Low-Dose Oral Contraceptives and Cardiovascular Arterial Disease: A Meta-Analysis". Journal of Clinical Endocrinology & Metabolism 90 (7): 3863–3870. DOI:10.1210/jc.2004-1958. PMID 15814774. </ref>
Meanwhile, several economists refer to the study of Nobel prize winner Simon Kuznets. He concluded that “no clear association appears to exist in the present sample of countries, or is likely to exist in other developed countries, between rates of growth of population and of product per capita." Other Nobel prize winners who said something similar are Gary Becker and Amartya Sen. Economists against the RH Bill also said that from 1961-2000, the Philippine population increased almost threefold, from 27 million to 76 million, while population incidence decreased from 59% to 34%. They stressed that the more probable cause of poor families is the limited schooling of the household head since 78% to 90% of the poor families have heads who did not finish high school.
The loudest voice against the Reproductive Health bill has been the Catholic Church, as they are against any type of artificial family planning because they believe it is a desecration of sexuality, an injustice committed by spouses who promised to give their entire bodies to the other spouse, and a lie in the language of self-giving. The Church, through Paul VI, is said to have prophesied that the promotion of contraception will lead to the disrespect of women (treating them as instruments of pleasure). It will also lead governments towards coercive population policies, and to more instances of infidelity and adultery. Although some pro-life advocates attempt to use social science to legitimate their claims of empirical links between contraception and many ‘social evils’, <ref name=jalsevac2008>John Jalsevac. ""Heaps of Empirical Evidence" Vindicate Pope Paul VI's Dire Warnings 40 Years Ago About Contraceptive Culture", Life Site News, Lifeissues.net, 2008-07-25. </ref> this view is not typical of the majority of contemporary social theory, nor is it the finding of most empirical social science studies of human sexuality and cross-cultural contraceptive practices.

Some historians and political scientists also refer to the 1974 US National Security Memorandum 200 that has become US National Policy. According to this, the United States should give paramount importance in favor of its national interest to control the population of countries who might impede the flow of important natural resources to the United States and will oppose the US politically. Among these countries targeted for population control is the Philippines. The NSSM 200 wants the US leadership to do this through the United Nations agencies through strong media campaign and through the national leadership of each country by using incentives and awards.<ref name=Tatad2008>Francisco Tatad (2008-09-14). Procreative Rights and Reproductive Wrongs.
Responsible Parenthood
The Responsible Parenthood and Reproductive Health Act of 2012 (Republic Act No. 10354), informally known as the Reproductive Health Law or RH Law, is a law in the Philippines, which guarantees universal access to methods on contraception, fertility control, sexual education, and maternal care.
While there is general agreement about its provisions on maternal and child health, there is great debate on its mandate that the Philippine government and the private sector will fund and undertake widespread distribution of family planning devices such as condoms, birth control pills, and IUDs, as the government continues to disseminate information on their use through all health care centers.
Passage of the legislation was controversial and highly divisive, with experts, academics, religious institutions, and major political figures declaring their support or opposition while it was pending in the legislature. Heated debates and rallies both supporting and opposing the RH Bill took place nationwide.
The Supreme Court delayed implementation of the law in March 2013 in response to challenges. On April 8, 2014, the Court ruled that the law was "not unconstitutional" but struck down eight provisions partially or in full.
