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Unsafe Abortion and Fundamentalism in the Philippines: Locating absences, dredging trenches

In 2005, the Development Alternatives with Women for a New Era (DAWN) completed a global policy research project on Health Sector Reforms, Maternal Mortality and Abortion across many countries representing various regions of the economic South. Lalaine Viado wrote the Philippine report covering the period 1964-2004.

Viado's book - Reproductive Health Politics, Health Sector Reforms and Religious Conservatism in the Philippines (1964-2004)This exhaustive undertaking retraced the history of population and reproductive health andrights issues in the country, and the dynamics of the political and ideological forces that held stake, then and now, on the state of the nation in these issues. Besides attending to the original objectives of the project, this wide coverage also meant to provide an avenue to review and refresh energies for reproductive rights advocacies in the country, guide new advocates, and determine how else to move forward.

This article draws mainly from the 50-page DAWN Philippine research report written by the author and discusses some of the findings, specifically on the issue of unsafe abortion.

The dominant discourse on the issue of unsafe abortion in the Philippines is fundamentalist in nature. By fundamentalist, I mean taking all courses of the abortion debates to the centrality of the fetus–as the rock bottom of the issue, the beginning and the end of the debate, and the unshakeable measure for damning those who go against this grain.

This discourse effects a high moral standard to those who uphold it. Those who resist it, or want to think beyond this, are pursued or dismissed to damnation, not only in the after life but in various fields of life–personal, political, social, even economic. Indeed, the risks can be too great for any aberrant thought or action that the word abortion became a label that must not be used liberally. Unless one tows the fundamentalist line.

The issue of unsafe abortion in the country is thus transformed into one of instigating fear among the citizens, of issuing political threats against a few politicians and local governments that want to take on a wider view, and possibly, of overthrowing national governments that cannot govern this fundamentalist line. This is the fundamentalist line crossing the borders of the moral and the political and, in the process, trampling on the fundamental democratic rights and freedoms of the Filipino people as citizens and as a country.

From the mind-boggling context of the Philippines as a democracy with a supposedly secular state, the full force of this fundamentalist line ironically, but not surprisingly, tended the population history of the country and determined its state of sexual and reproductive health and rights directly from the pulpit.

The Disconnect

There is, in addition, an unfavorable but deliberate disconnect in the way the fundamentalist line forges the issue of unsafe abortion in the country.

Only those who do not want to open their eyes fail to see that there is a woman at the heart of the issue. If unsafe abortion were a photo film, women are kept in the negative exposures.
Though masqueraded as holy to those who take up this fundamentalist positioning, it presents an un-holistic view of unsafe abortion. This single-minded track blurs the panoramic view of the issue at hand, and discourages comprehensive and critical understanding. Unsafe abortion is not simply about the fetus set in isolation from the very body that it clings to and lingers in. Only those who do not want to open their eyes fail to see that there is a woman at the heart of the issue.

If unsafe abortion were a photo film, women are kept in the negative exposures, and must remain there, because they create the positive exposures of the line they forge. Without women, there can be no fetus, and the fetus will not survive without women. But the obsession with a single entity can only lead to the abandonment of women. Or, abandoning women is the obsession the fundamentalists pursue. Whatever it is, their solid positioning depends on the crucial absence of women in society, and in particular, on the abortion discourse. The more society neglects and abandons women, the better they can institute their fundamentals.

Responses by the government, the public health system including medical professionals, the woman’s family and community, however, crystallise this fundamentalist attitude. For example, the scenario of a half-dead woman seeking help in a hospital due to complications from unsafe abortion will not elicit concern for the woman’s safety. It may stir fear for the soul of the woman, but not for her life. Given the stigma attached to women who undergo abortion, she is made to suffer even more in the hands of medical professionals, and in the eyes of her community and her family, if at all she survives.Then Vice President Gloria Macapagal-Arroyo being sworn into office, following the ouster  of President Joseph Estrada. Macapagal-Arroyo has blocked official interventions and civilian lobbying on artificial family planning such as the distribution of pills to women. With her in this photo is the late Jaime Cardinal Sin, a key player in the two People Power Revolutions. Photo from Tanikalang Ginto

Yet, a public uproar is instigated when a dead fetus is found in a public toilet. Welfare groups offer assistance, prayer groups congregate, local ordinances are issued, and the president of the country is appalled.

