Manila’s Women Battle Ban on Birth Control

On January 29, 2008, a group of women, together with activist organizations and individuals working on women's reproductive rights in Manila, filed a case to nullify an Executive Order which for over seven years has been the "official" basis for the de facto ban on contraceptives in city funded health facilities.

The Executive Order was issued by the former Mayor, Lito Atienza in 2000 and on paper "discouraged" the use of "artificial contraceptives," in the city's health and family planning programmes. For many years, advocates who wanted to challenge the order were unable to simply because nobody could produce the supposed policy. Not even local barangay (the smallest local government unit) chieftains at the community level could show advocates a copy of the order but swore they were informed by the Mayor's office it was very much in place.

In the past other local government officials also instituted similar "bans" at the provincial and city levels. Former Governor Joey Lina was said to have instituted such a ban during his term as Laguna Governor as early as the late 1990s. The former Puerto Princesa Mayor in the province of Palawan also imposed a similar ban in 2001.

What perhaps set the Manila ban apart was the sheer determination and political influence of its proponent, Mayor Lito Atienza, who was also the national president of Pro-Life Philippines when he was Manila Mayor. In fact, more than relying on a written policy (which no doubt the Mayor also shrewdly noted could always be questioned legally), he also systematically put into place, city health officials and employees (right down to the barangay health level) with his appointees who shared his restrictive beliefs on contraception.

Slowly but surely over the Mayor's nine-years in office, he was able to make both local officials and even hospital administrators comply with a policy that not only lacked legal basis but was also for many years, only vaguely (and inaccurately) alluded to as "an ordinance."

Even medical practitioners in the city-funded hospitals who were well aware of the legality of modern contraceptives and family planning methods such as surgical sterilization disclosed that it eventually became impossible to conduct these procedures when the hospital administration gave them warnings direct from the Mayor's office.

In the end, more than a written legal policy, the Mayor's main strategy to gain compliance was clearly also connected with his administrative power of control over the budgets of both barangay units and hospitals. Advocates responded by keeping the issue on the agenda, at times also gaining the ire of the Mayor who at one point announced a crackdown on "abortion clinics," all the while referring to family planning clinics giving out contraceptives. Keeping the pressure on in media, advocates were also featured on an on-line publication called "Medical Observer," where women's rights advocates working in health care and providing services in Manila, continued to criticize the baseless policy. On this occasion, an over-zealous apologist for the Mayor wrote to the editor of Medical Observer and proclaimed that the Mayor's acts had legal basis, and he cited the "Executive Order" which was issued in 2000. Ironically, the information on the exact number and date of the policy came straight from the Mayor's most ardent supporter. This allowed advocates to finally pinpoint the policy and later access it from the City's records office.

But the even greater irony of course was that in order to even bring the issue to court, a lot depended on more sacrifices on the part of women who themselves were already under the most pressure in Manila: those who were deprived of the services; denied access and experiencing direct discrimination and harm. Once more, theirs was the burden of bringing this issue to light.

The study conducted by the Center for Reproductive Rights and its local women's NGO partners last year entitled "Imposing Misery," already confirmed that indeed, there were many women who already experienced and were continuing to experience the harm because of the Mayor's policy. From being forced to make hard choices about risking pregnancy and allocating the meagre family budget to feed the family right down to the pressure of risking clandestine abortion, the report outlines the havoc the policy has wreaked upon the lives of Manila's poorest women. In the study, doctors from the city funded hospitals also noted the ever rising numbers of post abortion emergency cases that the hospital has had to deal with, making a direct link between the rise in abortions and the Manila policy.

Yet women also suffered the indignity of being paraded by the Mayor in his pro-life politics. At times they were given cash incentives and rewards that clearly augmented their family needs, but were also given publicly during the Mayor's sorties, as "a reward for having many children." These poor women were the convenient "campaign fodder," for the Mayor who was obviously only interested in projecting a popular public image of support for his position. The women who accepted the Mayor's "gifts" actually had little choice. In many ways, these cash rewards were barely even enough compensation for what the Mayor was already putting them through by his denial of basic health care and family planning.

Framing the legal issue as one of women's rights to reproductive health and family planning, Counsel for the Petitioners, Atty. Elizabeth Pangalangan (who is also a Professor of Law at the University of the Philippines) notes that the policy not only contravenes local laws like the Constitution and the Local Government Code but also international human rights standards.

Yet even as these claims are finally getting litigated in court, another challenge that advocates confront is the ensuing clash of positions which because of the Mayor's pro-life politics, has always tended to be framed as an issue about his "religious beliefs."

The policy itself very much reflects the Mayor's imposition of his "traditional Catholic views," which on the other hand, is hardly the only Catholic view on the matter. In fact, alternative and differing positions within the Catholic Church are well known elsewhere around the world not only around contraception but also HIV AIDS and abortion.

Womenlead Foundation, Inc. Executive Director, Atty. Claire Luczon notes: "Neither constitutional law, international law nor Catholic teaching on conscience supports any form of state imposition of religious beliefs, in this case, banning a legally mandated component of basic health and family planning at the local government level."

