Complete Reproductive Health Bill Text

http://rhbill.org/

SEC. 1. Title
This Act shall be known as the The Responsible Parenthood, Reproductive Health and Population and Development Act of 2011.

SEC. 2. Declaration of Policy

The State recognizes and guarantees the exercise of the universal basic human right to reproductive health by all persons, particularly of parents, couples and women, consistent with their religious convictions, cultural beliefs and the demands of responsible parenthood. Toward this end, there shall be no discrimination against any person on grounds of sex, age, religion, sexual orientation, disabilities, political affiliation and ethnicity. Moreover, the State recognizes and guarantees the promotion of gender equality, equity and womens empowerment as a health and human rights concern. The advancement and protection of womens human rights shall be central to the efforts of the State to address reproductive health care. As a distinct but inseparable measure to the guarantee of womens rights, the State recognizes and guarantees the promotion of the welfare and rights of children. The State likewise guarantees universal access to medically-safe, legal, affordable, effective and quality reproductive health care services, methods, devices, supplies and relevant information and education thereon even as it prioritizes the needs of women and children, among other underprivileged sectors. The State shall eradicate discriminatory practices, laws and policies that infringe on a persons exercise of reproductive health rights.

SEC. 3. Guiding Principles

The following principles constitute the framework upon which this Act is anchored: 1. 2. Freedom of choice, which is central to the exercise of right, must be Respect for, protection and fulfillment of reproductive health and rights fully guaranteed by the State; seek to promote the rights and welfare of couples, adult individuals, women and adolescents;

3.

Since human resource is among the principal asset of the country,

maternal health, safe delivery of healthy children and their full human development and responsible parenting must be ensured through effective reproductive health care; 4. The provision of medically safe, legal, accessible, affordable and effective reproductive health care services and supplies is essential in the promotion of peoples right to health, especially of the poor and marginalized; 5. 6. The State shall promote, without bias, all effective natural and modern The State shall promote programs that: (1) enable couples, individuals methods of family planning that are medically safe and legal; and women to have the number and spacing of children and reproductive spacing they desire with due consideration to the health of women and resources available to them; (2) achieve equitable allocation and utilization of resources; (3) ensure effective partnership among the national government, local government units and the private sector in the design, implementation, coordination, integration, monitoring and evaluation of people-centered programs to enhance quality of life and environmental protection; (4) conduct studies to analyze demographic trends towards sustainable human development and (5) conduct scientific studies to determine safety and efficacy of alternative medicines and methods for reproductive health care development; 7. The provision of reproductive health information, care and supplies shall be the joint responsibility of the National Government and the Local Government Units (LGUs); 8. Active participation by non-government, womens, peoples, civil society organizations and communities is crucial to ensure that reproductive health and population and development policies, plans, and programs will address the priority needs of the poor, especially women; 9. While this Act recognizes that abortion is illegal and punishable by law, the government shall ensure that all women needing care for post-abortion complications shall be treated and counseled in a humane, non-judgmental and compassionate manner;

10. There shall be no demographic or population targets and the mitigation of the population growth rate is incidental to the promotion of reproductive health and sustainable human development; 11. Gender equality and women empowerment are central elements of reproductive health and population and development; 12. The limited resources of the country cannot be suffered to be spread so thinly to service a burgeoning multitude making allocations grossly inadequate and effectively meaningless; 13. Development is a multi-faceted process that calls for the coordination and integration of policies, plans, programs and projects that seek to uplift the quality of life of the people, more particularly the poor, the needy and the marginalized; and 14. That a comprehensive reproductive health program addresses the needs of people throughout their life cycle.

SEC. 4. Definition of Terms

For the purposes of this Act, the following terms shall be defined as follows: Adolescence refers to the period of physical and physiological development of an individual from the onset of puberty to complete growth and maturity which usually begins between eleven (11) to thirteen (13) years and terminating at eighteen (18) to twenty (20) years of age; Adolescent Sexuality refers to, among others, the reproductive system, gender identity, values and beliefs, emotions, relationships and sexual behavior at adolescence; AIDS (Acquired Immune Deficiency Syndrome) refers to a condition characterized by a combination of signs and symptoms, caused by Human Immunodeficiency Virus(HIV) which attacks and weakens the bodys immune system, making the afflicted individual susceptible to other life-threatening infections; Anti-Retroviral Medicines (ARVs) refer to medications for the treatment of infection by retroviruses, primarily HIV; Basic Emergency Obstetric Care refers to lifesaving services for maternal complications being provided by a health facility or professional, which must include the following six signal functions: administration of parenteral antibiotics; administration of parenteral oxytocic drugs; administration of parenteral

anticonvulsants for pre-eclampsia and eclampsia; manual removal of placenta; removal of retained products; and assisted vaginal delivery; Comprehensive Emergency Obstetric Care refers to basic emergency obstetric care including deliveries by surgical procedure (caesarian section) and blood transfusion; Employer refers to any natural or juridical person who hires the services of a worker. The term shall not include any labor organization or any of its officers or agents except when acting as an employer; Family Planning refers to a program which enables couples, individuals and women to decide freely and responsibly the number and spacing of their children, acquire relevant information on reproductive health care, services and supplies and have access to a full range of safe, legal, affordable, effective natural and modern methods of limiting and spacing pregnancy; Gender Equality refers to the absence of discrimination on the basis of a persons sex, sexual orientation and gender identity in opportunities, allocation of resources or benefits and access to services; Gender Equity refers to fairness and justice in the distribution of benefits and responsibilities between women and men, and often requires women-specific projects and programs to end existing inequalities; Healthcare Service Provider refers to (1) health care institution, which is duly licensed and accredited and devoted primarily to the maintenance and operation of facilities for health promotion, disease prevention, diagnosis, treatment, and care of individuals suffering from illness, disease, injury, disability or deformity, or in need of obstetrical or other medical and nursing care; (2) a health care professional, who is a doctor of medicine, a nurse, or a midwife; (3) public health worker engaged in the delivery of health care services; and (4) barangay health worker who has undergone training programs under any accredited government and nongovernment organization and who voluntarily renders primarily health care services in the community after having been accredited to function as such by the local health board in accordance with the guidelines promulgated by the Department of Health (DOH); HIV (Human Immunodeficiency Virus) refers to the virus which causes AIDS; Male Responsibility refers to the involvement, commitment, accountability, and responsibility of males in relation to women in all areas of sexual and reproductive

health as well as the protection and promotion of reproductive health concerns specific to men; Maternal Death Review refers to a qualitative and in-depth study of the causes of maternal death with the primary purpose of preventing future deaths through changes or additions to programs, plans and policies; Modern Methods of Family Planning refer to safe, effective and legal methods, whether the natural, or the artificial that are registered with the Food and Drug Administration (FDA) of the DOH, to prevent pregnancy; People Living with HIV (PLWH) refer to individuals who have been tested and found to be infected with HIV; Poor refers to members of households identified as poor through the National Household Targeting System for Poverty Reduction by the Department of Social Welfare and Development (DSWD) or any subsequent system used by the national government in identifying the poor. Population and Development refers to a program that aims to: (1) help couples and parents achieve their desired family size; (2) improve reproductive health of individuals by addressing reproductive health problems; (3) contribute to decreased maternal and infant mortality rates and early child mortality; (4) reduce incidence of teenage pregnancy; and (5) recognize the linkage between population and sustainable human development; Reproductive Health refers to the state of complete physical, mental and social well-being and not merely the absence of disease or infirmity, in all matters relating to the reproductive system and to its functions and processes; Reproductive Health Care refers to the access to a full range of methods, facilities, services and supplies that contribute to reproductive health and well-being by preventing and solving reproductive health-related problems. It also includes sexual health, the purpose of which is the enhancement of life and personal relations. The elements of reproductive health care include the following:

(a) family planning information and services; (b) maternal, infant and child health and nutrition, including (c) proscription of abortion and management of abortion (d) adolescent and youth reproductive health;

breastfeeding; complications;

(e) prevention and management of reproductive tract infections (f) elimination of violence against women; (g) education and counseling on sexuality and reproductive health; (h) treatment of breast and reproductive tract cancers and other (i) male responsibility and participation in reproductive health; (j) prevention and treatment of infertility and sexual dysfunction; (k) reproductive health education for the adolescents; and (l) mental health aspect of reproductive health care.

