Being deprived of information is being deprived of choice

 

 

Try to imagine spending more than a decade of your life getting pregnant, giving birth and taking care of more children than you had planned for or can afford.

Try being told what you can and can not do with it comes to your body and your reproductive health.

Try to imagine getting pregnant without knowing how to stop.

It’s simply unimaginable.

But that’s exactly what life has been like for the women in city of Manila for the last 10 years since former Mayor Lito Atienza passed Executive Order 003.  The city ordinance states, “the City [of Manila] promotes responsible parenthood and upholds natural family planning not just as a method, but as a way of self-awareness in promoting the culture of life while discouraging the use of artificial methods of contraception like condoms, pills, intrauterine devices, surgical sterilization, and other.” 

While in its exact words, it says that the city will take a pro-life stance and will only promote natural family planning methods, it in reality, prohibits information and access to the modern contraception services mentioned above from the public hospitals and clinics of Manila.

Modern contraception can still be purchased over the counter in pharmacies or at private clinics and hospitals, which is no problem for women who can afford it. However, for these women who live on USD 4 a day and exist on a hand-to-mouth sustenance, this is an option that is simply way beyond their means.

During his term, Lito Atienza, a staunch pro-life advocate, gave out sacks of rice to reward constituents with large families. Now that he is no longer in office, there is no one to continue his brand of “charity” work.

In the meantime, the women of Manila, a city of more than 1.5 million people with the highest population density of any major city in the world, continue to suffer.  They are denied reproductive health services and continue, helplessly, to get pregnant. Some get pregnant so frequently that the short intervals between pregnancies not only impact their health, but also that of their newborn children.

 “Imposing Misery: The Impact of Manila’s Ban on Contraception”, is a study done by Linangan ng Kababaihan, Inc. (Likhaan), Reproductive Health, Rights and Ethics Center for Studies and Training (ReproCen) and the Center for Reproductive Rights. The study, conducted in November 2006 – January 2007, assesses the impact of Executive Order 003, seven years since its implementation. Interviews with more than 67 different individuals, ranging from Manila residents to the city health officials, were conducted.

In these excerpts, directly lifted from the study,  the women of Manila share the impact of the E.O. 003 on their everyday life, their health and their intimate relationships.

Married, yet afraid of getting pregnant

Tina Montales, age 36, has eight children but her ideal number was two. Under the EO, she cannot get the family planning services she needs and has had difficulty avoiding pregnancy as a result. Her local health center stopped providing the contraceptive pills she used to get for free. She wanted a tubal ligation after her fourth pregnancy, but her local hospital no longer offered the service.

Having eight children to feed and care for has stretched her family’s income so that it is barely enough to buy their food and meet their basic needs. The thought of getting pregnant again worries her.

Our daily income is 150 pesos from scavenging. My family’s breakfast includes three sachets of coffee and a few pieces of pandesal [bread rolls]. We make do with soy sauce or salt if we can’t afford to buy ten pesos’ cooked vegetable for lunch or dried fish for dinner.

 My eldest son died of rheumatic heart disease. Most of our earnings went to his medication. My husband lost his job as security guard after he was unable to pay more than 3,000 pesos needed to renew his license.

One woman, who has eight children, was advised by her doctor not to get pregnant after her fourth child because of her poor health:

The doctor at OM [Ospital ng Maynila] advised me not to get pregnant anymore because of my rheumatic heart condition. I wanted to have ligation, but OM hasn’t been providing FP [family planning] services. I was referred to Fabella Hospital but I couldn’t afford the 2,000 peso fee.

Intimate relationships become strained, abusive

As a way of coping with lack of access to family planning, women interviewed would often try to refuse sex with their partner to avoid pregnancy.

Women described how this puts a strain on their relationships and has led to heated altercations, temporary separation and even sexual violence. More often than not, women yield to their partners’ wishes rather than create a shameful situation where the neighbors learn they fight because of sex.

My husband and I would quarrel when I refused to have sex for fear of getting pregnant. He suspected me of having an extramarital affair. He would hit me on the thighs. He left us for the province and didn’t communicate. I worked as a laundry woman to support myself and my 6 children. We were separated for one year.

Some women finally succumb to their husbands to avoid confrontation and abuse:

Sometimes when there’s no money to buy condoms and I don’t want to have sex with my husband, he gets angry and forces me. I tell him, “Aren’t you ashamed of yourself? You’ve got so many kids already and we don’t have privacy.” Our house is very small; we sleep together with the kids. Only a thin wall separates us from the neighbors and I don’t want them to hear us arguing, so I justgive into what my husband wants.

Most men leave the responsibility of family planning to their partners. They don’t want to get vasectomies, thinking that it will hamper their sexual performance and affect their virility.

We used to fight, shout at each other when I refused to have sex. I feel embarrassed if people learn that we fight because of sex so now I just give in to my husband’s sexual needs, all the time. Ako na lang maghahanapng paraan para di mabuntis. [I take it upon myself to look for ways not to get pregnant.]

I spoke and met with some of these women in December 2008, when I did a story about the Reproductive Health Bill for Xinhua News Agency.  The stories they told me were the same – they panic with every delayed period; they fervently want to stop having children that they can no longer feed, but simply don’t know how.

When telling their forlorn stories, you can not imagine how little they assert themselves, which I believe is related to how resigned they are to their fate.  They find ways to survive each day, foregoing meals — just to make it to the next day. Others, who are perhaps more desperate, try to get an unsafe abortion, sometimes risking their life in the process.

It is iniquitous that in this day and age, women do not have access to such basic information about their bodies and their reproductive health.

Can you imagine yourself with such limited resources and even fewer choices?

Can you imagine yourself not having any control over your body, your health?

Can you imagine having family planning methods that do not take into consideration your own financial capacity, your needs as a couple and your religious beliefs, literally imposed on you?

Can you imagine yourself rendered helpless and powerless?

Such is misery is unthinkable.

Imposing it on someone, as the case of the women of Manila, is a harsh and unjust punishment.