Far too often in this world the subjugation and suffering of women takes on forms that are nothing short of shocking. Although perhaps not completely shocking to those of us in the reproductive health and justice movement, the encompassing newly published Forsaken Lives: The Harmful Impact of the Philippine Criminal Abortion Ban by the innovative Center for Reproductive Rights is both incredibly powerful and devastating as it discusses in detail “the human suffering caused by the criminal ban on abortion [in the Philippines] and the challenges it creates for health service providers.” By examining and exposing “human rights violations resulting from the imposition of a criminal prohibition on abortion…based on the experiences of women who have undergone unsafe abortion procedures and survived to tell their stories,” for the first time, this important report reveals the impact of these oppressive abortion restrictions on the lives of women and their families from a human rights vantage point. 

The report is striking as it reveals the tremendous discrimination, hardships, hypocrisy, lies, violence, and abuse that women and girls suffer as they seek desperate solutions to their unplanned pregnancies. Globally, roughly 70,000 girls and women suffer and die from unsafe abortion procedures every year from the 20 million unsafe abortions that occur every year. Many times that number suffer debilitating health conditions resulting from the same. 

In the Philippines, the basic status of abortion is that it is illegal, banned by the rule of law in the present constitution that pronounces–among its policies–the recognition of the Filipino family as the foundation of the nation and that the state shall equally protect the life of the mother and the life of the unborn from conception. As a result of this “equal protection” ban that disallows safe and legal abortion, approximately 20 percent of all maternal deaths in the country are due to unsafe abortion. In 2008 alone, there were an estimated 560,000 abortions performed annually in the Philippines, which resulted in 90,000 hospitalizations of women from abortion-related complications and an eventual 1,000 deaths. Tragic, preventable deaths…. 

The Philippines is one of a handful of countries in the world that bans abortions in all circumstances with no clear exceptions, not even for the life of the woman. Women and girls who obtain abortions risk prosecution and a prison sentence of up to six years. This also applies to anyone providing or assisting in the procedure; medical professionals risk the loss of their licenses. The obvious public health crisis, human rights violations, and gender inequality of Filipino women are rampant as they suffer and die from their country’s extreme abortion ban. “Criminalization of abortion has not prevented abortion in the Philippines, but it has made it extremely unsafe.” This is not new–it is a well-documented global theme that we have seen time and time again in those countries with restrictive abortion laws. But it remains tragic, heart-breaking, and unnecessary when women die from preventable causes that so clearly would improve their health, save their lives, and preserve their dignity.   

Further, a 2007 Reuters article describes abortion in the country as “a national secret” where abortion is very common, yet rarely discussed publicly and where the influence of the Catholic Church is nothing short of overwhelming. Catholic clerics have been relentless in their ability to prevent any liberalization of any reproductive health/women’s health initiatives, including contraceptive policies, which in effect prohibit access to virtually all forms of birth control that would prevent unintended pregnancies (and hence the need for abortion) in the first place. In its typical oppressive form, the Catholic hierarchy does throw women a crumb and urges the use of natural family planning rather than the birth control pill or condoms.

According to Father Melvin Castro, executive secretary of the Episcopal Commission on Family and Life: “The natural family planning method is a good option, not only a good one, but an effective one.”  How and what does he know? Talk about inaccuracy and hypocrisy. In this country of 880 inhabited islands, where the population is currently estimated at 90 million, and is expected to reach 142 million by 2040, the limited and broken societal infrastructure, the culture of corruption, and constant presence of pervasive poverty are vividly seen in the eyes of women longing for a better life and future for themselves and the children they already have.

According to an extensive 2006 Guttmacher Institute report Unintended Pregnancy and Induced Abortion in the Philippines, over 50 percent of Filipinas who have had abortions were not using any family planning. Of those who were practicing some method of birth control, three-fourths were using only the church-sanctioned methods of rhythm or withdrawal. (Did you say effective, Father Castro? That appears to be very wrong…).  Further, it is estimated that most Filipinas who have abortions are married, Roman Catholic, and have at least three children. The majority of these women terminate their pregnancies because they cannot afford another child–a well-known situation of the clear and basic human need for survival.