I do not say this should not be the case for the dead fetus. I say, why does a woman who has had unsafe abortion, lying half-dead yet unattended in a hospital, not stir as much public furor? Who takes up the cudgels for her? Why is the country’s woman president not at all appalled by the knowledge that another woman, her life on the line, needed medical help but did not get it? Why is right to life not invoked for the woman?

By skipping women, the fundamentalist line may be fractured. Nonetheless, it shall remain solid for as long as there are no answers to questions that factor in women’s rights and well-being.

The Women in International Consensus Documents

The Philippines is signatory to many international agreements on women. But much needs to be done to fully comply with its obligations. The International Conference on Population and Development (ICPD) Programme of Action under Paragraph 8.25 states that:

“Prevention of unwanted pregnancies must always be given the highest priority and all attempts should be made to eliminate the need for abortion. Women who have unwanted pregnancies should have ready access to reliable information and compassionate counseling…in circumstances where abortion is not against the law, such abortion should be safe. In all cases, women should have access to quality services for the management of complication arising from abortion. Post-abortion counseling, education, and family planning services should be offered promptly, which will also help avoid repeat abortions.”

The World Conference on Women (FWCW) Platform for Action Paragraph 97 also states that:

"Unsafe abortions threaten the lives of a large number of women, representing a grave public health problem. Most of these deaths, health problems and injuries are preventable through improved access to adequate health-care services, including safe and effective family planning methods and emergency obstetric care…”

The same language is echoed in other consensus documents that the Philippines is signatory to such as the Fourth World Summit on Social Development (WSSD) Declaration Commitment 6(p) and Programme of Action 38(d), and the World Conference on Human Rights Programme of Action (47).1 In addition, the Philippines has ratified international treaties that codify the rights of women such as the Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW), the Covenant on Economic, Social and Cultural Rights, the Convention Against Torture, the Convention Against Racial Discrimination, and the Covenant on Civil and Political Rights2.

The Conservatives

These landmark agreements are landmines to those who pursue an endless fortification of the fundamentalist stand. At the Plus 5 and 10 reviews of the ICPD Programme of Action and Beijing Platform for Action, they were seen working overtime to undermine these documents.

Outside meeting halls, they would be clad in jet black cloaks and, sometimes, parade the banner of a dead fetus. What is terrifying for me, however, is not the picture of a dead fetus that they hold; it is what they have done in this country, or perhaps even in others, that made the picture very real. They literally and figuratively brought the picture of a dead fetus from an unsafe abortion. In actual government negotiations, they employ varying strategies and tactics – from covert to overt, from diplomatic to diabolic, from persuasion to persecution. A lot more happens outside plenary halls and official meeting rooms; they call nations’ capitals to revert to their stand, in case official delegations totter away from it.

Contraceptive use is not just rejected. It is demonised. Among Catholics, it may be a ground for ex-communication and for being denied “holy communion.”
The Philippines is most prone to these scare tactics, always giving in to pressures from the Vatican and/or the United States. At the ICPD Plus 10 review in December 2002, however, this beloved country exceptionally withstood the pressures and reaffirmed ICPD along with all the countries of the United Nations’ Economic and Social Commission for Asia and the Pacific (ESCAP). This was a shining moment for this country as oftentimes, in international negotiations, her national sovereignty is just a phone call away!

The Alliances

The Catholic Church already rejected contraceptive methods as far back as the Marcos administration even with its Malthusian approach to population control. It issued several pastoral letters on the first national population policy and the legalisation of sterilisation as a form of contraceptive3. The Population Commission, the policy making body tasked to recommend population programs related to economic and social development, was supportive of the Church position. At its establishment in 1969, it recommended the exclusion of sterilisation from the range of family planning methods.

