This column may contain strong language, sexual content, adult humor, and other themes that may not be suitable for minors. Parental guidance is strongly advised.
With inclusive growth a strong focus of the 2017 ASEAN Summit currently taking place in Manila, women’s unrestricted access to birth control, it is hoped, should be part of the discussion.
As Melinda Gates observed in an interview with The New York Times, birth control is women’s way out of poverty, and she has made it the mission of her life to provide poor women in developing countries access to contraception.
“If you allow a woman—if you counsel her so it’s truly voluntary—to have a contraceptive tool and she can space those births, it unlocks the cycle of poverty for her. In the early days, I’d be out traveling for the foundation, I’d be there to talk to women about vaccines, I’m going to be frank, for their children, and what they would say to me is: ‘O.K., I have questions for you. What about that contraceptive, how come I can’t get it anymore?’ To me, it’s one of the greatest injustices.”
All throughout the ASEAN region, artificial contraception is widely available, with the exception of (surprise, surprise) the Philippines. Even Myanmar offers women long-term contraception for free, while in Laos, contraceptives are available even in rural areas as the government sends community-based distribution workers trained by the Laotian government and the UN Population Fund to offer family planning advice and distribute free contraceptives in the remotest villages.
In Cambodia, the patch, the ring and the diaphragm are not available, but oral contraceptives and the copper IUD are easy to find, and depo injections and implants are actually the preferred method of birth control of many Cambodian women.
Even in Brunei, the local Guardian pharmacy carries oral contraceptives, dispensed upon the presentation of a prescription from a gynecologist. In Malaysia, they can be purchased off the counter; however, the Women, Family and Community Development Ministry in 2015 mandated that single women may be prescribed birth control at designated clinics only after they have agreed to “counseling,” in an attempt to discourage “random sex.”
Vietnam has had a two-child law in effect since 1993; it has been credited with successfully controlling the country’s population. The BBC even called the measure “one of the most effective in the world.” However, it is a coercive system, and enforces the will of the state without giving citizens much of a choice, resulting in forced sterilizations and abortions, not to mention expulsion from the Communist Party, confiscation of land and other financial penalties for couples who are in violation of the law.
While this policy ignores the right of couples and individuals to plan the size of their families and the spacing of their children freely and responsibly, it does make access to contraception convenient and stress-free.
Which is not the case in this country. We love to trumpet our impressive rankings in gender equality across the ASEAN region—the Global Gender Gap Index, which measures the gap between women and men on health, education, economic and political indicators, has the Philippines coming in first globally in terms of educational attainment and the health and survival indicators—yet we continue to limit women’s opportunities to rise out of poverty, gain employment, and financial independence by restricting their access to modern contraception. And this is despite an existing Reproductive Health Law that was finally passed in 2012 after being stuck in Congress for 14 years. The RH Law, if and when it is fully implemented, would give over six million women in need access to birth control. However, the full implementation of this law is being threatened by a TRO issued by the Supreme Court in 2015 that put on hold the renewal of licenses for several contraceptives, thanks to a petition brought forward by a Catholic pro-life group alleging that implants and other birth control devices were abortifacients.
Yes, really.
The TRO prohibited the Food and Drug Administration (FDA) from “granting any and all pending applications for registration and/or recertification for reproductive products and supplies, including contraceptive drugs and devices.”
That includes birth control pills, implants, rings and intrauterine devices. Expiring stock is languishing in storerooms, unlikely to be replenished, thanks to the TRO. Supplies are expected to run out by 2020, at which time only condoms would be the only form of birth control available.
Sadly, it is the poorest women who will be impacted the most. Even better-off women will be inconvenienced, as they would have to buy their supply of contraceptives overseas. While some contraceptives can easily be obtained over the counter, others require a prescription, which means a visit to a gynecologist, effectively adding to the cost.
Already now, it’s a ridiculously laborious procedure to access certain forms of birth control. Recently, my gynecologist sent me off with a prescription for Mirena, the intrauterine device. I didn’t realize it would be a trek of Amazing Race proportions to buy something that was easily obtainable abroad, albeit with a prescription, and free on my insurance plan.
First stop was the dispensary of the same hospital my doctor had her practice, one of the biggest and most modern in the country. No Mirena. The drugstore across the street, the country’s largest chain, yielded nothing. They’d never even heard of the device. Over the next week, I called several drugstores and hospitals. Nothing. I checked with pharmacies in Hong Kong, but they wouldn’t sell me the Mirena over the counter. The brilliant Bengali doctor who’d delivered my two children at The Matilda Hospital in Hong Kong was on holiday. I called Marie Stopes Clinic and debated whether to go all the way to Caloocan just to find out whether the Mirena was in stock, information they somehow could not give me over the phone.
Finally, I called Bayer, the manufacturers of the Mirena, who passed me from extension to extension until I got the cell number of the Philippines sales representative. She told me that she could deliver the device to me personally upon presentation of my doctor’s prescription. I might have given her a tip, too, if she was actually trained to insert into my uterus!
It’s baffling how such a simple, straightforward issue of birth control is often turned into a murky ethical minefield exploited by politicians and the church and rabid pro-lifers. Statistics have shown that poverty levels indeed drop when women have greater control of their own fertility. Catherine Rampel, writing in The Washington Post, said “giving women control over their own fertility also promotes economic security, education attainment, income mobility and more stable environments for American children.” And presumably that same reasoning applies to children everywhere, no matter the country.
B. Wiser is the author of Making Love in Spanish, a novel published by Anvil Publishing and available in National Book Store and Powerbooks, as well as online. When not assuming her Sasha Fierce alter-ego, she takes on the role of serious journalist and media consultant.
For comments and questions, e-mail b.wiser.ph@gmail.com.
Disclaimer: The views expressed here are solely those of the author in her private capacity and do not in any way represent the views of Preen.ph, or any other entity of the Inquirer Group of Companies.
Art by Dorothy Guya
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