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Desperate women seek desperate measures

By ELENA MASILUNGAN

By ELENA MASILUNGAN
Newsbreak’s Maggie de Pano Fellow

Poor pregnant women are faced with very few choices

MANILA, Philippines – Many mothers go through abortion for economic reasons.

According to a 2006 study made by the Guttmacher Institute, the average Filipino woman wants 2.5 children, a goal that can be achieved if she uses effective family planning methods. But to almost half of the female population, this need remains unmet.

The study also notes that nearly half of the 1.43 million pregnancies each year in the country were unintended and six out of 10 Filipino women had experienced an unintended pregnancy.

Amelia is weighed down–figuratively and literally–by the bags she’s selling and the burden of earning a living for her 8 children

“I never wanted a large family,” said Amelia, the street vendor we interviewed for this series. After the birth of her second child, she asked the midwife in the health center about family planning.

When she asked about free condoms and contraceptive pills, the midwife informed her that they were not giving them out anymore ever since the city mayor issued an order allowing only natural family methods for residents.

By coincidence, a nongovernment organization visited the community to research on the reproductive health practices of the women living there. It also held training on family planning and maternal and child health for the mothers.

“When the NGO left, we bought our own condoms but only if we had extra money. Later on, what extra money we had we spent on food and other expenses for the children.”

“I attended the training. They also gave free condoms to us. One day, they came with doctors who did tubal ligation to mothers who wanted to have them. At another time, the doctors did vasectomy,” she said.

Amelia availed of the free condoms and gave them to her husband. “At first, he did not want to use it. He said there was no need for us yet to plan our family because we had just two children at that time. But I was stubborn. I told him that ‘no condom, no loving-loving.’ Eventually, he gave in,” Amelia said, laughing.

The NGO stayed in the community for a little over a year. When it left, Amelia’s supply of free condoms went with it.

“When the NGO left, we bought our own condoms but only if we had extra money. Later on, what extra money we had we spent on food and other expenses for the children. We used ‘withdrawal’ but it is not as effective as the condom. So I started getting pregnant again,” she said.

When Amelia learned that she was pregnant with her ninth child, she became desperate.

“I thought at once of abortion.” Many of her neighbors who had unwanted pregnancy had been through it already anyway. A hilot living in their neighborhood helped perform the abortion. Amelia told her husband what she wanted to do. “He agreed because he knew that with the kind of life that we have right now, there is no way that we can afford another child.”

Posters on maternal mortality

Posters around the Fabella Memorial Hospital speak about saving mothers’ lives. The Philippines has one of the highest maternal mortality rates in southeast Asia

The decision almost cost Amelia her life. (See first part: Dying in silence, how abortion kills)

Gambling with life

“Once a woman has decided to have an abortion because of an unwanted pregnancy, there is nothing much that anybody can do to change her mind. Not even a doctor’s cautionary advice will do,” noted Dr. Alejandro San Pedro, an OB-Gyne.

As chair of the Department of Obstetrics and Gynecology of the Bulacan Provincial Hospital, San Pedro has counseled a number of women who have dealt with unwanted pregnancy and has experienced treating patients with post-abortion complications as a result of unsafe abortion.

A woman with an unwanted pregnancy is ready to risk all to end it, doctors say. Many go to the extent of having an unsafe abortion where the possibility of suffering from further disabilities, and even dying, is a real gamble.

While Filipinos generally believe that pregnancy is a blessing from the heavens, not all pregnant women feel the same way.

This is true among many poor mothers particularly when the prospect of having one more child could spell economic doom for the family. This is also true for those who want to protect their health from medical complications arising from pregnancy.

There are also women who opt to have unsafe abortion rather than give birth to a child who was the result of rape or incest. Or those who do not want to get pregnant but are unable to control their fertility because of lack of access to information and affordable contraceptive methods.

Therapeutic abortion

Most doctors interviewed for this story think that abortion is justified in certain cases, particularly if based on ethical grounds.

“In some ways, it would be kinder to just end the pregnancy rather than have the mother carry it to term when there is no chance at all that her baby will live longer.”

One is when the pregnancy is the result of rape or incest. The other is when it threatens the health, or even the life, of the mother, such as when she has eclampsia, malignant hypertension, or a heart condition.

They would also consider therapeutic abortion in cases of ectopic pregnancy or fetus malformation or deformity such as anencephaly, a condition present at birth where the brain of the baby does not develop fully and for which there is no treatment.

But doctors in the country are in a legal bind even on this matter. (See: what the law says about abortion)

“In other countries, doctors will end the pregnancy as soon as they detect anencephaly,” said an OB-Gyne doctor, who prefers to remain anonymous.

