Status of reproductive health and rights in the Philippines

Abby* (not her real name), a 17-year-old living in Manila, has a one-year-old daughter and is currently five months pregnant. She was disowned by her family after the first pregnancy and soon after dropped out of school as she had no means to personally support her education or afford daycare.

Abby was barred from access to free contraceptives available at her local health center because she was unable to obtain consent from her parents as required under the law. Even after her daughter’s birth, she was not counseled on contraceptive use, leaving her vulnerable to another high-risk adolescent pregnancy.

Abby’s story is all too familiar as the latest National Demographic and Health Survey show that almost three out of 10 of girls (aged 15 to 19) have unmet need for family planning and that, in 2015, one out of 10 live births were to girls between the ages of 15-19.

In 2012, the Responsible Parenthood and Reproductive Health Act (RPRHA) passed, which guarantees universal and free access to modern contraceptives specially for poor women. However, the RPRHA is actually one of the least progressive reproductive health laws in the world. It reinforces the criminal ban on abortion without any clear exceptions, it imposes a ban on the purchase of dedicated emergency contraceptives by all national hospitals, and it mandates parental consent for minors to access contraceptives without exception. These legal restrictions, and the stigma they cause, disproportionately impact poor women and adolescent girls.

Before the RPRHA was passed, the United Nations Committee on the Elimination of Discrimination against Women (UN CEDAW) conducted a special inquiry in Nove mber 2012 into the violations of reproductive rights occurring in Manila stemming from a ban on modern contraceptives. Since the inquiry and the initial passage of RPRHA, the government has not fully delivered on its promise to protect the reproductive rights for girls like Abby, who are grappling with the unavailability and inaccessibility of modern contraceptives.

A Look Back on CEDAW Special Inquiry

The inquiry was the first of its kind in Asia and on reproductive rights. UN CEDAW experts visited the Philippines for almost a week, interviewing government officials and women and girls who faced violations of their human rights as a result of an executive order (EO 003) introduced in 2000 which declared the city as pro-life and acted as a de facto ban on modern contraceptives in public health centers and facilities funded by the Manila City local government.

 UN CEDAW found that EO 003 together with other restrictive laws and local orders—including the 2011 Manila City ban on public funding for modern contraceptives, the criminal penalties for undertaking abortion, and prohibition of emergency contraceptives—contributed to higher rates of unintended pregnancies, unsafe abortions, maternal deaths, and greater exposure to HIV and other sexually transmitted infections.

The Committee found the national government ultimately accountable for “grave and systematic” violations of women’s reproductive rights, due to its failure to ensure proper oversight of local government units responsible for providing family planning services.

The Committee recommended that the government immediately repeal restrictive laws and policies, and ensure universal access to reproductive health services including modern and emergency contraceptives for all women including adolescents. The Committee also urged the government to rely on scientific findings and human rights norms to promote women’s rights and well-being rather than on religious principles.

Way forward

While the government has taken several positive steps to promote and protect reproductive rights in the country since the inquiry, much more needs to be done to ensure minors like Abby have equitable access to the full range of reproductive health services.

One important step forward was the first national inquiry on reproductive health and rights by the Commission on Human Rights in 2016 which echoed the UN CEDAW’s  recommendations.

Early this year, President Rodrigo Duterte issued an EO to expedite efforts to achieve zero unmet need for modern family planning services for all poor households by 2018.

Also, a new Department of Health policy aimed to strengthen post-abortion care services in public and private health facilities was issued in November 2016.

Most recently, the Food and Drug Administration (FDA) released a resolution re-certifying 51 contraceptive products, including Implanon and Implanon NXT, as non-abortifacients. Since the FDA recertification was the pre-condition for lifting of Supreme Court Temporary Restraining Order (TRO) on contraception, a gamut of birth control products and services should now be available for all 13 million Filipino women who are in urgent need of it.

Notwithstanding these positive developments, legal and practical barriers persist and the government should intensify its commitment and actions to advance reproductive rights. 

While similar recommendations on reproductive health and rights were expressed by UN human rights bodies in 2016 and 2017, the government failed to adequately respond to them and make real headway on the ground. And if progress has been made, the government should take as an opportunity to demonstrate this and other steps taken to implement the inquiry recommendations in its report due in July 2018 to the UN CEDAW.

At the national level, the government should repeal the RPRHA provision that requires parental consent to access modern contraceptive and denies adolescent parents from controlling their reproductive autonomy. Dedicated emergency contraceptives should also be made legally available in all health facilities.

To provide the full range of reproductive health services, the government should decriminalize abortion in all cases and adopt rules to ensure access to legal abortion as recommended by the UN CEDAW.

The post-abortion care policy introduced almost a year ago, should be implemented immediately.

As we mark the 5th anniversary of the UN CEDAW special inquiry this month, the Philippine government should give its full support and ensure immediate action to put an end to the discrimination and disempowerment that women and girls like Abby are exposed to due to the continuing lack of access to the full range of reproductive health services and information.

(Jihan Jacob lives in Quezon City and is a legal fellow at the Center for Reproductive Rights.)