Birth Control Tourism: Manila Residents Leave Town for Contraception


Nine years into former Manila Mayor Lito Atienza’s total ban contraceptives, which purported to "discourage"
modern family planning methods,
the city has yet to reverse the policy and practice. While the city of Manila keeps contraception inaccessible, how are Manila’s residents getting
the family planning services they need? Are Manila’s residents obtaining birth control from nearby cities?

According to a "quick survey"
of Family Planning Needs in the City of Manila conducted by the Manila
Health Department in August 2007, 72.10% percent of Manilans use modern contraceptives, despite the lack of complete family
planning services in the City. Indeed, the rate is unusually high given
that the national average
is 49%
,
and even in neighboring Quezon City, which provides family planning services
to its residents, modern contraceptive use is at 66%.

Because of limitations of
both funding and time, the quick survey’s sample and methodology had
clear problems. Respondents were mostly those who accessed
the clinics specifically to get the service. This could explain why
the rate is significantly higher than in nearby cities and the national
average. Dr. Zelda Zablan of the Demographic Research and Development
Foundation (DRDF) also pointed out that any study on "unmet
needs" in family planning has to include currently pregnant women
as well as lactating women since they also need to be asked the obvious
questions: "Were they practicing family planning at the time of pregnancy?
Was the pregnancy planned?"

UNFPA has also noted the gaps in the data and recommended a more
detailed household survey. In coordination with the Cooperative Movement
for Encouraging NSV (Non-scalpel vasectomy), UNFPA looked into the situation
of the two most depressed districts in the city of Manila and confirmed
that the demand for family planning services remains quite high, with
women desiring family planning both for spacing births and the number
of births.

According to Manila
residents, there are still very few community health centers able to
offer family planning and in some cases, only Depo Provera is offered.
Unlike his predecessor, the incumbent Mayor, former Senator Alfredo
Lim, has stated that he supports the choice of couples in family planning
and has no problem including modern methods alongside natural family
planning methods in the city’s program.

This year, however, Manila
residents can’t expect a lot to change. The year’s budget still
does not allocate funds for universal family planning methods or any
expansion of reproductive health care services. The Mayor has not revoked
his predecessor’s Executive Order.

Early this year, Manila residents filed a case to
nullify Atienza’s Executive Order
.
But because the incumbent Mayor was already former Senator Lim at the
time of filing, his office was named respondent. The current Mayor is, after
all, in the best position to make the changes the petitioners required:
the revocation of the order discouraging modern family planning, and
the provision of reproductive health care in Manila.

Through his policy, Atienza
also kept the Department of Health (DOH) from allocating available supplies
of contraceptives and conducting their programs in Manila. In 2005,
the DOH program "ligtas buntis" (safe pregnancy) was opposed by both
Atienza and the conservative members of the Catholic hierarchy. When
the program was launched by the DOH, it did not include Manila.

A study conducted
by the Center for Reproductive Rights

and its local partners in Manila in 2007 confirmed that women who bore
the brunt of the former Mayor’s policy against contraceptives were
still exposed to the health
risks and dire choices arising from unplanned pregnancies, long after
Atienza ended his term
.
The CRR study also reported that women who could not access family planning
in Manila were already resorting to visiting nearby cities such as Quezon
City while others sought services from private clinics run by non-government
organizations. The resourcefulness of Manila residents in the face of
adversity is laudable — but Manila’s current administration needs to
get its act together.

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