World of My Own: En Contra Speech for Sen. Sotto's turno en contra speech on RH Bill

Sen. Sotto asked, "Papaano mahahadlangan o mababawasan ng artificial contraceptives na ito, na walang dudang walang medicinal value at hindi rin nakagagamot, ang mga insidente ng pagkamatay ng ina sa panganganak? Kung totoo man na ito ay isang reproductive health bill, paano makapagliligtas ng buhay ang mga gamot na isinusulong ng batas na ito? Maituturing bang “medicines” itong contraceptives, intrauterine devices, condoms, injectables, at ang iba pang tinatawag na legal at ligtas na produkto at kagamitan para sa pagpaplano ng pamilya? Makagagamot ba ang mga ito ng karamdaman o makapapawi ng sakit, o kaya ay may kakayahang makapagpagaling?"

The WHO (World Health Organization) estimates that complications arise in 15% of pregnancies, serious enough to hospitalize or kill women. From the 2 million plus live births alone, some 300,000 maternal complications occur yearly. This is 7 times the DOH’s annual count for TB, 19 times for heart diseases, and 20 times for malaria in women. As a result, more than 11 women die needlessly each day. Adequate number of skilled birth attendants and prompt referral to hospitals with emergency obstetric care are proven life-saving solutions to maternal complications. For women who wish to stop childbearing, family planning (FP) is the best preventive measure. All 3 interventions are part of RH. Proper birth spacing reduces infant deaths. The WHO says at least 2 years should pass between a birth and the next pregnancy. In our country, the infant mortality rate of those with less than 2 years birth interval is twice those with 3. The more effective and user-friendly the FP method used, the greater the chances of the next child to survive. Unintended pregnancies precede almost all induced abortions. Of all unintended pregnancies, 68% occur in women without any FP method, and 24% happen to those using traditional FP like withdrawal or calendar-abstinence. If all those who want to space or stop childbearing would use modern FP, abortions would fall by some 500,000—close to 90% of the estimated total. In our country where abortion is strictly criminalized, and where 90,000 women are hospitalized yearly for complications, it would be reckless and heartless not to ensure prevention through FP. RH will need and therefore support many levels of health facilities. These range from barangay health stations, for basic prenatal, infant and FP care; health centers, for safe birthing, more difficult RH services like IUD insertions, and management of sexually transmitted infections; and hospitals, for emergency obstetric and newborn care and surgical contraception. Strong RH facilities will be the backbone of a strong and fairly distributed public health facility system. Delaying sex, avoiding multiple partners or using condoms prevent genital warts or HPV infections that cause cervical cancers. Self-breast exams and Pap smears can detect early signs of cancers which can be cured if treated early. All these are part of RH education and care. Contraceptives do not heighten cancer risks; combined pills actually reduce the risk of endometrial and ovarian cancers.*

Sen. Sotto said, "Hindi lamang ito pambansang polisiya sa reproductive health, kung hindi isang polisiya sa populasyon, dahil hindi tayo makabubuo ng ang isang situwasyon kung saan tatapyasin ang laki ng mga pamilya ng hindi pinaliliit ang populasyon ng bansa, kaya ang kalalabasan ay ang paggamit ng birth control bilang instrumento para paliitin ang populasyon. Ito ang tunay na layunin ng panukalang batas na ito. Ang bill na ito ay hindi tungkol sa pagpapahalaga sa reproductive health ng ating kababaihan, kung hindi tungkol sa pagkontrol sa demograpiya at populasyon sa pamamagitan ng tuloy-tuloy at sadyang pagpapaliit sa laki ng pamilyang Pilipino."

Couples and women nowadays want smaller families. When surveyed about their ideal number of children, women in their 40s want slightly more than 3, but those in their teens and early 20s want just slightly more than 2. Moreover, couples end up with families larger than what they desire. On average, Filipino women want close to 2 children but end up with 3. This gap between desired and actual family size is present in all social classes and regions, but is biggest among those who are poor. RH indicators show severe inequities between the rich and poor. For example, 94% of women in the richest quintile have a skilled attendant at birth compared to only 26% in the poorest. The richest have 3 times higher tubal ligation rates compared to the poorest. This equity gap in tubal ligation partly explains why the wealthy hardly exceed their planned number of children, while the poorest get an extra 2. Infant deaths among the poorest are almost 3 times compared to the richest, which partly explains why the poor plan for more children. An RH law will promote equity in health through stronger public health services accessible to poor families. RH health services are needed wherever people are establishing their families. For example, a report by the MDG Task Force points out the need for 1 fulltime midwife to attend to every 100 to 200 annual live births. Other health staffs are needed for the millions who need prenatal and postpartum care, infant care and family planning. Investing in these core public health staff will serve the basic needs of many communities. Currently, most young people enter relationships and even married life without the benefit of systematic inputs by any of our social institutions. As a result of just one faulty sexual decision, many young women and men can lose their future, their health and sometimes their lives. We insist on young voters’ education for an activity that occurs once every 3 years, but leave our young people with little preparation to cope with major life events like puberty and sexual maturation. Ensuring modern FP for all who need it would increase spending from P1.9 B to P4.0 B, but the medical costs for unintended pregnancies would fall from P3.5 B to P0.6 B, resulting in a net savings of P0.8 B. There is evidence that families with fewer children do spend more for health and education.*

Honorable Senator Sotto, here are 10 facts about RH Bill as outlined by Senator Pia Cayetano. Just in case you haven't read the provisions of the bill. **

FACT 1: #RHBill gives a person freedom to choose what family planning method to use, or NOT to use any method at all.

FACT 2: #RHBill does not legalize abortion. In fact, it explicitly adheres to the penal law on abortion.

FACT 3: #RHBill does not impose an ideal family size and leaves this decision to couples.

FACT 4: #RHBill respects the religious convictions and cultural beliefs of all.

FACT 5: #RHBill will not teach a 10-year-old how to use condoms. RH education is age- and development- appropriate.

FACT 6: #RHBill promotes BOTH natural & artificial methods.

FACT 7: Contraceptives are safe and effective family planning tools .

FACT 8: #RHBill will not indiscriminately distribute condoms to all.

Reproductive Health care is not all about contraceptives, but addresses real and unmet needs of women and families. The need for a mobile health vehicle in particular is important to reach far-flung areas where health care is inaccessible. These services may not only save a mother’s life, but will help couples plan the number and spacing of their children. Minors and the youth also have RH needs, which we should address primarily through age-appropriate RH education and counseling. But we should also not turn a blind eye to the alarming problems of teenage pregnancy (we have the highest teenage pregnancy rate in Southeast Asia) and numerous cases of young children being sexually abused, sometimes by members of their own family. These are real issues which we should not trivialize by irresponsible statements that the government would freely give away contraceptives to the youth under the RH bill.

FACT 9: An average of 11 mothers die daily. That’s a fact.