(RTIs), HIV and AIDS and other sexually transmittable infections (STIs);

gynecological conditions and disorders;

Reproductive Health Care Program refers to the systematic and integrated provision of reproductive health care to all citizens especially the poor, marginalized and those in vulnerable and crisis situations; Reproductive Health Rights refer to the rights of couples, individuals and women to decide freely and responsibly whether or not to have children; to determine the number, spacing and timing of their children; to make decisions concerning reproduction free of discrimination, coercion and violence; to have relevant information; and to attain the highest condition of sexual and reproductive health; Reproductive Health and Sexuality Education refers to a lifelong learning process of providing and acquiring complete, accurate and relevant information and education on reproductive health and sexuality through life skills education and other approaches; Reproductive Tract Infection (RTI) refers to sexually transmitted infections, and other types of infections affecting the reproductive system; Responsible Parenthood refers to the will, ability and commitment of parents to adequately respond to the needs and aspirations of the family and children by responsibly and freely exercising their reproductive health rights; Sexually Transmitted Infection (STI) refers to any infection that may be acquired or passed on through sexual contact; Skilled Attendant refers to an accredited health professional, such as midwife, doctor or nurse, who has been educated and trained in the skills needed to manage normal (uncomplicated) pregnancies, childbirth and the immediate postnatal period, and in the identification, management and referral of complications in women and

newborns, to exclude traditional birth attendant or midwife (hilot), whether trained or not; Skilled Birth Attendance refers to childbirth managed by a skilled attendant including the enabling conditions of necessary equipment and support of a functioning health system, and the transport and referral facilities for emergency obstetric care; and Sustainable Human Development refers to bringing people, particularly the poor and vulnerable, to the center of development process, the central purpose of which is the creation of an enabling environment in which all can enjoy long, healthy and productive lives, and done in a manner that promotes their rights and protects the life opportunities of future generations and the natural ecosystem on which all life depends.

SEC. 5. Midwives for Skilled Attendance

The Local Government Units (LGUs) with the assistance of the DOH, shall employ an adequate number of midwives through regular employment or service contracting, subject to the provisions of the Local Government Code, to achieve a minimum ratio of one (1) fulltime skilled birth attendant for every one hundred fifty (150) deliveries per year, to be based on the annual number of actual deliveries or live births for the past two (2) years; Provided, That people in geographically isolated and depressed areas shall be provided the same level of access.

SEC. 6. Emergency Obstetric Care

Each province and city, with the assistance of the DOH, shall establish or upgrade hospitals with adequate and qualified personnel, equipment and supplies to be able to provide emergency obstetric and neonatal care. For every 500,000 population, there shall be at least one (1) hospital with comprehensive emergency obstetric and neonatal care and four (4) hospitals or other health facilities with basic emergency obstetric and neonatal care; Provided, That people in geographically isolated and depressed areas shall be provided the same level of access.

SEC. 7. Access to Family Planning

All accredited health facilities shall provide a full range of modern family planning methods, except in specialty hospitals which may render such services on an optional basis. For poor patients, such services shall be fully covered by the

Philippine Health Insurance Corporation (PhilHealth) and/or government financial assistance on a no balance billing. After the use of any PhilHealth benefit involving childbirth and all other pregnancyrelated services, if the beneficiary wishes to space or prevent her next pregnancy, PhilHealth shall pay for the full cost of family planning.

SEC. 8. Maternal and Newborn Health Care in Crisis Situations

The LGUs and the DOH shall ensure that a Minimum Initial Service Package (MISP) for reproductive health, including maternal and neonatal health care kits and services as defined by the DOH, will be given proper attention in crisis situations such as disasters and humanitarian crises. MISP shall become part of all responses by national agencies at the onset of crisis and emergencies. Temporary facilities such as evacuation centers and refugee camps shall be equipped to respond to the special needs in the following situations: normal and complicated deliveries, pregnancy complications, miscarriage and post-abortion complications, spread of HIV/AIDS and STIs, and sexual and gender-based violence.

SEC. 9. Maternal Death Review

All LGUs, national and local government hospitals, and other public health units shall conduct annual maternal death review in accordance with the guidelines set by the DOH.

SEC. 10. Family Planning Supplies as Essential Medicines

Products and supplies for modern family planning methods shall be part of the National Drug Formulary and the same shall be included in the regular purchase of essential medicines and supplies of all national and local hospitals and other government health units.

SEC. 10. Family Planning Supplies as Essential Medicines

Products and supplies for modern family planning methods shall be part of the National Drug Formulary and the same shall be included in the regular purchase of

essential medicines and supplies of all national and local hospitals and other government health units.

SEC. 11. Procurement and Distribution of Family Planning Supplies

The DOH shall spearhead the efficient procurement, distribution to LGUs and usagemonitoring of family planning supplies for the whole country. The DOH shall coordinate with all appropriate LGUs to plan and implement this procurement and distribution program. The supply and budget allotment shall be based on, among others, the current levels and projections of the following:

(a) number of women of reproductive age and couples who want to (b) contraceptive prevalence rate, by type of method used; and (c) cost of family planning supplies.

space or limit their children;

SEC. 12. Integration of Responsible Parenthood and Family Planning Component in Anti-Poverty Programs
A multi-dimensional approach shall be adopted in the implementation of policies and programs to fight poverty. Towards this end, the DOH shall endeavor to integrate a responsible parenthood and family planning component into all antipoverty and other sustainable human development programs of government, with corresponding fund support. The DOH shall provide such programs technical support, including capacity-building and monitoring.

SEC. 13. Roles of Local Government in Family Planning Programs

The LGUs shall ensure that poor families receive preferential access to services, commodities and programs for family planning. The role of Population Officers at municipal, city and barangay levels in the family planning effort shall be strengthened. The Barangay Health Workers and volunteers shall be capacitated to give priority to family planning work.

SEC. 14. Benefits for Serious and Life-Threatening Reproductive Health Conditions
All serious and life threatening reproductive health conditions such as HIV and AIDS, breast and reproductive tract cancers, obstetric complications, menopausal and post-menopausal related conditions shall be given the maximum benefits as provided by PhilHealth programs.

SEC. 15. Mobile Health Care Service

Each Congressional District may be provided with at least one (1) Mobile Health Care Service (MHCS) in the form of a van or other means of transportation appropriate to coastal or mountainous areas. The MHCS shall deliver health care supplies and services to constituents, more particularly to the poor and needy, and shall be used to disseminate knowledge and information on reproductive health. The purchase of the MHCS may be funded from the Priority Development Assistance Fund (PDAF) of each congressional district. The operation and maintenance of the MHCS shall be operated by skilled health providers and adequately equipped with a wide range of reproductive health care materials and information dissemination devices and equipment, the latter including, but not limited to, a television set for audiovisual presentations. All MHCS shall be operated by a focal city or municipality within a congressional district.