In the Philippines, doctors are compelled to let the pregnancy continue and wait for the baby to die, which may take a few hours, days, or weeks after delivery, she added. “In some ways, it would be kinder to just end the pregnancy rather than have the mother carry it to term when there is no chance at all that her baby will live longer.”

Cost of contraceptives 

  • Depending on size and texture, condoms cost anywhere from P31 to P38.25
  • A mat of 28 contraceptive pills cost anywhere from P33.50 to P1,028.50
  • While it appears more humane and compassionate, especially for the mother, to terminate an anencephalic pregnancy, doctors do not do this in deference to the guidelines of the Philippine Obstetrics and Gynecological Society that regard the fetus “as a patient from the time of conception.”

    This blanket ban further fuels the demand for underground and unsafe abortion services in the country.

    Dangerous procedures

    The common ways of unsafe abortion include painful massages by hilots, taking abortion-inducing drugs such as misoprostol, inserting catheters or other pointed objects into the uteri, undergoing dilation and curettage (raspa), drinking herbal concoctions that induce muscle contractions in the uterus, and even doing heavy physical labor and jumping from great heights.

    Many women combine two or three of these methods together when trying to get rid of unwanted pregnancies.

    But these methods of getting rid of a fetus could be dangerous. A whole range of medical complications can develop from unsafe abortion, including hemorrhage, sepsis, perforation of the uterus, damage to other internal organs, and toxic reactions to the chemicals or the drugs taken to induce abortion.

    Patients may also have to undergo hysterectomy and be unable to bear children anymore in the future. Worse, complications from unsafe abortion can be fatal and can result in the patients’ death.

    These risks, however, are not enough to deter women from having an abortion.

    Pregnant women wait to consult a doctor at the Fabella Memorial Hospital (LUIS LIWANAG for the Center for Reproductive Health)

    Pregnant women wait to consult a doctor at the Fabella Memorial Hospital

    A 2008 Guttmacher Institute study bears this out: out of 560,000 women who had induced abortions, 90,000 of them were treated for complications, and 1,000 of them died because of these post-abortion complications.

    Choices

    “If I have other choices, I would not have an abortion,” Amelia said. “I wanted to try and use contraceptives but I don’t have any money to buy them. I tried withdrawal, even abstinence, but they didn’t work.”

    After her abortion, while recovering in the hospital for complications she sustained after the procedure, Amelia asked the doctor to do a tubal ligation on her. “I should have done it years ago when doctors brought by the NGO offered to do it for us for free. But I did not know any

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    Having an abortion is one experience that she said she does not want to ever live through again. “I do not want to experience that terrible pain again. I do not want to experience being scolded and shamed by people who do not know me. I do not want to experience the panic and fear of being arrested or losing my life,” she said.

    The way things are, Amelia said, she will never live down the guilt. “The guilt because I killed my own child never leaves me. They said I will never be forgiven by God for this one sin.”

    The only remedy to salve a guilty conscience is to pray. “I keep praying to Him everyday. I believe that He understands my reason for doing what I did. If He cannot forgive me, I pray that He can at least have mercy on me,” she sighed. - Newsbreak

     

    The series was produced under the Maggie de Pano Fund for Investigative Reporting on Health. The Fund, which is managed by Newsbreak, is made possible through a grant from Macare Medicals, Inc.

    Also in this series:

    Dying in silence: How abortion kills Filipino mothers

    Abortion in the Philippines: what the law says

    CATEGORY: Health, In-Depth, Investigations, Women & Children
    TAGS: , , , ,
    1. Johnny Lin says:

      Despite all the miseries, misfortunes and even unnecessary death of poor women, legal abortion is not the answer. A responsible well crafted RHB is, only after proper healthcare measures and safeguards are enacted. What we need are:
      1. Nationwide availabilabilty of well equipped barangay health centers, municipal and regional hospitals with competent healthcare providers. Inadequate facilities will not reduce morbidity and mortality rates mentioned in this article and the previous article,”desperate women resort to desperate measures”.
      2. Properly trained, healthcare personnel, educators and social workers not only in medical emergencies but also in preventive care.
      3. Knowledgeable NGO and government sponsored ancillary services assisting women seeking reproductive advice.
      4. Understanding by church authorities that certain medical contraceptive measures are acceptable.
      Responsible guidance includes recognition of proven health safety preventive measures in modern
      times.
      5. Government must enact and implement laws seeking lenghty prison for abortion practitioners. Reproductive prevention or contraception works if done properly.