At the threshold of the new millennium, contraceptive use is not just rejected. It is demonised. Among Catholics, it may be a ground for ex-communication and for being denied “holy communion”4, as was the case for women in Malitbog, Bukidnon if they did not remove their intrauterine devices (IUDs) 5. The Department of Health was the first to raise the issue of IUD as abortifacients. In 2001, it directed the Bureau of Food and Drugs (BFAD) 6 to check on the IUD’s abortifacient effects. This was despite findings contrary to the studies of the World Health Organization and the American College of Obstetricians and Gynecologists7.

The convergence of religious conservatives in the country could not be more apparent than on the issue of rejecting contraceptives and promoting “natural family planning”8 (NFP). Local government units (LGUs) in the city of Manila and in the provinces of Laguna and Palawan issued ordinances prohibiting all forms of contraception except NFP. The national government under Macapagal-Arroyo diverted 70 million pesos allocated in 2000 for the purchase of contraceptives to funding NFP9.

The USAID, after years of providing 80 per cent of the total contraceptive supplies in the Philippines, has pulled out totally from this role. Pharmaceutical companies, commercial suppliers of contraceptives and the retail business sector are no less than willing to fill in this huge gap. Short of calling this a heroic act, the enthusiasm with which they meet the swelling demand for contraceptive supplies is, however, far removed from promoting women’s rights. The profiteering motives do not ensure access for all, especially to those who need them most. They merely capitalise on the country’s conservatism that created the demand for a profitable business.The Philippine government is a staunch ally of the United States. The Bush administration has been consistent in rejecting women’s reproductive rights. Photo from Wikipedia Commons

The powerful triumvirate of the Church, State and Capitalist interests has never been more apparent as it is now on the supposedly simple issues of contraceptives. The reversal to fundamentalist trends and their re- consolidation in the local and international levels have made the issue of contraception very challenging in the country. Ironically, contraceptive use is not even the end-goal of women’s rights!

But forty years of damning contraceptives and making them inaccessible to women constitute the building blocks of the phenomenon of unsafe abortion in the country today.

The Body of Claims

At the cusps of the triangulation of theState, Church, and the Capitalist marketon the issue of unsafe abortion is, infact, a discursive issue that is no longerjust about promoting the fetus. Thepartnering and partaking of the religiousconservatives and fundamentalist forcesfrom all three fronts manifest diverseinterests in staking out claims to defineand control women and their bodies.

Controlling women’s bodies has been the organising theme for the religious conservatives and fundamentalists to come together, regardless of their differences in other fields or geographical distance. Much like the sound wave or echo that brings whales together no matter the distance among them, the desire to control women’s bodies is a language with similar functions but with the additional enticement of blood to a hungry predator. An unfair comparison, perhaps, as a whale’s echo is not just used to catch preys.

By religious conservatives and fundamentalists, I do not refer to all Roman Catholics who comprise 81 per cent of the country’s population. I have met many Catholics who would like to see the day when their own Catholic belief is devoid of its anti-women stance, and when the Church affirms the exercise of their own free will over their lives and bodies. In short, a Catholic is not always a religious conservative or fundamentalist.

I also do not point to the entire religion of Roman Catholicism, or other Christian congregations, or to Islam.

By religious conservatives and fundamentalists, I refer to the ideological forces, possibly from many religions and social institutions, mustering their power and influences to undermine women as both a philosophical and political project to maintain and preserve patriarchal powers. These patriarchal assemblies, both local and international, oftentimes use religion to legitimise their claim against women, to control them and gain ownership of their bodies.