SEC. 16. Mandatory Age-Appropriate Reproductive Health and Sexuality Education

Age-appropriate Reproductive Health and Sexuality Education shall be taught by adequately trained teachers in formal and non-formal educational system starting from Grade Five up to Fourth Year High School using life skills and other approaches. The Reproductive Health and Sexuality Education shall commence at the start of the school year immediately following one (1) year from the effectivity of this Act to allow the training of concerned teachers. The Department of Education (DepEd), the Commission on Higher Education (CHED), the Technical Education and Skills Development Authority (TESDA), the DSWD, and the DOH shall formulate the Reproductive Health and Sexuality Education curriculum. Such curriculum shall be common to both public and private schools, out of school youth, and enrollees in the Alternative Learning System (ALS) based on, but not limited to, the

psychosocial and the physical wellbeing, the demography and reproductive health, and the legal aspects of reproductive health. Age-appropriate Reproductive Health and Sexuality Education shall be integrated in all relevant subjects and shall include, but not limited to, the following topics:

(a) Values formation; (b) Knowledge and skills in self protection against discrimination, (c) Physical, social and emotional changes in adolescents; (d) Childrens and womens rights; (e) Fertility awareness; (f) STI, HIV and AIDS; (g) Population and development; (h) Responsible relationship; (i) Family planning methods; (j) Proscription and hazards of abortion; (k) Gender and development; and (l) Responsible parenthood.

sexual violence and abuse, and teen pregnancy;

The DepEd, CHED, DSWD, TESDA and DOH shall provide concerned parents with adequate and relevant scientific materials on the age-appropriate topics and manner of teaching Reproductive Health and Sexuality Education to their children.

SEC. 17. Additional Duty of the Local Population Officer

Each Local Population Officer of every city and municipality shall furnish free instructions and information on responsible parenthood, family planning, breastfeeding, infant nutrition and other relevant aspects of this Act to all applicants for marriage license. In the absence of a local Population Officer, a Family Planning Officer under the Local Health Office shall discharge the additional duty of the Population Officer.

SEC. 18. Certificate of Compliance

No marriage license shall be issued by the Local Civil Registrar unless the applicants present a Certificate of Compliance issued for free by the local Family Planning Office certifying that they had duly received adequate instructions and information on responsible parenthood, family planning, breastfeeding and infant nutrition.

SEC. 19. Capability Building of Barangay Health Workers

Barangay Health Workers and other community-based health workers shall undergo training on the promotion of reproductive health and shall receive at least 10% increase in honoraria, upon successful completion of training.

SEC. 20. Ideal Family Size

The State shall assist couples, parents and individuals to achieve their desired family size within the context of responsible parenthood for sustainable development and encourage them to have two children as the ideal family size. Attaining the ideal family size is neither mandatory nor compulsory. No punitive action shall be imposed on parents having more than two children.

SEC. 21. Employers Responsibilities

The Department of Labor and Employment (DOLE) shall ensure that employers respect the reproductive rights of workers. Consistent with the intent of Article 134 of the Labor Code, employers with more than two hundred (200) employees shall provide reproductive health services to all employees in their own respective health facilities. Those with less than two hundred (200) workers shall enter into partnerships with hospitals, health facilities, or health professionals in their areas for the delivery of reproductive health services. Employers shall furnish in writing the following information to all employees and applicants:

(a) The medical and health benefits which workers are entitled to,

including maternity and paternity leave benefits and the availability of family planning services;

(b) The reproductive health hazards associated with work, including

hazards that may affect their reproductive functions especially pregnant women; and

(c) The availability of health facilities for workers.

Employers are obliged to monitor pregnant working employees among their workforce and ensure that they are provided paid half-day prenatal medical leaves for each month of the pregnancy period that the pregnant employee is employed in their company or organization. These paid pre-natal medical leaves shall be

reimbursable from the Social Security System (SSS) or the Government Service Insurance System (GSIS), as the case may be.

SEC. 22. Pro Bono Services for Indigent Women

Private and non-government reproductive health care service providers, including but not limited to gynecologists and obstetricians, are mandated to provide at least forty-eight (48) hours annually of reproductive health services, ranging from providing information and education to rendering medical services free of charge to indigent and low income patients, especially to pregnant adolescents. These fortyeight (48) hours annual pro bono services shall be included as pre-requisite in the accreditation under the PhilHealth.

SEC. 23. Sexual and Reproductive Health Programs for Persons With Disabilities (PWDs)
The cities and municipalities must ensure that barriers to reproductive health services for PWDs are obliterated by the following:

(a) providing physical access, and resolving transportation and

proximity issues to clinics, hospitals and places where public health education is provided, contraceptives are sold or distributed or other places where reproductive health services are provided;

(b) adapting examination tables and other laboratory procedures to (c) increasing access to information and communication materials on

the needs and conditions of persons with disabilities; sexual and reproductive health in braille, large print, simple language, and pictures;

(d) providing continuing education and inclusion rights of persons with (e) undertaking activities to raise awareness and address

disabilities among health-care providers; and misconceptions among the general public on the stigma and their lack of knowledge on the sexual and reproductive health needs and rights of persons with disabilities.

SEC. 24. Right to Reproductive Health Care Information

The government shall guarantee the right of any person to provide or receive nonfraudulent information about the availability of reproductive health care services, including family planning, and prenatal care. The DOH and the Philippine Information Agency (PIA) shall initiate and sustain a heightened nationwide multi-media campaign to raise the level of public awareness of the protection and promotion of reproductive health and rights including family planning and population and development.

SEC. 25. Implementing Mechanisms

Pursuant to the herein declared policy, the DOH and the Local Health Units in cities and municipalities shall serve as the lead agencies for the implementation of this Act and shall integrate in their regular operations the following functions:

(a) Ensure full and efficient implementation of the Reproductive Health (b) Ensure peoples access to medically safe, legal, effective, quality (c) Ensure that reproductive health services are delivered with a full

Care Program; and affordable reproductive health supplies and services; range of supplies, facilities and equipment and that healthcare service providers are adequately trained for such reproductive health care delivery;

(d) Take active steps to expand the coverage of the National Health

Insurance Program (NHIP), especially among poor and marginalized women, to include the full range of reproductive health services and supplies as health insurance benefits;

(e) Strengthen the capacities of health regulatory agencies to ensure

safe, legal, effective, quality, accessible and affordable reproductive health services and commodities with the concurrent strengthening and enforcement of regulatory mandates and mechanisms;

(f) Promulgate a set of minimum reproductive health standards for

public health facilities, which shall be included in the criteria for accreditation. These minimum reproductive health standards shall provide for the monitoring of pregnant mothers, and a minimum package of reproductive health programs that shall be available and affordable at all

levels of the public health system except in specialty hospitals where such services are provided on optional basis;

(g) Facilitate the involvement and participation of NGOs and the

private sector in reproductive health care service delivery and in the production, distribution and delivery of quality reproductive health and family planning supplies and commodities to make them accessible and affordable to ordinary citizens;

(h) Furnish LGUs with appropriate information and resources to keep

them updated on current studies and researches relating to responsible parenthood, family planning, breastfeeding and infant nutrition; and

(i) Perform such other functions necessary to attain the purposes of

this Act. The Commission on Population (POPCOM), as an attached agency of DOH, shall serve as the coordinating body in the implementation of this Act and shall have the following functions:

(a) Integrate on a continuing basis the interrelated reproductive health

and population development agenda consistent with the herein declared national policy, taking into account regional and local concerns;

(b) Provide the mechanism to ensure active and full participation of

the private sector and the citizenry through their organizations in the planning and implementation of reproductive health care and population and development programs and projects; and

(c) Conduct sustained and effective information drives on sustainable

human development and on all methods of family planning to prevent unintended, unplanned and mistimed pregnancies.

SEC. 26. Reporting Requirements

Before the end of April of each year, the DOH shall submit an annual report to the President of the Philippines, the President of the Senate and the Speaker of the House of Representatives (HOR). The report shall provide a definitive and comprehensive assessment of the implementation of its programs and those of other government agencies and instrumentalities, civil society and the private sector and recommend appropriate priorities for executive and legislative actions. The report shall be printed and distributed to all national agencies, the LGUs, civil society and the private sector organizations involved in said programs.

