Philippines abortion crisis

By Carlos H. Conde
The New York Times
Published: Monday, May 16, 2005

MANILA — Built in the late 1500s by the Spaniards, Quiapo Church is one of the most prominent symbols of Roman Catholicism in the Philippines.

Located in the center of Manila, right along a busy boulevard with side streets teeming with bootlegged DVDs, Filipinos who pray for miracles flock to this church. Inside is a supposedly miraculous life-size statue of Jesus carrying the cross.

To hundreds of Filipino women every year, Quiapo Church provides a solution – some say another kind of miracle – to a specific predicament: unwanted pregnancy.

Every day, pregnant women go to this church not only to pray but to buy abortion drugs from the dozens of stalls that surround it.

“You could say we provide instant miracles to women,” said a 58-year-old vendor, who agreed to talk on the condition of anonymity.

For years now, the woman said, she has been selling herbs and certain abortifacients right outside the church’s main entrance, barely 20 paces from the Monument for Children, a representation of a fetus outside the womb, cherubs, Christ’s wounded hands and a sobbing mother.

Today, Quiapo Church has become almost synonymous with abortion. It is a testament not only to a people’s abiding faith but also to one of the more tragic facts in Philippine society, where abortion is illegal and the Roman Catholic Church condemns any woman who has one. But more and more women are undergoing abortions, and more and more of them are dying because abortions are largely clandestine and unsafe.

Precisely because of the enormous power of Roman Catholicism – more than 80 percent of Filipinos are Catholics – the government does not have a clear policy on abortion. Filipino politicians never mention it in their public pronouncements except to condemn it. Meanwhile, reports of women dying or hospitalized because of induced abortion, or of fetuses found in garbage dumps, are becoming more common.

In some instances, fetuses are dumped in and around Catholic churches in the mother’s belief that it would save the child’s soul. Reproductive-rights groups believe, however, that it is done to spite a church that condemns women who abort their pregnancies.

Some hospitals refuse to treat women for abortion-related illnesses like profuse bleeding because, as one health official put it, “they look at these women as sinners.” In a few instances, according to women’s groups, doctors have performed postabortion dilation and curettage without anesthesia as a punishment for these women.

Official estimates put annual abortions at 400,000 to 500,000, and rising. The World Health Organization estimate puts the figure at nearly 800,000, one of the highest rates of unsafe abortions in Asia.

Seventy percent of unwanted pregnancies in the Philippines end in abortion said Jean-Marc Olivé, the country representative of the World Health Organization. One of four pregnancies in the Philippines end in abortion, according to Pro-Life Philippines, an anti-abortion group.

According to the Department of Health, nearly 100,000 women who have unsafe abortions every year end up in the hospital.

The Philippines, with its high population growth rate (2.6 percent) and low rate of contraceptive use (an estimated 35 percent) also has an increasing number of teenage pregnancies. As many as 17 percent of all unsafe abortions are done on teenage or young mothers, according to the Department of Health.

Compounding the problem is the fact that 36 percent of Filipino women become pregnant before marriage and 45 percent of all pregnancies are either unwanted or ill-timed, according to the World Health Organization.

There are “a lot of unmet needs regarding family planning or planning and spacing pregnancies in the Philippines,” said Olivé of the WHO. “Families, it seems, would like at least one child less than what they have.”

About 4 in 5 abortions in the Philippines are for economic reasons, according to a survey by the University of the Philippines. In many cases, said Jocelyn Pacete, a spokeswoman for Likhaan, a women’s health group based in Manila, “the mother can’t afford another child, so ends up choosing her five living children over the fetus in her womb.”

Doctors who perform abortions clandestinely in clinics typically charge 2,000 to 5,000 pesos, or $37 to $93, according to one report. Many Filipinos cannot afford such fees, so they turn to Quiapo Church or to one of several other churches around the country near which abortifacients are sold.

In Quiapo, the best-selling abortifacient is Cytotec, a drug for ulcers. Before it was banned largely through the lobbying efforts of Pro-Life Philippines, Cytotec could be bought over the counter for 20 pesos. Today, it sells on the black marketfor 50 to 120 pesos per tablet. Most of the Cytotec now circulating is smuggled in from South Korea and Bangkok, according to Pilar Versoza, a nun who runs Pro-Life Philippines.

The vendors around Quiapo also sell concoctions extracted from herbs and roots they claim will induce menstruation, a euphemism for abortion. Usually a vendor eyes a woman passing by, trying to gauge whether she is interested in the vendor’s wares. If the woman so much as glances at the leaves and bottles on display, the vendor calls out with a knowing, even conspiratorial, look on her face. “Problem with menstruation?” the vendor asks.

Versoza said some of the vendors also arrange for abortion procedures to take place. Versoza’s group has been battling with these vendors for years. “We would assign volunteers to chase after women who had just bought from the vendors and tell them about their options,” Versoza said. One time, Pro-Life Philippines put up a sign near the church telling women that they had options other than abortion. A few days later, the sign was torn down.

Versoza believes that a syndicate organizes the vendors, which may explain why, even with the raids and arrests ordered by Manila’s mayor, who is an officer in Pro-Life Philippines, the selling of abortifacients continues.

“Unsafe abortion is a very serious public health issue, a silent scourge,” said Dr. Diego Danila, who oversees the monitoring of abortion cases and maternal deaths for the Department of Health. Danila said attempts to address unsafe abortion through initiatives like more vigorous family planning is almost always opposed by the church and anti-abortion groups.

“Our hands are tied,” Danila said. “Our mandate is to follow what Malacañang orders us to do,” he added, referring to the presidential palace.

Although the Health Department has been putting into effect a family-planning program that the church criticizes, President Gloria Macapagal Arroyo, a devout Roman Catholic, has repeatedly said abortion is immoral.

Abortion opponents believe that a reproductive-health bill pending in Congress practically legalizes abortion. The bill’s intention, according to its authors, is to empower women to make more informed choices about their body.

Versoza of Pro-Life Philippines said she believed that abortion had become a convenient option for a number of Filipino women because they are made to believe that that is how they should exercise their rights over their body.

“But there are options,” she said. “Education is one, but the way sex education is being taught in school and in the media does not help. What is being imparted to our children is information, not values formation.”

Olivé, of the World Health Organization, said the rise in the number of unsafe abortions could be traced to a lack of information.

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