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YOU CAN
ignore the problem all you want, but it won't go away: abortion.
The statistics alone are shocking, cause for concern —
about 400,000 cases in the Philippines annually.
Abortion
is illegal in this country. It is condemned by the Church;
it is unacceptable to the Philippine Population Management
Program. But it is being resorted to, clandestinely, with
health hazards to the woman. And sometimes, because of complications,
the patient lands in a hospital.
The hazardous
procedures include use of drugs and herbal concoctions, deep
abdominal manipulation, or massage or vaginal catheterization.
"Induced
abortion is the fourth leading cause of maternal deaths in
the country," declares the first State of the Philippine
Population Report (SPPR), published by the Commission
on Population (Popcom) with assistance from the United Nations
Population Fund (UNFPA).
Statistics
from the Department of Health show that, from 1994 to 1998,
abortion and its complications were consistently the third
leading cause of hospital discharges (after normal delivery
and pneumonia) in DOH-retained hospitals.
Overall,
about one out of every four women who have undergone induced
abortion (as opposed to spontaneous abortion or miscarriage)
is hospitalized. The most common complications areinternal
bleeding, infection, and a perforated uterus. Many of the
patients suffer from feelings of guilt, remorse, and depression.
"Indeed,
abortion is an experience women would not want to undergo
if only they have other viable options," the SPPR states.
One viable option is contraceptive use, but family planning
methods are not always readily available in all regions of
the country, especially in remote areas.
The extent
of the problem may be gleaned from a study by the Philippine
General Hospital's Department of Obstetrics and Gynecology,
conducted from January 1990 to April 1994. During that period,
the hospital had to treat 10,260 cases of induced abortions
— an average of close to 200 cases a month, or more than
six cases daily at PGH alone.
A more
comprehensive study on clandestine abortion was undertaken
by the University of the Philippines Population Institute
in 1994. It concluded that the number of induced abortions
was estimated to be four to six times the number admitted
in hospitals.
"Applying
this estimate to the 1994 national data, there is a high possibility
that there were 320,000 to 480,000 Filipino women who submitted
themselves to the risk and trauma of induced abortion in 1994,"
the report notes.
The ratio
is 16 abortions per 100 pregnancies, or one abortion out of
every six pregnancies. The abortion rate from the UPPI study
is 20 to 30 per 1,000 women of childbearing age, with Metro
Manila having the highest abortion rate at 50.
These
Philippine estimates based on available data are higher than
in other Asian countries like Japan, Bangladesh and India,
lower than Vietnam, China, Mongolia, and South Korea.
In most
cases, induced abortions are resorted to following an unintended
pregnancy. Women who seek abortion "risk not only legal
and religious condemnation, but also the possibility of death
or permanent disabilities."
Because
of the criminal liability and the social stigma attached to
abortion, the women keep silent about their experience. "But
the more the women tryto keep it to themselves, the more the
public is unable to realize the seriousness of the issue,"
the SPPR points out.
The population
report, titled "Time to Act: Needs, Options, Decisions,"
thus considers abortion a social and public health concern.
"The unplanned pregnancy could have been prevented in
the first place, avoiding the huge cost of treating abortion
complications that puts more pressure on an already stretched
health budget,." the SPPR said.
Who are
these troubled if not distraught women who seek to terminate
their pregnancy?
The UPPI
study found that most of the women who have had an abortion
were married or living in, often in their mid-20s or older,
with at least one child. A larger study — 3,703 women
admitted in four government hospitals in 1993 — has come
up with a similar profile. Most of the women respondents were
also over 20, Catholic, and educated but unemployed.
They come
from large households, and are often aged 20-29.
Among
married women, the main reasons for undergoing an abortion
were (1) economic in nature, (2) too many pregnancies, and
(3) a large family size. The reasons most often cited by unmarried
women were (1) unpreparedness, (2) work demands, and (3) economic
plight.
In some
situations, it was the husband or the partner who exerted
the greater influence but more often, it was the woman who
made the decision to terminate the pregnancy. Economic reason
overrode the social, health and legal considerations. In some
cases, the women did not even know that abortion is illegal.
"Economic
difficulty is the common reason for both the married and the
unmarried, implying that a good majority belongs to the poor,"
the SPPR said. "The common denominator is a pregnancy
that is ill timed, unplanned, and unintended."
As one
researcher puts it, "As long as wealth and resources
are not evenly distributed in the country, the problem of
poverty will continue to stalk all of us; and abortion will
remain a symptom of a social cancer that we cannot solve by
the mechanical application of the law."
What seems
certain, however, going by the example in other countries,
is that wider and more effective use of legal and medically
approved contraceptive methods lessens the incidence of abortion.
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