The annual report shall evaluate the content, implementation and impact of all policies related to reproductive health and family planning to ensure that such policies promote, protect and fulfill reproductive health and rights, particularly of parents, couples and women.

SEC. 27. Congressional Oversight Committee (COC)

There is hereby created a Congressional Oversight Committee composed of five (5) members each from the Senate and the HOR. The members from the Senate and the HOR shall be appointed by the Senate President and the Speaker, respectively, based on proportional representation of the parties or coalition therein with at least one (1) member representing the Minority. The COC shall be headed by the respective Chairs of the Committee on Youth, Women and Family Relations of the Senate and the Committee on Population and Family Relations of the HOR. The Secretariat of the COC shall come from the existing Secretariat personnel of the Senate and the HOR committees concerned The COC shall monitor and ensure the effective implementation of this Act, determine the inherent weakness and loopholes in the law, recommend the necessary remedial legislator or administrative measures and perform such other duties and functions as may be necessary to attain the objectives of this Act.

SEC. 28. Prohibited Acts

The following acts are prohibited:

(a) Any healthcare service provider, whether public or private, who

o (1) Knowingly withhold information or restrict the dissemination

shall: thereof, or intentionally provide incorrect information regarding programs and services on reproductive health, including the right to informed choice and access to a full range of legal, medicallysafe and effective family planning methods;
o (2) Refuse to perform legal and medically-safe reproductive

health procedures on any person of legal age on the ground of lack of third party consent or authorization. In case of married persons, the mutual consent of the spouses shall be preferred. However in case of disagreement, the decision of the one undergoing the procedure shall prevail. In the case of abused minors where

parents or other family members are the respondent, accused or convicted perpetrators as certified by the proper prosecutorial office or court, no prior parental consent shall be necessary; and
o (3) Refuse to extend health care services and information on

account of the persons marital status, gender, sexual orientation, age, religion, personal circumstances, or nature of work; Provided, That, the conscientious objection of a healthcare service provider based on his/her ethical or religious beliefs shall be respected; however, the conscientious objector shall immediately refer the person seeking such care and services to another healthcare service provider within the same facility or one which is conveniently accessible who is willing to provide the requisite information and services; Provided, further, That the person is not in an emergency condition or serious case as defined in RA 8344 otherwise known as An Act Penalizing the Refusal of Hospitals and Medical Clinics to Administer Appropriate Initial Medical Treatment and Support in Emergency and Serious Cases.

(b) Any public official who, personally or through a subordinate,

prohibits or restricts the delivery of legal and medically-safe reproductive health care services, including family planning; or forces, coerces or induces any person to use such services.

(c) Any employer or his representative who shall require an employee

or applicant, as a condition for employment or continued employment, to undergo sterilization or use or not use any family planning method; neither shall pregnancy be a ground for non-hiring or termination of employment.

(d) Any person who shall falsify a certificate of compliance as required (e) Any person who maliciously engages in disinformation about the

in Section 15 of this Act; and intent or provisions of this Act.

SEC. 29. Penalties

Any violation of this Act or commission of the foregoing prohibited acts shall be penalized by imprisonment ranging from one (1) month to six (6) months or a fine of Ten Thousand (P 10,000.00) to Fifty Thousand Pesos (P 50,000.00) or both such fine and imprisonment at the discretion of the competent court; Provided That, if

the offender is a public official or employee, he or she shall suffer the accessory penalty of dismissal from the government service and forfeiture of retirement benefits. If the offender is a juridical person, the penalty shall be imposed upon the president or any responsible officer. An offender who is an alien shall, after service of sentence, be deported immediately without further proceedings by the Bureau of Immigration.

SEC. 30. Appropriations

The amounts appropriated in the current annual General Appropriations Act (GAA) for Family Health and Responsible Parenting under the DOH and POPCOM shall be allocated and utilized for the initial implementation of this Act. Such additional sums necessary to implement this Act; provide for the upgrading of facilities necessary to meet Basic Emergency Obstetric Care and Comprehensive Emergency Obstetric Care standards; train and deploy skilled health providers; procure family planning supplies and commodities as provided in Sec. 6; and implement other reproductive health services, shall be included in the subsequent GAA.

SEC. 31. Implementing Rules and Regulations

Within sixty (60) days from the effectivity of this Act, the Secretary of the DOH shall formulate and adopt amendments to the existing rules and regulations to carry out the objectives of this Act, in consultation with the Secretaries of the DepED, the Department of Interior and Local Government (DILG), the DOLE, the DSWD, the Director General of the National Economic and Development Authority (NEDA), and the Commissioner of CHED, the Philippine Commission on Women (PCW), and two NGOs or Peoples Organizations (POs) for women. Full dissemination of the IRR to the public shall be ensured.

SEC. 32. Separability Clause

If any part or provision of this Act is held invalid or unconstitutional, other provisions not affected thereby shall remain in force and effect.

SEC. 33. Repealing Clause

All other laws, decrees, orders, issuances, rules and regulations which are inconsistent with the provisions of this Act are hereby repealed, amended or modified accordingly.

SEC. 34. Effectivity

This Act shall take effect fifteen (15) days after its publication in at least two (2) newspapers of general circulation. The following principles constitute the framework upon which this Act is anchored: 1. 2. Freedom of choice, which is central to the exercise of right, must be Respect for, protection and fulfillment of reproductive health and rights fully guaranteed by the State; seek to promote the rights and welfare of couples, adult individuals, women and adolescents; 3. Since human resource is among the principal asset of the country, maternal health, safe delivery of healthy children and their full human development and responsible parenting must be ensured through effective reproductive health care; 4. The provision of medically safe, legal, accessible, affordable and effective reproductive health care services and supplies is essential in the promotion of peoples right to health, especially of the poor and marginalized; 5. 6. The State shall promote, without bias, all effective natural and modern The State shall promote programs that: (1) enable couples, individuals methods of family planning that are medically safe and legal; and women to have the number and spacing of children and reproductive spacing they desire with due consideration to the health of women and resources available to them; (2) achieve equitable allocation and utilization of resources; (3) ensure effective partnership among the national government, local government units and the private sector in the design, implementation, coordination, integration, monitoring and evaluation of people-centered programs to enhance quality of life and environmental protection; (4) conduct studies to analyze demographic trends towards sustainable human development and (5) conduct scientific studies to determine safety and efficacy of alternative medicines and methods for reproductive health care development; 7. The provision of reproductive health information, care and supplies shall be the joint responsibility of the National Government and the Local Government Units (LGUs);

8.

Active participation by non-government, womens, peoples, civil

society organizations and communities is crucial to ensure that reproductive health and population and development policies, plans, and programs will address the priority needs of the poor, especially women; 9. While this Act recognizes that abortion is illegal and punishable by law, the government shall ensure that all women needing care for post-abortion complications shall be treated and counseled in a humane, non-judgmental and compassionate manner; 10. There shall be no demographic or population targets and the mitigation of the population growth rate is incidental to the promotion of reproductive health and sustainable human development; 11. Gender equality and women empowerment are central elements of reproductive health and population and development; 12. The limited resources of the country cannot be suffered to be spread so thinly to service a burgeoning multitude making allocations grossly inadequate and effectively meaningless; 13. Development is a multi-faceted process that calls for the coordination and integration of policies, plans, programs and projects that seek to uplift the quality of life of the people, more particularly the poor, the needy and the marginalized; and 14. That a comprehensive reproductive health program addresses the needs of people throughout their life cycle.