    2. Has this become a pro-abortion website now? I thought news outfits were supposed to be balanced.

    3. “The study also notes that nearly half of the 1.43 million pregnancies each year in the country were unintended and six out of 10 Filipino women had experienced an unintended pregnancy.”

      What a crap! When you engaged in sex, expect to be pregnant! If you do not intend to be pregnant, use condom, self-help, withdraw, or do it when you were safe!

    4. do you often comment on perfectly intelligible online articles you don’t read first?

    5. GEMMA BAGAYAUA-MENDOZA says:

      Good day CFC,

      These stories on abortion are part of a series that Ms. Elena Masilungan worked on under the Maggie De Pano Fellowships on investigative reporting on health which is managed by Newsbreak.

      Under the same program, another fellow, Ms. Ana Santos produced a series on the impact of new technology and new lifestyles on sexual practices. You may want to visit those stories through the links below:

      Hot sex and hiv: growing but hiding

      Sex and the workplace

      Are you into sexual networking

      A second batch of Fellows under the program are currently looking into health financing issues.

      Hope this clarifies your query.

    6. Johnny Lin says:

      Jcc
      You are right about responsible thinking before sex. There is no such thing as “unintended pregnancy” in premeditated sex. Basic culprit is “uncontrolled mutual sexual desires”. Responsible control is the solution! Only rape or incest results to unintended pregnancy. And poverty is a lousy excuse because COMMON SENSE does not have financial boundaries. Researches funded by interested parties, more often, authors conclude studies or skew wordings, such as “unintended pregnancy”, favorable to the funding foundation principles. In healthcare, drug efficacy researches funded by pharmaceutical companies making the drugs under study always have questionable integrity.

    7. johnny,

      it seems that we are the only commnenters here whose thinking runs on the same level. :)

    8. Johnny Lin says:

      Jcc
      There are many of us though we might be the most vocal. He he. This matter is deja vu for me. I despise when poverty is made an excuse for personal irresponsibility. We symphatize with the daily struggle of Amelia feeding her family but I do not condone her blaming society, poverty and lack of government for the reason of her pain from getting abortion. She and her husband were solely responsible for having NINE pregnancies. This article seemed to sensationalize her pain from personal decision getting botched abortion rather than condemning their sexual lifestyle as an example of irresponsible parenthood. Check this statement above: “by the time Amelia got her 9th pregnancy, when she became desperate”. Amelia is a vendor so she knows how to count, at least. Responsible impoverish parents by their 3rd or 4th child start worrying. AMELIA, WHAT ABOUT THE 5TH, 6TH? Blech attitude, eff reasoning! Strict attendance to parental educational forum in every barangay as a precondition to receiving cash assistance from SWD is one component RHB should have!

    9. heheehehee.. we were 12 in the family. yes, we were poor, but my parents provided us with what they earned by their brawn, though lacking the maybe, but we do not blame anyone. up to now i tried to help my two sisters who are still poor, but i would not have recommended to my mother to stop birthing. my two sisters are much enttled as i do to see this wonderful world, if you go by George Armstrong’s song.

    10. i mean, Louis Armstrong.

    11. Oh yeah. I’m sure you are very responsible Jcc. In fact I’m sure you are a model citizen. I am sure you have earned every right to pontificate.

      But what do we do with those who aren’t model citizens like you? Let me see. Why not let them bleed to death unattended by medical professionals? After all, they’re stupid and irresponsible. It’s their fault they’re in that rut.

      Or better yet, why not put them in prison? After all, abortion is a crime. Let’s just do that and leave their children to go roaming in the streets, huh? Who knows they might be lucky enough to be adopted by good citizens like you, right? Like in the soap operas?

    12. Johnny Lin says:

      Jcc
      Your responsible parents practiced intended(designer) pregnancies. Raised your family without blaming society or government; quite a lofty achievement. Thats their choice but you could not compare your family with every multichildren families. Others are just not as strong as your family. The problem is when multichildren parents blamesocieties and government on the miserable lives. People know their status in life so financially incapable multichildren parents should have worried early enough rather than late or else dont blame others on misfortunes, the character of responsible parents. Consciously breaking the law is also not a good excuse. Still, the government and societies have
      the moral obligation providing assistance to those who seek help and moral support. That is compassionate duty of every citizen.

    13. people have free will and they willed that they birth too many, then they must suffer the consequences of their free will.

      there is no such thing as altruism. altruism is given with string-attached. altruism towards relatives is made to ensure the promotion of your reproductive genes. altruism towards your neighbor is being performed consciously hoping that they will in turn be kind to you. the first theory is darwinian, the second by sociologist Robert Trivers.

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