Economic and demographic premises
The Philippines is the 39th most densely populated country, with a density over 335 per squared kilometer,[20] and the population growth rate is 1.9% (2010 Census),[21] 1.957% (2010 est. by CIA World Factbook), or 1.85% (2005–2010 high variant estimate by the UN Population Division, World Population Prospects: The 2008 Revision) coming from 3.1 in 1960.[citation needed]
The 2013 total fertility rate (TFR) is 3.20 births per woman, from a TFR of 7 in 1960.[22] In addition, the total fertility rate for the richest quintile of the population is 2.0, which is about one third the TFR of the poorest quintile (5.9 children per woman). The TFR for women with college education is 2.3, about half that of women with only an elementary education (4.5 children per woman).[23]
Congressman Lagman states that the bill "recognizes the verifiable link between a huge population and poverty. Unbridled population growth stunts socioeconomic development and aggravates poverty".[15]
The University of the Philippines School of Economics presented two papers in support of the bill: Population and Poverty: the Real Score (2004), and Population, Poverty, Politics and the Reproductive Health Bill (2008). According to these economists, which include Solita Monsod, Gerardo Sicat, Cayetano Paderanga, Ernesto M. Pernia, and Stella Alabastro-Quimbo, "rapid population growth and high fertility rates, especially among the poor, do exacerbate poverty and make it harder for the government to address it", while at the same time clarifying that it would be "extreme" to view "population growth as the principal cause of poverty that would justify the government resorting to draconian and coercive measures to deal with the problem (e.g., denial of basic services and subsidies to families with more than two children)". They illustrate the connection between rapid population growth and poverty by comparing the economic growth and population growth rates of Thailand, Indonesia, and the Philippines, wherein the first two grew more rapidly than the Philippines due to lower population growth rates.[10] They stressed that "the experience from across Asia indicates that a population policy cum government-funded [family planning] program has been a critical complement to sound economic policy and poverty reduction".[9]
In Population and Poverty, Aniceto Orbeta, Jr., showed that poverty incidence is higher among big families: 57.3% of Filipino families with seven children are in poverty while only 23.8% of families who have two children live below the poverty threshold.[12]
Proponents argue that smaller families and wider birth intervals resulting from the use of contraceptives allow families to invest more in each child’s education, health, nutrition and eventually reduce poverty and hunger at the household level.[9] At the national level, fertility reduction cuts the cost of social services with fewer people attending school or seeking medical care and as demand eases for housing, transportation, jobs, water, food, and other natural resources.[5][10][24] The Asian Development Bank in 2004 also listed a large population as one of the major causes of poverty in the country, together with weak macroeconomic management, employment issues, an underperforming agricultural sector and an unfinished land reform agenda, governance issues including corruption.
Contraception and abortion relationship
Proponents argue that research by the Guttmacher Institute, involved in advancing international reproductive health, reveals that the use of contraceptives can reduce abortion rates by 85%. Proponents such as 14 Ateneo de Manila University professors, argued thus: "Studies show that the majority of women who go for an abortion are married or in a consensual union (91%), the mother of three or more children (57%), and poor (68%) (Juarez, Cabigon, and Singh 2005). For these women, terminating a pregnancy is an anguished choice they make in the face of severe constraints. When women who had attempted an abortion were asked their reasons for doing so, their top three responses were: they could not afford the economic cost of raising another child (72%); their pregnancy occurred too soon after the last one (57%); and they already have enough children (54%). One in ten women (13%) who had attempted an abortion revealed that this was because her pregnancy resulted from forced sex (ibid.). Thus, for these women, abortion has become a family planning method, in the absence of information on and access to any reliable means to prevent an unplanned and unwanted pregnancy".[24]
The bill, said Clara Padilla of EnGender Rights Inc, will "help reduce the number of abortions by providing increased access to information and services on modern contraceptive methods, that in turn will reduce the number of unwanted—and often aborted—pregnancies".[39]
Both sides of the debate accuse the other side of deception and misleading the public. The pro-RH people accuse the anti-RH group of misleading the public by calling the bill an abortion bill, when the bill states that abortion remains a crime and is punishable. The anti-RH advocates accuse the RH supporters of hiding from the public the international population control agenda which includes abortion and they refer to U.S. Secretary Hillary Clinton who said that RH includes abortion.
Health reasons
Stating that contraception is a lie and "against the beginning of new life", the Philippine Medical Association also stressed that the "health risks of contraception to women are considerable; the list of side effects is long, and includes high blood pressure, strokes, increased incidence of some forms of cancer".
Proponents such as E. Ansioco of Democratic Socialist Women of the Philippines argued that "The World Health Organization (WHO) includes contraceptives in its Model Lists of Essential Drugs" and thus are safe medicines.[13][14] "Medical and scientific evidence," says the main proponent, "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 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...But the risk of dying from a pregnancy is 1 in 10,000."
Culture war and its implications
The national debate is seen as part of a wider culture war.[66] Passage or non-passage of the bill have negative implications depending on the views. Proponents state that the non-passage of the bill will mean keeping the Philippines in a backward state and unable to achieve the Millennium Development Goals, especially the points on poverty alleviation and maternal health. It will mean reneging on international commitments and will slow down modernization. Also the poor will not have free access to family planning support that many have expressed desires to have, and thus will have more children than they can care for, and will not have the money to invest in education to break the intergenerational poverty they are trapped in. Proponents also accuse the Catholic Church of holding the Philippines "hostage" and violating the separation of church and state.[67] They argue that a decreased population growth will lead to improved quality of life and economic development.