Ten Good Reasons to Pass the RH Bill Now

http://www.likhaan.org/content/ten-good-reasons-pass-rh-bill-now

In 1998, RH was a bland program that 2 DOH secretaries wished to mainstream into the health system. Now, RH or reproductive health is a byword that has gripped the public consciousness. Majority have supported RH in endless surveys while congressional and presidential debates have erupted on the issue. Why is there majority support for RH? Many strategic and practical reasons. Here are 10 easy ones:

RH DOES 1 Protect the health & lives of mothers

The WHO (World Health Organization) estimates that complications arise in 15% of pregnancies, serious enough to hospitalize or kill women. From the 2 million plus live births alone, some 300,000 maternal complications occur yearly. This is 7 times the DOHs annual count for TB, 19 times for heart diseases, and 20 times for malaria in women. As a result, more than 11 women die needlessly each day. Adequate number of skilled birth attendants and prompt referral to hospitals with emergency obstetric care are proven life-saving solutions to maternal complications. For women who wish to stop childbearing, family planning (FP) is the best preventive measure. All 3 interventions are part of RH.

2 Save babies

Proper birth spacing reduces infant deaths. The WHO says at least 2 years should pass between a birth and the next pregnancy. In our country, the infant mortality rate of those with less than 2 years birth interval is twice those with 3. The more effective and user-friendly the FP method used, the greater the chances of the next child to survive.

3 Respond to the majority who want smaller families

Couples and women nowadays want smaller families. When surveyed about their ideal number of children, women in their 40s want slightly more than 3, but those in their teens and early 20s want just slightly more than 2. Moreover, couples end up with families larger than what they desire. On average, Filipino women want close to 2 children but end up with 3. This gap between desired and actual family size is present in all social classes and regions, but is biggest among those who are poor.

4 Promote equity for poor families

RH indicators show severe inequities between the rich and poor. For example, 94% of women in the richest quintile have a skilled attendant at birth compared to only 26% in the poorest. The richest have 3 times higher tubal ligation rates compared to the poorest. This equity gap in tubal ligation partly explains why the wealthy hardly exceed their planned number of children, while the poorest get an extra 2. Infant deaths among the poorest are almost 3 times compared to the richest, which partly explains why the poor plan for more children. An RH law will promote equity in health through stronger public health services accessible to poor families.

5 Prevent induced abortions

Unintended pregnancies precede almost all induced abortions. Of all unintended pregnancies, 68% occur in women without any FP method, and 24% happen to those using traditional FP like withdrawal or calendarabstinence. If all those who want to space or stop childbearing would use modern FP, abortions would fall by some 500,000close to 90% of the estimated total. In our country where abortion is strictly criminalized, and where 90,000 women are hospitalized yearly for complications, it would be reckless and heartless not to ensure prevention through FP.

6 Support and deploy more public midwives, nurses and doctors

RH health services are needed wherever people are establishing their families. For example, a report by the MDG Task Force points out the need for 1 fulltime midwife to attend to every 100 to 200 annual live births. Other health staff are needed for the millions who need prenatal and postpartum care, infant care and family planning. Investing in these core public health staff will serve the basic needs of many communities.

7 Guarantee funding for & equal access to health facilities

RH will need and therefore support many levels of health facilities. These range from barangay health stations, for basic prenatal, infant and FP care; health centers, for safe birthing, more difficult RH services like IUD insertions, and management of sexually transmitted infections; and hospitals, for emergency obstetric and newborn care and surgical contraception. Strong RH facilities will be the backbone of a strong and fairly distributed public health facility system.

8 Give accurate & positive sexuality education to young people

Currently, most young people enter relationships and even married life without the benefit of systematic inputs by any of our social institutions. As a result of just one faulty sexual decision, many young women and men can lose their future, their health and sometimes their lives. We insist on young voters education for an activity that occurs once every 3 years, but leave our young people with little preparation to cope with major life events like puberty and sexual maturation.

9 Reduce cancer deaths

Delaying sex, avoiding multiple partners or using condoms prevent genital warts or HPV infections that cause cervical cancers. Self breast exams and Pap smears can detect early signs of cancers which can be cured if treated early. All these are part of RH education and care. Contraceptives do not heighten cancer risks; combined pills actually reduce the risk of endometrial and ovarian cancers.

10 Save money that can be used for even more social spending

Ensuring modern FP for all who need it would increase spending from P1.9 B to P4.0 B, but the medical costs for unintended pregnancies would fall from P3.5 B to P0.6 B, resulting in a net savings of P0.8 B. There is evidence that families with fewer children do spend more for health and education.

Choosing Life, Rejecting the RH Bill

http://www.cbcpnews.com/?q=node/14472
(A Pastoral Letter of the Catholic Bishops Conference of the Philippines)

Our Filipino Brothers and Sisters: The State values the dignity of every human person and guarantees full respect for human rights (Art. II, Section 11). The State recognizes the sanctity of family life and shall protect and strengthen the family as a basic autonomous social institution. It shall equally protect the life of the mother and the life of the unborn from conception (Art. II, Section 12). Background We begin by citing the Philippine Constitution. We do so because we intend to write you on the basis of the fundamental ideals and aspirations of the Filipino people and not on the basis of specifically Catholic religious teachings.

We are at a crossroads as a nation. Before us are several versions of a proposed bill, the Reproductive Health bill or sanitized as a Responsible Parenthood bill. This proposed bill in all its versions calls us to make a moral choice: to choose life or to choose death. At the outset we thank the government for affording us an opportunity to express our views in friendly dialogue. Sadly our dialogue has simply revealed how far apart our respective positions are. Therefore, instead of building false hopes, we wish at the present time to draw up clearly what we object to and what we stand for. Moral Choices at the Crossroads -- at EDSA I and Now Twenty five years ago in 1986 we Catholic Bishops made a prophetic moral judgment on political leadership. With this prophetic declaration we believe that we somehow significantly helped open the door for EDSA I and a window of political integrity. Today we come to a new national crossroads and we now have to make a similar moral choice. Our President rallied the country with the election cry, Kung walang corrupt walang mahirap. As religious leaders we believe that there is a greater form of corruption, namely, moral corruption which is really the root of all corruption. On the present issue, it would be morally corrupt to disregard the moral implications of the RH bill. This is our unanimous collective moral judgment: We strongly reject the RH bill. Commonly Shared Human and Cultural Values Two Fundamental Principles Far from being simply a Catholic issue, the RH bill is a major attack on authentic human values and on Filipino cultural values regarding human life that all of us have cherished since time immemorial. Simply stated the RH Bill does not respect moral sense that is central to Filipino cultures. It is the product of the spirit of this world, a secularist, materialistic spirit that considers morality as a set of teachings from which one can choose, according to the spirit of the age. Some it accepts, others it does not accept. Unfortunately, we see the subtle spread of this post-modern spirit in our own Filipino society. Our position stands firmly on two of the core principles commonly shared by all who believe in God: (1) Human life is the most sacred physical gift with which God, the author of life, endows a human being. Placing artificial obstacles to prevent human life from being formed and being born most certainly contradicts this fundamental truth of human life. In the light of the widespread influence of the post-modern spirit in our world, we consider this position as nothing less than prophetic. As religious leaders we must proclaim this truth fearlessly in season and out of season.

