It took a committed president of the Philippines, Benigno Aquino III, and a Filipino Congress concerned about rising maternal mortality and continuing population growth amid widespread poverty, to overcome strong opposition from the Roman Catholic church and make contraception freely accessible to millions of poor women beginning in 2013.
The adoption in mid-December of a new law, the Responsible Parenthood and Reproductive Health Act, did more than crown a decades-long campaign for family planning services that all Filipinos could afford. It proved again – around the world and in most faiths – that religious objections can be countered when there is enough political will to persevere in the public interest.
“The passing of the reproductive health act is a most welcome development,” Mavic Cabrera-Balleza, a Filipino advocate for women’s rights internationally, said in an e-mail interview. “It is a great Christmas gift to Filipino women (as well as men) that would have a long-lasting impact on their future. It is the gift of access and choice in contraception methods, fertility control, sex education and maternal care.
“Reports indicate that 22% of married Filipino women of reproductive age express a desire to avoid pregnancies but are not using any family planning method because they lack information or access to family planning methods or both,” said Cabrera-Balleza, who is president of the World Association of Community Radio Broadcasters/Women’s International Network and the international coordinator of the Global Network of Women Peacebuilders. “I look forward to the full and effective implementation of this law including large scale education on sexual and reproductive health and rights and widespread and free distribution of contraceptive devices such as condoms, birth control pills and IUDs.”
The Philippines has the second-highest fertility rate in the Association of Southeast Asian Nations (Asean), at an average of 3.2 live births per woman (ages 15-44) in an island country of more than 95 million people. That is roughly 30 million more people than Thailand, which is more than one and a half times larger in land area. Only Laos, a more sparsely populated country than the Philippines, has a higher fertility rate, 3.9. Thailand’s fertility rate is 1.6, Indonesia’s is 2.3 and Vietnam’s 2.0, according to United Nations and World Bank figures. The new nation of Timor-Leste, which hopes to join the regional association, tops the Southeast Asian area with a fertility rate of 5.7, among the highest in the world.
In the Philippines, the new law will allow government financing of family planning clinics and birth control commodities for poor women. As in many other developing countries, wealthier women have been free to choose contraception to limit family size or sustain their health and help stabilize their families’ economies. There are other examples of government support for family planning in countries with strong religious majorities opposing such options. Both Mexico and Brazil, with Catholic majority populations, and Bangladesh, Indonesia and Iran, where Muslims predominate, have lowered fertility rates substantially since international family planning campaigns began more than half a century ago. Buddhist Bhutan and Sri Lanka, with Buddhists, Christians, Hindus and Muslims, have also seen fertility rates drop.
In Africa, family planning advocates have been reaching out to more Evangelical Protestant churches as well as Catholic communities. The United Nations Population Fund, which has in the past shied away from putting a strong emphasis on contraception (because it was seen as a cultural intrusion or a throwback to population control), took an unambiguous stand in its State of the World Population 2012 report, the first commissioned under a new executive director, Babatunde Osotimehin, a physician and former Nigerian health minister.
The report, By Choice, Not by Chance, described family planning as a human right and said that it should be available to everyone. It estimated that 222 million women lack access to contraceptives, the majority in developing countries. “Ensuring universal access to voluntary family planning is a matter of protecting human rights,” the report said. “But it is also a matter of social and economic development.”
The Population Fund, UNFPA, reported that of the 80 million unintended pregnancies that were likely to have occurred in 2012, 40 million would probably end in abortion, a killer of girls and women in poor countries, where the procedure is most often unsafe. This conclusion should challenge the misguided thinking of those who argue against providing more birth control tools to women (and men) in developing countries while at the same time denying funds to UNFPA and nongovernmental organizations that advocate for safe abortion where that becomes a last or single option.
President Aquino of the Philippines, setting out his policy on family planning in April 2011, opposed abortion. But he added: “I am in favor of giving couples the right to choose how best to manage their families so that in the end, their welfare and that of their children are best served. The State must respect each individual’s right to follow his or her conscience and religious convictions on matters and issues pertaining to the unity of the family and the sacredness of human life from conception to natural death.”
His later campaign to guarantee that right has succeeded. But reports from the Philippines say that powerful figures in the Catholic church plan to take the government to court to have the new family planning law overturned. The dispute may continue, but a huge step has been taken in making family planning a legal human right in a country where many thought it would never be possible.