Less than 25 percent of these women who have an abortion obtain a surgical procedure. The rest (30 percent) either ingest herbs, other concoctions, or drugs such as the anti-ulcer Cytotec/misoprostol without medical supervision; insert catheters or other objects in their vaginas; drink alcohol or use hormonal drugs (20 percent); starve themselves or throw themselves down stairs; or find a traditional midwife–known as a hilot–to violently pound/crush their lower abdomens in the hopes of inducing what is an extraordinarily painful and horrific abortion. Most Filipinas only succeed in ending their pregnancies after multiple and dangerous attempts–once again, demonstrating yet another universal truth: That when a woman has decided that she must have an abortion–that it is truly the only choice given the conditions of her life–she will literally do anything and everything to obtain one, even risking her life and health.

And in the Philippines, even when women are able to seek out help for the life-threatening medical complications that are caused by such desperate and brutal measures, far too many are treated harshly by the doctors and nurses who seek to punish them. In fact, pain-killers are often withheld because

some “doctors feel that women need to feel the pain [resulting from the unsafe abortions] so that they will remember it and not do it again.”

Did we say ignorant, punitive, cruel, and a total lack of compassion and understanding of women’s needs, lives, and realities as to why they need the abortion in the first place? 

Forsaken Women reminds us:

“As is the case, most women who are forced to resort to unsafe abortion in the Philippines belong to the lower economic rungs of society, although even more affluent women with better access to health care are known to turn to unsafe abortion…”

The report skillfully goes on to discuss the horrific impact of stigmatizing abortion; making the procedure inaccessible in any and all situations, including pregnancy dangers to the life and health of the woman; the governmental denial of access to effective birth control; the degrading and violent treatment of women seeking post-abortion care; the marginalization of post-abortion care in the health care system (due to lack of resources, lack of training, and negative attitudes); gender-based violence and the denial of women’s full equality; as well as the pervasive power of the Catholic hierarchy that transcends the government’s obligation to guarantee the separation of church and the resultant brutal sacrificing of women’s health needs and lives as a result.

These key findings are illustrated by the heart-breaking stories of Maricel, Haydee, Mercedes, Isabel, Mylene, Cieo, Ana, and Lisa, some of whom died and all of whom suffered from the violence of illegal abortion and the misogynist policies of their country. Their stories and voices cry out for true societal change and full recognition as complete human beings needing compassion and support and with full moral agency to make ethical decisions about their pregnancies that are right and necessary for their lives and survival.

Nancy Northup, the president of the Center for Reproductive Rights, stated unequivocally (August 2^nd, 2010 New York Times):

“Manila [the capital of the Philippines and seat of the federal government] has created a dire human rights crisis” with hundreds of thousands of women resorting to unsafe abortion “to protect their health, their families, and their livelihood. Yet, the government sits idly by, refusing to tackle the issue or reform the policies that exacerbate it.” The Philippine government … [has] an obligation to break the silence around the issue of unsafe abortion and enable the voices of women to become a basis for change…”

In closing, Lisa’s story of seeking out post-abortion care in a hospital and her powerful words noted below cry out for so much: her health, dignity, justice, compassion, confidentiality, equality, and a complete end to legal, judicial, medical, and societal harassment, neglect, stigmatization, discrimination, and humiliation:

“In the morning, around 7 a.m., a nurse put a [large sign] at the foot of my bed. Written on it was the word  ‘abortion.’ They put that sign for me. Every patient who had a D &C had an abortion sign…There were only two of us who had a D&C… with the abortion sign…There was no chart with my name, only the word abortion…”

So…this is the standard scenario in the Philippines…a modern day scarlet letter designed to punish and frighten.  Lisa greeted her at the hospital where she reluctantly and desperately needed medical attention.  I mentioned at the beginning that this report contained shocking information…and the shock may remain with you for a long time as you read through it. I may have heard these tragic and heavy stories before, but I always remember that each one represents a terrified woman and I still become angry and impassioned. I hope to never become accustomed to any of them.

Lisa speaks for the 1,000 Filipinas and the nearly 70,000 women who die from illegal abortions each year and the 20 million who suffer from the brutality of illegal abortions. She is one of them…and so are we all.

ADDENDUM: The CRR report has provoked this reaction by a women’s rights advocate who is calling for the legalization of abortion, in at least some circumstances in the Philippines, as noted today in the Manila Standard…