(2) It is parents, cooperating with God, who bring children into the world. It is also they who have the primary inalienable right and responsibility to nurture them, care for them, and educate them that they might grow as mature persons according to the will of the Creator. What We Specifically Object to in the RH Bill Advocates contend that the RH bill promotes reproductive health. The RH Bill certainly does not. It does not protect the health of the sacred human life that is being formed or born. The very name contraceptive already reveals the anti-life nature of the means that the RH bill promotes. These artificial means are fatal to human life, either preventing it from fruition or actually destroying it. Moreover, scientists have known for a long time that contraceptives may cause cancer. Contraceptives are hazardous to a womans health. Advocates also say that the RH bill will reduce abortion rates. But many scientific analysts themselves wonder why prevalent contraceptive use sometimes raises the abortion rate. In truth, contraceptives provide a false sense of security that takes away the inhibition to sexual activity. Scientists have noted numerous cases of contraceptive failure. Abortion is resorted to, an act that all religious traditions would judge as sinful. Safe sex to diminish abortion rate is false propaganda. Advocates moreover say that the RH bill will prevent the spread of HIV/AIDS. This goes against the grain of many available scientific data. In some countries where condom use is prevalent, HIV/ AIDS continues to spread. Condoms provide a false security that strongly entices individuals towards increased sexual activity, increasing likewise the incidence of HIV/AIDS. Safe sex to prevent HIV /AIDS is false propaganda. Advocates also assert that the RH Bill empowers women with ownership of their own bodies. This is in line with the post-modern spirit declaring that women have power over their own bodies without the dictation of any religion. How misguided this so-called new truth is! For, indeed, as created by God our bodies are given to us to keep and nourish. We are stewards of our own bodies and we must follow Gods will on this matter according to an informed and right conscience. Such a conscience must certainly be enlightened and guided by religious and moral teachings provided by various religious and cultural traditions regarding the fundamental dignity and worth of human life. Advocates also say that the RH bill is necessary to stop overpopulation and to escape from poverty. Our own government statistical office has concluded that there is no overpopulation in the Philippines but only the over-concentration of population in a number of urban centers. Despite other findings to the contrary, we must also consider the findings of a significant group of renowned economic scholars, including economic Nobel laureates, who have found no direct correlation between population and poverty. In fact, many Filipino scholars have concluded that population is not the cause of our poverty. The causes of our poverty are: flawed philosophies of development, misguided economic policies, greed, corruption, social inequities, lack of access to education, poor economic and social services, poor infrastructures, etc. World organizations

estimate that in our country more than P400 billion pesos are lost yearly to corruption. The conclusion is unavoidable: for our country to escape from poverty, we have to address the real causes of poverty and not population. In the light of the above, we express our clear objections: 1. We object to the non-consideration of moral principles, the bedrock of law, in legislative discussions of bills that are intended for the good of individuals and for the common good. 2. We are against the anti-life, anti-natal and contraceptive mentality that is reflected in media and in some proposed legislative bills. 3. We object strongly to efforts at railroading the passage of the RH bill. 4. We denounce the over-all trajectory of the RH bill towards population control. 5. We denounce the use of public funds for contraceptives and sterilization. 6. We condemn compulsory sex education that would effectively let parents abdicate their primary role of educating their own children, especially in an area of life sexuality which is a sacred gift of God. What We Stand For On this matter of proposed RH bills, these are our firm convictions: 1. We are deeply concerned about the plight of the many poor, especially of suffering women, who are struggling for a better life and who must seek it outside of our country, or have recourse to a livelihood less than decent. 2. We are pro-life. We must defend human life from the moment of conception or fertilization up to its natural end. 3. We believe in the responsible and natural regulation of births through Natural Family Planning for which character building is necessary which involves sacrifice, discipline and respect for the dignity of the spouse. 4. We believe that we are only stewards of our own bodies. Responsibility over our own bodies must follow the will of God who speaks to us through conscience. 5. We hold that on the choices related to the RH bill, conscience must not only be informed but most of all rightly guided through the teachings of ones faith. 6. We believe in the freedom of religion and the right of conscientious objection in matters that are contrary to ones faith. The sanctions and penalties embodied in the proposed RH bill are one more reason for us to denounce it.

Our Calls As religious leaders we have deeply and prayerfully reflected on this burning issue. We have unanimously made the moral judgment to reject the RH agenda and to choose life. 1. We call for a fundamental transformation of our attitudes and behavior towards all human life especially the most defenseless, namely, human life being formed or being conceived. The cheapness with which many seem to consider human life is a great bane to our religiousoriented nation. 2. We call upon our legislators to consider the RH bill in the light of the God-given dignity and worth of human life and, therefore, to shelve it completely as contrary to our ideals and aspirations as a people. We thank our legislators who have filed bills to defend human life from the moment of conception and call upon all other legislators to join their ranks. 3. We thank the great multitude of lay people all over the country, and particularly the dedicated groups who made their presence felt in the halls of Congress, to defend and promote our position. We call upon other lay people and adherents of other religions to join the advocacy to defend and promote our commonly shared ideals and aspirations. 4. We call on our government to address effectively the real causes of poverty such as corruption, lack of social and economic services, lack of access to education and the benefits of development, social inequities. 5. We call for the establishment of more hospitals and clinics in the rural areas, the deployment of more health personnel to provide more access to health services, the building of more schools, the provision of more aid to the poor for education, and the building of more and better infrastructures necessary for development. 6. We echo the challenge we prophetically uttered 25 years ago at EDSA I and call upon all people of good will who share our conviction: let us pray together, reason together, decide together, act together, always to the end that the truth prevail over the many threats to human life and to our shared human and cultural values. We commend our efforts against the RH bill (or the Responsible Parenthood bill its new name) to the blessing of our almighty and loving God, from whom all life comes and for whom it is destined. For the Catholic Bishops Conference of the Philippines. +NEREO P. ODCHIMAR, D.D. Bishop of Tandag President, CBCP January 30, 2011

Reproductive Health Bill

http://en.wikipedia.org/wiki/Reproductive_Health_Bill The Reproductive Health bills, popularly known as the RH Bill, are Philippine bills aiming to guarantee universal access to methods and information on birth control and maternal care. The bills have become the center of a contentious national debate. There are presently two bills with the same goals: House Bill No. 4244 or An Act Providing for a Comprehensive Policy on Responsible Parenthood, Reproductive Health, and Population and Development, and For Other Purposes introduced by Albay 1st district Representative Edcel Lagman, and Senate Bill No. 2378 or An Act Providing For a National Policy on Reproductive Health and Population and Development introduced by Senator Miriam Defensor Santiago. While there is general agreement about its provisions on maternal and child health, there is great debate on its key proposal that the Filipino taxpayer and the private sector will fund and undertake widespread distribution of family planning devices such as birth control pills (BCPs) and IUDs, as the government continues to disseminate information on their use through all health care centers. Private companies and the public and private elementary and secondary school system will be required to participate in this information and product dissemination as a way of controlling the fast growing population of the Philippines.[1] The bill is highly divisive, with experts, academics, religious institutions, and major political figures both supporting and opposing it, often criticizing the government and each other in the process. The issue is so divisive that at one point, the Catholic Bishops Conference of the Philippines threatened to excommunicate the President, Benigno Aquino III if he supported the bill.

Background
The first time the Reproductive Health Bill was proposed was in 1998. During the present 15th Congress, the RH Bills filed are those authored by (1) House Minority Leader Edcel Lagman of Albay, HB 96; (2) Iloilo Rep. Janette Garin, HB 101, (3) Akbayan Representatives Kaka Bag-ao & Walden Bello; HB 513, (4) Muntinlupa Representative Rodolfo Biazon, HB 1160, (5) Iloilo Representative Augusto Syjuco, HB 1520, (6) Gabriela Rep. Luzviminda Ilagan. In the Senate, Sen. Michael Angelo F.

Perolina has filed her own version of the RH bill which, she says, will be part of the countrys commitment to international covenants. On January 31, 2011, the House of Representatives Committee on Population and Family Relations voted to consolidate all House versions of the bill, which is entitled An Act Providing for a Comprehensive Policy on Responsible Parenthood, Reproductive Health and Population Development and for Other Purposes.[2][3] [edit]Stated

purpose

One of the main concerns of the bill, according to the Explanatory Note, is that population of the Philippines makes it the 12th most populous nation in the world today, that the Filipino womens fertility rate is at the upper bracket of 206 countries. It states that studies and surveys show that the Filipinos are responsive to having smaller-sized families through free choice of family planning methods. It also refers to studies which show that rapid population growth exacerbates poverty while poverty spawns rapid population growth. And so it aims for improved quality of life through a consistent and coherent national population policy. [edit]History According to the Senate Policy Brief titled Promoting Reproductive Health, the history of reproductive health in the Philippines dates back to 1967 when leaders of 12 countries including the Philippines'Ferdinand Marcos signed the Declaration on Population.[4] [5] The Philippines agreed that the population problem be considered as the principal element for long-term economic development. Thus, the Population Commission (Popcom) was created to push for a lower family size norm and provide information and services to lower fertility rates.[1] Starting 1967, the USAID started shouldering 80% of the total family planning commodities (contraceptives) of the country, which amounted to US$ 3 Million annually.
[1]

US National Security Memorandum: paramount importance of world population control through programs of UN and USAID.

