The reality of abortion in the Philippines

Just this August, Maria (not her real name), a 21-year old rape victim who became pregnant as a result of the rape with a child with dwarfism condition, died a day after giving birth due to childbirth complications.  Her mother lamented that her daughter might be alive today had her daughter been able access to safe and legal abortion.

I have interviewed many poor women who divulged risking their health and lives by self-inducing abortion using catheters or dispensing drugs without proper dosage and supervision eventually suffering complications.  

Such cases are common in our country where over half of the pregnancies are unintended, and about 17% and one-third of the unintended pregnancies end in abortion nationwide and in the National Capital Region, respectively, and where two-thirds of those who induce abortion are poor.  

Views, religion, and abortion 

The 2004 national survey on abortion showed that nearly 90% of those who induce abortion are Catholic. Regardless of Church teachings, Filipino women still resort to abortion with the poor, rural and young women being the most vulnerable to self-induced unsafe abortion.

Although the Reproductive Health (RH) Law provides humane, non-judgmental, compassionate post-abortion care and, a law known as RA 8344 provides for stabilizing patients in serious cases such as when a woman is bleeding due to complications from self-induced unsafe abortion, making abortion safe and legal is the best means for women who resort to abortion to be assured that their health and lives are not at risk. 

 Even with RA 8344, the problem, in the past years and until now, is that some medical health care providers erroneously deny life-saving procedures even in cases of intrauterine fetal death where therapeutic abortion is needed to save the life of the woman.  

In cases of ectopic pregnancy where the pregnancy occurs outside the uterine cavity, surgery is necessary to save a woman’s life. Within a few hours from a ruptured ectopic pregnancy, the abdomen becomes rigid and the woman goes into shock. Ectopic pregnancy is a life-threatening, emergency condition requiring immediate surgery.

Expressing negative views on abortion is dangerous because it maintains the status quo where many medical providers threaten women with prosecution in cases of intrauterine fetal death, spontaneous abortionabortion due to trauma from intimate partner violence and self-induced abortion.  

As a consequence of these threats of prosecution, women end up dying because they delay going to hospitals or do not seek emergency medical care at all.

Judgmental views about known abortifacients such as Cytotec must be eliminated because these are lifesaving medications necessary for the evacuation of the uterus for incomplete abortion, missed abortion, intrauterine fetal death, severe eclampsia, labor induction, post-partum hemorrhage, and cervical ripening prior to obstetrical/gynecological procedures such as therapeutic curettage and insertion of intrauterine devices.

Abortion and law

The current criminal law on abortion is an outdated colonial law that violates the rights to health and life of Filipino women.  

It was a direct translation of the old Spanish Penal Code of 1870s that used to criminalize abortion—in the time of the Spanish friars and conquistadores.  Without knowing the full consequences of such a harsh and restrictive law, our Congress enacted the criminal provision in our Revised Penal Code of 1930.  

At the time the law was adopted, Filipino women did not even have the right to vote, there was no Universal Declaration of Human Rights and no international human rights treaties such as the International Covenant on Civil and Political Rights (ICCPR, 1976), the International Covenant on Economic, Social and Cultural Rights (ICESCR, 1976), Convention on the Elimination of All Forms of Discrimination against Women (CEDAW, 1981), Convention Against Torture (CAT, 1987), and Convention on the Rights of the Child (CRC, 1990).  These came much later.

Denying women access to safe and legal abortion is a means to control women’s bodies, propagating subordination of women where women’s decisions including personal decisions related to pregnancy and childbirth are totally disregarded. 

Permitting restrictions on women’s right to decide their own bodies perpetuate discrimination against women and inequality of women in law in clear violation of women’s right to equal protection of the law and women’s right to privacy.  

Allowing penal provisions imposed on women who induce abortion and those who assist them to prevail in Philippine law based on religious standards violates the constitutional guarantee of non-establishment of religion. 

Denying access to safe and legal abortion is a public health issue.  

The illegality of abortion with no clear exceptions drives women to self-induce abortion unnecessarily endangering their health and lives. If we want health care service providers to provide humane, non-judgmental, compassionate post-abortion care and if we want to reduce maternal mortality and morbidity due to unsafe abortion, then we should rethink the archaic colonial law that restricts access to safe and legal abortion.