Controlling women’s bodies is also the very cradle of the hegemonic capitalist system. It is a massive nesting ground for profit, and to an even greater extent, ensures the survival of the current economic system.
Moreover, this anti-women position has been a remarkable theme for unifying ideological forces, no matter how they may battle against each other on the economic, military, religious, and political fronts. They join hands in clamping down on the fundamental democratic rights of women to decide over their own bodies. In international negotiations, for example, warring countries like the US and Iran, religious groupings like the Vatican and some Islamic states, are like-minded partners in rejecting women’s reproductive self-determination and sexual autonomy.

Controlling women’s bodies is also the very cradle of the hegemonic capitalist system. It is a massive nesting ground for profit, and to an even greater extent, ensures the survival of the current economic system. Thus, exploiting women and controlling their bodies are the common denominators that unite economic players, whether globally or locally, despite the competition encouraged by the “free-market” model. For multi-billion dollar beauty companies, for example, women’s bodies mean profit as long as they are the ones dictating how women should look like, and join others in forbidding women’s agency and autonomy over their lives and bodies.

Indeed, the patriarchal forces are marshalling all powers and forces in all avenues in society, whether in religion, politics, economics, or elsewhere, to render women absent in various fields of life, and drown them in the abyss of the immaterial and the irrelevant.

The Counter-Claims

One crucial point to reiterate here is that the fundamentalist perspective on unsafe abortion will never see women beyond their uterus and what it should contain. The rights of women over their own bodies are not only absent but purposefully hidden in the recesses of their conservative postulations. Thus, advocates for women’s rights, particularly for reproductive self-determination and sexual autonomy, and the religious conservatives and fundamentalists will never see eye to eye. The former asserts the centrality of women and their ownership of their bodies, and the latter completely overlooks women as a principal entity in the issue.

Many women’s rights advocates in this country are practising Catholics. They do risk social isolation and being labeled “abortionists” which is perhaps as horrific as the post 9-11 label, “terrorist.” However, unlike the presumed terrorists who are also referred to as “religious extremists,” pointing to a particular religious community that they belong to, women’s rights advocates can be branded as being “anti-religion. Whatever label is attached, women risk being terrorised by the powerful religious conservatives in the country in the process of forging their counter-claims.

Catholic women could only cling to the belief that the liberating nature of their advocacy is an integral part of belonging to a religious community, and, indeed, of practising their Catholic faith.

The Trenches

An ideological war exists on who owns and controls women’s bodies. The overpowering involvement and dominant positioning of patriarchal forces in Philippine society present draconian obstacles to feminist claims that it is the women who own and should control their own bodies. Engagement in this ideological war may be harsh and difficult, but not impossible when it is the women themselves who stand and reclaim their bodies.

Specific to the issue of unsafe abortion, however, there are a few things that have been lurking and need to be dredged from our trenches.

Democratic rights

One is the cost of our curtailed democratic rights and freedoms to the strength of our advocacies. Because sanctions can be harsh, the shape of advocacies somehow vacillates, by focusing more on the less controversial aspects of the advocacy, perhaps from fear of damnation or sadly, from the very identification of some women’s rights advocates with the fundamentalist line. Yes, some can be champions of women’s rights in politics, for example, but that right is not inclusive of the right to bodily integrity wherein lies the feminist adage, the personal is political.

This political vacillation can also be seen in the conceptual differences between reproductive rights advocates and reproductive health advocates. The former takes the case and issues around reproduction as a woman’s right and her sole decision over her own sexuality. The latter does not always take a rights-based perspective, as when reproduction is considered solely from a health perspective.

The curtailment of our democratic rights need not always lead to the estrangement of our advocacy from the rights-based perspective.

The problem in health perspectives

Filipino women are already drowned out by the absences rendered by the vast conservative alliance. Why then would the growing maternal mortality rates—whether as a consequence of unsafe abortion or a simple medical case of hypertension in child birth— spark concern in various social institutions, when this alliance, dictating on the very institutions of government, is only too willing to dig the graves and put women to rest into the hidden recesses of Philippine society eternally?