In 1975, the United States adopted as its policy the National Security Study Memorandum 200: Implications of Worldwide Population Growth for U.S. Security and

Overseas Interests (NSSM200). The policy gives "paramount importance" to population control measures and the promotion of contraception among 13 populous countries, including the Philippines to control rapid population growth which they deem to be inimical to the socio-political and economic growth of these countries and to the national interests of the United States, since the "U.S. economy will require large and increasing amounts of minerals from abroad", and these countries can produce destabilizing opposition forces against the United States.[6] It recommends the US leadership to "influence national leaders" and that "improved world-wide support for populationrelated efforts should be sought through increased emphasis on mass media and other population education and motivation programs by the U.N., USIA, and USAID."[6] Different presidents had different points of emphasis. President Marcos pushed for a systematic distribution of contraceptives all over the country, a policy that was called "coercive," by its leading administrator.[5] The Cory Aquino administration focused on giving couples the right to have the number of children they prefer, while the Ramos presidency shifted from population control to population management. Estrada used mixed methods of reducing fertility rates, while Arroyo focused on mainstreaming natural family planning, while stating that contraceptives are openly sold in the country.[1] In 1989, the Philippine Legislators Committee on Population and Development (PLCPD) was established, "dedicated to the formulation of viable public policies requiring legislation on population management and socio-economic development." In 2000, the Philippines signed the Millennium Declaration and committed to attain the MDG goals by 2015, including promoting gender equality and health. In 2003, USAID started its phase out of a 33 year old program by which free contraceptives where given to the country. Aid recipients such as the Philippines faced the challenge to fund its own contraception program.[1] In 2004, the Department of Health introduced the Philippines Contraceptive Self-Reliance Strategy, arranging for the replacement of these donations with domestically provided contraceptives.[1] In August 2010, the government announced a collaborative work with the USAID in implementing a comprehensive marketing and communications strategy in favor of family planning called "May Plano Ako" (I Have a Plan).

[edit]Key definitions House Bills 101 and 513, and Senate Bill 2378 define the term "reproductive health care" as follows:
Reproductive Health Care - refers to the state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity, in all matters relating to the reproductive system and to its functions and processes. This implies that people are able to have a satisfying and safe sex life, that they have the capability to reproduce and the freedom to decide if, when and how often to do so, provided that these are not against the law. This further implies that women and men attain equal relationships in matters related to sexual relations and reproduction.[7]

House Bill 96 replaces "have a satisfying and safe sex life" with "enjoy responsible and safe sex" but is otherwise identical in its definition. House Bill 1160 omits "a satisfying and" but is otherwise identical. House Bill 3387 omits the word "complete" before physical, and replaces "attain" with "are afforded," but is otherwise identical.[7] Reproductive Rights are defined by House Bills 101, 513, 1160, 3387, and Senate Bill 2378 as follows:
the rights of individuals and couples, to decide freely and responsibly whether or not to have children; the number, spacing and timing of their children; to make other decisions concerning reproduction free of discrimination, coercion and violence; to have the information and means to do so; and to attain the highest standard of sexual and reproductive health.[7]

House Bill 96 replaces "other decisions" with "allied decisions," but is otherwise identical.[7] The opposition says that by supporting such definitions, the country will guarantee this same right of having "a satisfying and safe sex life" and the freedom of decision to unmarried children and teenagers, since they are "people" and "individuals." They argue that this will lead to promiscuity among the young.[8] They say that the terminology is part of deceptive "verbal engineering" since RH is not in favor of reproduction, and contraceptives are not healthy, but RH is presented as something good.[citation needed] [edit]Bill content [edit]Sections

Philippine Population Density Map. Darker areas mean more population.

The basic content of the Consolidated Reproductive Health Bill is divided into the following sections.
1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. Title Declaration of Policy Guiding Principles Definition of Terms Midwives for Skilled Attendance Emergency Obstetric Care Access to Family Planning Maternal and Newborn Health Care in Crisis Situations Maternal Death Review Family Planning Supplies as Essential Medicines Procurement and Distribution of Family Planning Supplies Integration of Family Planning and Responsible Parenthood Component in AntiRoles of Local Government in Family Planning Programs Benefits for Serious and Life-Threatening Reproductive Health Conditions Mobile Health Care Service Mandatory Age-Appropriate Reproductive Health and Sexuality Education Additional Duty of the Local Population Officer Certificate of Compliance Capability Building of Barangay Health Workers

Poverty Programs

20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 34.

Ideal Family Size Employers Responsibilities Pro Bono Services for Indigent Women Sexual And Reproductive Health Programs For Persons With Disabilities (PWDs) Right to Reproductive Health Care Information Implementing Mechanisms Reporting Requirements Congressional Oversight Committee Prohibited Acts Penalties Appropriations Implementing Rules and Regulations Separability Clause Repealing Clause Effectivity

[edit]Summary

of major provisions

The bill mandates the government to promote, without bias, all effective natural and modern methods of family planning that are medically safe and legal.[3] Although abortion is recognized as illegal and punishable by law, the bill states that the government shall ensure that all women needing care for post-abortion complications shall be treated and counseled in a humane, non-judgmental and compassionate manner.[3] The bill calls for a multi-dimensional approach integrates a component of family planning and responsible parenthood into all government anti-poverty programs.[3] Under the bill, age-appropriate reproductive health and sexuality education is required from grade five to fourth year high school using life-skills and other approaches.[3] The bill also mandates the Department of Labor and Employment to guarantee the reproductive health rights of its female employees. Companies with less than 200 workers are required to enter into partnership with health care providers in their area for the delivery of reproductive health services.[3]

Employers are obliged to monitor pregnant working employees among their workforce and ensure they are provided paid half-day prenatal medical leaves for each month of the pregnancy period that they are employed.[3] The national government and local governments will ensure the availability of reproductive health care services, including family planning and prenatal care.[3] Any person or public official who prohibits or restricts the delivery of legal and medically safe reproductive health care services will be meted penalty by imprisonment or a fine.[3] [edit]Summary of support and criticism Proponents argue: (1) Economic studies, especially the experience in Asia,[9] show that rapid population growth and high fertility rates, especially among the poor, exacerbate poverty and make it harder for the government to address it.[10][11] (2) Empirical studies show that poverty incidence is higher among big families.[10][12] Smaller families and wider birth intervals could allow families to invest more in each childs education, health, nutrition and eventually reduce poverty and hunger at the household level.[1][9][10] (3) Ten to eleven maternal deaths daily could be reduced if they had access to basic healthcare and essential minerals like iron and calcium, according to the DOH; (4) Studies show that 44% of the pregnancies in the poorest quintile are unanticipated, and among the poorest women who would like to avoid pregnancy, at least 41% do not use any contraceptive method because of lack of information or access.[9][10] and "Among the poorest families, 22% of married women of reproductive age express a desire to avoid pregnancies but are still not using any family planning method,"[9] (5) use of contraception, which the World Health Organization has listed as essential medicines,[13] [14] will lower the rate of abortions as it has done in other parts of the world, according to the Guttmacher Institute.[15](6) An SWS survey of 2008 showed that 71% of the respondents are in favor of the bill,[16] (7) at the heart of the bill is the free choice given to people on the use of reproductive health, enabling the people, especially the poor to have the number of children they want and can care for. Opponents of the bill argue that: (1) "The world's leading scientific experts" have resolved the issues related to the bill and show that the "RH Bill is based on wrong economics" as the 2003 Rand Corporation study shows that "there is little cross-country evidence that population growth impedes or promotes economic growth".[17][18] (2) The bill takes away limited government funds from treating many high priority medical and food needs and transfers them to fund harmful and deadly devices.[19] The latest studies in scientific journals and organizations show that the ordinary birth control pill,[20] and