Arguably, there is hardly anything religious let alone moral in restricting women's access to health care and endangering their lives. In an opinion piece, Dr. Sylvia Estrada Claudio a Fellow of the Action for Economic Reforms underscores the importance of the case filed by the women of Manila:

"Within the context of this discrimination against them, the high point of the narrative lies in the women petitioners' nobility. Most of the petitioners cannot regain what they have lost. When asked, many of them say they are doing it for the sake of all women who still need and seek the means to decide over the size of their families. They remain fearful of reprisals even if a new mayor now sits in City Hall. Politicians of Atienza's mold strike fear into the hearts of those who disagree with them. That fear, no matter what his allies say, is not one that comes from Atienza's moral rectitude or his closeness to an avenging god."

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  • invalid-0

    Ms. Austria,

    Artificial contraception is unconstitutional in the Philippines. “Cultural imperialism” from the West to push population control policies that are failing in Europe and elsewhere are ludicrous. So is this lawsuit.

    Sec. Atienza’s stance to promote the long term economic welfare of the Philippines is to be applauded. It is a shame that the “learned” are being duped into a contraceptive mentality that will not serve Filipinos in the long run. See the Lancet Oncology Journal citing over 20 studies that cites the Pill as a carcinagen for breast cancer. In a country that does not have mammogram access around the corner in every region, promoting artifical contraception is not the best healthcare policy for women, especially when there have been more advances in Natural Family Planning in the last 5 years.

    Your constitution and the values of the Filipino people are noted worldwide for an example of upholding the highest dignity for women and families. Myopic attempts at sabotage of this does not advance women’s rights. Women will be harmed by this dangerous line of thinking.

    No woman who did not receive municipal funding for artificial contraception was denied an opportunity for practicing family planning. Natural family planning according to the Billings Ovulation Method is advocated by the World Health organization as being medically effective in over 90% of the time, (better effectiveness than condom use). Your president went before the UN and advocated this method of family planning. Your DOH officials are supposed to be offering this alternative to every client according to Filipino law.

    If the professionals mentioned in your article would be willing to look at the method and find ways to implement this with their resources, that would be a better use of time and talent than suing someone who is no longer governing the city of Manila.

    Thank you for the discourse.

  • invalid-0

    The sneering, condescending tone of the previous commentator exemplifies the archaic, totalitarian thinking of those who would deny women a choice. As a matter of fact, despite all the pro-life posturings of Atienza, his irrational policy will cause more abortions to be performed in Manila, rather than less. I bear witness every day to the poverty that is fostered by Atienza and his church cohorts.

  • invalid-0

    […] Atienza’s contraceptive ban is featured in international mainstream media. […]

  • invalid-0

    I completely share your frustration about the poverty in the streets but the answer to economic stability is not in exterminating or sterilizing mothers, it is in supporting them with better maternal care, nutrition. It is in improving the quality and access for schools. It is in strengthening families by providing for microfinance opportunities and cleaning up the government for better business so families, not from aristocracy, can end the cycle of poverty and become self-sustaining.

    The thinking of radical feminists is dying out in the U.S. Most college educated women no longer believe that legalized abortion is an answer, and in fact are returning to motherhood full time to bear children. I have deep compassion for what you see every day because I have seen it, too, but the answer is not in bashing Sec. Atienza. The answer is in using time, talent and treasure and focusing on the economic welfare of the future of the Philippines together.

    The reproductive healthcare bureaucracy that your world view seeks to establish has lead to disasterous results of gendercide for infant girls in Vietnam, India, China. The totalitarianism that you project on a different world view is unfounded when you consider that the true agenda behind this fight is to legalize abortion. Look at the 3 bills pushing a Two Child Policy in your House of Representatives now. These are not Filipino values. These are from outside sources who want to exterminate Filipinos when they have the resources to help you build a stronger infrastructure.

    The true agenda for Filipinos should be to uphold your constitution and be model for other developing nations to tell International Planned Parenthood to back off.

    Women who want contraception are able to receive it through massive donor campaigns of Intl Planned Parenthood affiliates around the world. Contraception is readily available in Manila at every drug store. Women do have a choice and the need to be fully aware of the risks of contraception on their long term health as many women in America are. Taxpayers in the Philippines and in the U.S. should not have to support funding something they do not believe in. In the U.S., many of us are choosing not to abort, not to contracept, and are grateful for the witness of Filipino families who do have children.

  • invalid-0

    The argument that pits “nutrition/shelter and basic needs” against women’s decision making over their reproductive health and lives portrays a false dichotomy. Is the former Mayor and others like him THE authority to tell these women and their families HOW to make their moral and ethical decisions about birth spacing and family planning? Come on, not even Catholic teaching on conscience supports that kind of egregious exercise of state power. Making these services available affords people the choice and the space to make informed choices. It doesn’t force them to do anything against their will. On the other hand, meddling with women’s ability to make these decisions by withholding perfectly safe and legal health services is a serious offense, not only against the law and human rights but also against conscience and free will.