While the high maternal mortality rate is alarming enough to make a case of gender discrimination and human rights violation in welfare societies, it has not led to improved policies and legislation for women undergoing unsafe abortion. As a window to how the conservative stance has appropriated political and, perhaps, even public attitude, I will not be surprised if maternal death is viewed as just punishment for those who had unsafe abortion.

Advocacies around collecting sympathies “only” through horrific statistics on women’s deaths are not necessarily effective when a government cannot even see women when they are alive. As maternal mortality rates are not just statistics but pure women’s bodies, there needs to be more focus on women’s bodies while they are still alive and active members of society. That focus is ownership and full control.

Gender equality

Gender mainstreaming work has yet to tackle the issue of unsafe abortion. This is not a simple case of a work backlog or a political hiccup. Gender equality work in gender mainstreaming efforts has, long ago, departed from the issue of women’s sexual autonomy and reproductive self-determination, and from the women’s movement that helped create it.

Abortion is an issue that is women-specific. Men cannot have abortion. Why then will it figure in gender equality and gender mainstreaming efforts of the government or even of gender consultants and experts?

The distinction between gender equality and the advocacy for women’s control of their bodies is most apparent in our very own constitution. How can it happen that the 1987 Philippine Constitution maintains a gender equality provision in Article 2, Section 14 that co-exists hand in hand with an anti-abortion provision
in Article 2 Section 12? How does this society understand gender equality?

Women’s agency and choice over their own bodies have yet to land in the murky province of gender equality. Ever wonder now why the government, the private sector, and even the church, are funding and promoting gender mainstreaming?

Lalaine P. Viado is the researcher and author of Health Reform, Maternal Mortality and Abortion in the Philippines. This country report was commissioned by the Development Alternatives with Women for a New Era (DAWN) for its global policy research project on the same topic. She is also author of the book Reproductive Health Politics, Health Sector Reforms and Religious Conservatism in the Philippines (1964-2004) published by DAWN (Nigeria, 2005). Both authorships are cited in INTERLINKING POLICY, POLITICS AND WOMEN’S REPRODUCTIVE RIGHTS: A study of health sector reform, maternal mortality and abortion in selected countries of the South (Brasil, 2007) coordinated by SONIA CORRÊA of DAWN Sexual and Reproductive Health and Rights Program. Lalaine works with several women’s organisations nationally, regionally and internationally around various women’s issues including sexual and reproductive rights, media and popular culture, south-to-south partnerships, among others. 

Endtnotes
1 Sexual and Reproductive Health Briefing Cards. Family Care International; The Human Rights of Children and their Sexual and Reproductive Health: A Fact Sheet Series. The International Sexual and Reproductive Rights Coalition.
2 Marcelo, Alexandrina B., “Demystifying Abortion in the Philippines” A paper presentation at the 1st National  Conference on Sexual and Reproductive Health “Empowering Stakeholders on Sexual and Reproductive Health”. Pasay, 15-16 January 2004.
3 Herrin, Alejandro. Population Policy in the Philippines 1969-2002. Philippine Institute for Development Studies.  September 2002.
4 Receiving the Eucharistic bread during Holy Mass
5 Church Forces Women to Remove IUDs, Philippine Daily Inquirer. 22 November 2002
6 BFAD, with its strengthened regulatory powers under the Health Sector Reform Agenda, has, at this time, delisted Levonorgestrel 750 mcg also known as Postinor and made it illegal. Postinor is an emergency contraceptive that prevents pregnancy from unprotected sex.
7 http://www.fhi.org/en/RH/Pubs/factsheets/mechact.htm
8 “Natural family planning” is kept in quotation marks because from a DAWN perspective natural contraception does not really exist. What is named as such are behavioral methods that require human agency and decision and consequently are not at all “natural”’ INTERLINKING POLICY, POLITICS AND WOMEN’S REPRODUCTIVE RIGHTS: A study of health sector reform, maternal mortality and abortion in selected countries of the South. Brasil, 2007. page 39
9 Philippine Leader Diverted Money for Contraceptives: UN Official. AFP via NewsEdge Corporation. 23 October 2003. 

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