We should also welcome discussion on exceptions in cases of rape, incest, danger to the health and life of the woman, grave fetal infirmity incompatible with life outside the uterus, or allow abortion up to 14 weeks of pregnancy or, better yet, simply repeal the penal provisions imposing penalty on the women who induce abortion and the service providers assisting them.

In other countries

Access to safe and legal abortion is also a social justice issue with rich women being able to go to places like Hong Kong where abortion is safe and legal while poor women who do not have funds to go abroad end up self-inducing unsafeabortion.  

We need to address the prevailing inequality besetting poor women. Serving this social justice concern will contribute to greatly reducing maternal deaths and morbidity related to self-induced unsafe abortion.  

Allowing outmoded colonial penal laws on abortion in Philippine law makes us all complicit to the estimated 3 women who die each day from self-induced unsafe abortion.  Letting such law prevail in our society breeds hatred and hostility towards Filipino women who resorted to self-induced and unsafe abortion. Our laws should never countenance this.   

Other predominantly Catholic countries and former Spanish colonies have liberalized their laws on abortion. 

Spain legalized abortion on request during the first 14 weeks of the pregnancy in 2010 and other predominantly Catholic countries such as Belgium, France, Italy, Portugal, Poland, Hungary, Costa Rica, and Ireland and former Spanish colonies such as Uruguay and Colombia allowed abortion on certain grounds. This leaves the Philippines to contend with its antiquated colonial Spanish law.  

Asian countries such as China, Japan, Malaysia, Singapore and Vietnam have liberal abortion laws while Cambodia, Indonesia and Thailand have recently liberalized their laws to allow abortion on certain grounds.

Some people mistakenly believe that the Philippine Constitution prohibits abortion because of the provision on equal protection of the life of the woman and the unborn from conception.  

On the contrary, other countries with constitutions and laws explicitly protecting the life of the unborn or life from conception allow abortion under certain exceptions such as Ireland, Slovak Republic, Poland, Kenya, Hungary, and Costa Rica.

In the complaint of LC v Peru filed with the Committee on Elimination of Discrimination against Women (CEDAW Committee), L.C. was 13 years old when a 34-year old man started sexually abusing her.  She became pregnant as a result of the rape and, in a state of depression, attempted suicide by jumping from a building, suffering spinal injuries with “a risk of permanent disability."  

Despite her serious and deteriorating condition, her doctors refused to perform an operation because she was pregnant and denied her request for therapeutic abortion. L.C. then miscarried spontaneously.  

The Committee recommended to Peru in 2009 to provide reparation to L.C., review its laws to establish effective access to therapeutic abortion, include protocols to ensure health services are available and accessible in public facilities, and decriminalize abortion when the pregnancy results from rape.

The 2006 CEDAW Concluding Comments recommended for the Philippines to remove the punitive provisions imposed on women who induce abortion and to provide access to quality services for the management of complications arising from unsafe abortions to reduce maternal mortality rates.

In the 2014 CEDAW Committee report on the inquiry on reproductive rights violations in the Philippines, the Committee recommended for the Philippines to amend articles 256 to 259 of the Revised Penal Code to “legalize abortion in cases of rape, incest, threats to the life and/or health of the mother, or serious malformation of the fetus and decriminalize all other cases where women undergo abortion.”

Upholding reproductive rights

In this day and age, we must uphold reproductive rights to the fullest extent where we champion women’s rights. Our country will be a step closer to women’s equality when every woman who decides to have an abortion is able to do so in a safe and legal manner.  

We owe such enabling environment to our mothers, sisters, and daughters who risked their health and lives by making the difficult decision to self-induce unsafe abortion and most especially to the women and adolescent girls who were hospitalized, threatened by health care providers, and those who died because of our long-standing restrictive abortion laws. 

Our rule of law is governed by secular standards, not religious standards.  To uphold women’s rights to equality and eliminate discrimination, women must have access to safe and legal abortion. Philippine law must uphold secular standards, human rights, and public health. 

We should all should work towards a humane society where no woman should die from unsafe abortion. Making abortion safe and legal will save the lives of women. – Rappler.com 

Clara Rita Padilla is the founder and executive director of EnGendeRights. She spearheaded the submission of the request for inquiry to the CEDAW Committee. She holds a Juris Doctor degree from the Ateneo de Manila University and has been practicing law for over 21 years working in the field of gender, gender-based violence, sexual and reproductive health and rights, and sexual orientation, gender identity and expression.

Photo of equipment and ultrasonograph from Shutterstock