the IUD[21] are abortifacient to fertilized eggs: they kill young human embryos, who as such are human beings equally worthy of respect,[22] making the bill unconstitutional.[23] [24] (3) Leading secular social scientists like Nobel prize winner, George Akerlof and US National Defense Consultant, Lionel Tiger, have shown empirical evidence that contraceptives have deleterious social effects (abortion, premarital sex, female impoverishment, fatherless children, teenage pregnancies, and poverty).[25][26] Harvard Director Edward Green concluded that the "best studies" show that more condoms promote the spread of AIDS.[27] Combined estrogen-progestogen oral contraceptives (the most common type prescribed globally) are carcinogenic,[28][29] and confers other serious health risks.[30][31] The increased usage of contraceptives, which implies that some babies are unwanted, will eventually lead to more abortion.[23](4) People's freedom to access contraceptives is not restricted by any opposing law, being available in family planning NGOs, stores, etc. The country is not a welfare state: taxpayer's money should not be used for personal practices that are harmful and immoral; it can be used to inform people of the harm of BCPs. (5) A 2009 survey showed that 92% rejected the bill when informed of its detailed provisions and penalties.[32] (6) The penal provisions constitute a violation of free choice and conscience, and establishes religious persecution.[33] President Aquino stated he was not an author of the bill. He also stated that he gives full support to a firm population policy, educating parents to be responsible, providing contraceptives to those who ask for them, but he refuses to promote contraceptive use. He said that his position "is more aptly called responsible parenthood rather than reproductive health."[34][35] [edit]Economic and demographic premises The Philippines are densely populated, with a density over 300 per squared kilometer, and the population growth rate is 2.04 (2007 Census), 1.957% (2010 est. by CIA World Fact Book), or 1.85% (2005-2010 high variant estimate by the UN Population Division, World Population Prospects: The 2008 Revision) coming from 3.1 in 1960. The 2010 total fertility rate (TFR) is 3.23 births per woman, from a TFR of 7 in 1960.[36] In addition, the total fertility rate for the richest quintile of the population is 2.0, which is about one third the TFR of the poorest quintile (5.9 children per woman). The TFR for women with college education is 2.3, about half that of women with only an elementary education (4.5 children per woman).[37]

Congressman Lagman states that the bill "recognizes the verifiable link between a huge population and poverty. Unbridled population growth stunts socioeconomic development and aggravates poverty."[15] The University of the Philippines' School of Economics presented two papers in support of the bill: Population and Poverty: the Real Score (2004), and Population, Poverty, Politics and the Reproductive Health Bill (2008). According to these economists, which include Solita Monsod, Gerardo Sicat, Cayetano Paderanga, Ernesto M. Pernia, and Stella Alabastro-Quimbo, "rapid population growth and high fertility rates, especially among the poor, do exacerbate poverty and make it harder for the government to address it," while at the same time clarifying that it would be "extreme" to view "population growth as the principal cause of poverty that would justify the government resorting to draconian and coercive measures to deal with the problem (e.g., denial of basic services and subsidies to families with more than two children)." They illustrate the connection between rapid population growth and poverty by comparing the economic growth and population growth rates of Thailand, Indonesia, and the Philippines, wherein the first two grew more rapidly than the Philippines due to lower population growth rates.[10] They stressed that "the experience from across Asia indicates that a population policy cum government-funded [family planning] program has been a critical complement to sound economic policy and poverty reduction."[9] In Population and Poverty, Aniceto Orbeta, Jr, showed that poverty incidence is higher among big families: 57.3% of Filipino families with seven children are in poverty while only 23.8% of families who have two children live below the poverty threshold.[12]

Percentage of population living below poverty line (2003). Darker areas mean more poverty.

Proponents argue that smaller families and wider birth intervals resulting from the use of contraceptives allow families to invest more in each childs education, health, nutrition and eventually reduce poverty and hunger at the household level.[9] At the national level, fertility reduction cuts the cost of social services with fewer people attending school or seeking medical care and as demand eases for housing, transportation, jobs, water, food and other natural resources.[1][10][38] The Asian Development Bank in 2004 also listed a large population as one of the major causes of poverty in the country, together with weak macroeconomic management, employment issues, an underperforming agricultural sector and an unfinished land reform agenda, governance issues including corruption.[11] [edit]Criticism

of premises

Opposing the bill, Former Finance Secretary Roberto de Ocampo wrote that it is "truly disingenuous for anyone to proceed on the premise that the poor are to blame for the nations poverty." He emphasized that the government should apply the principle of first things first and focus on the root causes of the poverty (e.g. poor governance, corruption) and apply many other alternatives to solve the problem (e.g. giving up pork barrel, raising tax collection efficiency).[33] They also point to the five factors for high economic growth and reduction of poverty shown by the 2008 Commission on Growth and Development headed by Nobel prize winner Michael Spence, which does not include population control.[18] Opponents also refer to a 2003 Rand Corporation study which concluded that "there is little cross-country evidence that population growth impedes or promotes economic growth...population neutralism has in fact been the predominant school in thinking among academics about population growth for the last half-century."[17] In his Primerwhich critiques the bill, Economist Roberto de Vera refers to Nobel prize winner Simon Kuznets's study which concludes that no clear association appears to exist in the present sample of countries, or is likely to exist in other developed countries, between rates of growth of population and of product per capita." Julian Simon compared parallel countries such as North and South Korea, East and West Germany whose birthrates were practically the same but whose economic growth was entirely different due to different governance factors. De Vera says that "similar conclusions have been arrived at by the US National Research Council in 1986 and in the UN Population Fund (UNFPA) Consultative Meeting of Economists in 1992" and the studies of Hanushek and Wommann (2007), Doppelhoffer, Miller, Sala-I-Martin (2004),

Ahlburg (1996), etc.[39][40] The other Nobel Prize winner who expressed the same view is Gary Becker.[41][42] De Vera also states that from 19612000, as Philippine population increased almost three times, poverty decreased from 59% to 34%.[40] He stressed that the more probable cause of poor families is not family size but the limited schooling of the household head: 78% to 90% of the poor households had heads with no high school diploma, preventing them from getting good paying jobs. He refers to studies which show that 90% of the time the poor want the children they have: as helpers in the farm and investment for a secure old age.[39][40] Instead of aiming at population decrease, De Vera stressed that the country should focus through education on cashing in on a possible demographic dividend, a period of rapid economic growth that can happens when the labor force is growing faster than the dependents (children and elderly), thus reducing poverty significantly.[39][40] In a recent development, two authors of the Reproductive Health Bill changed their stand on the provisions of the bill regarding population and development. Reps. Emerciana de Jesus and Luzviminda Ilagan wanted to delete three provisions which state that "gender equality and women empowerment are central elements of reproductive health and population and development," which integrate responsible parenthood and family planning programs into anti-poverty initiatives, and which name the Population Commission as a coordinating body. The two party-list representatives strongly state that poverty is not due to over-population but because of inequality and corruption.[43] [edit]Maternal health and deaths

Birthing services are key to solving maternal deaths

The proponents state that RH will mean: (1) Information and access to natural and modern family planning (2) Maternal, infant and child health and nutrition (3) Promotion of breast feeding (4) Prevention of abortion and management of post-abortion complications (5) Adolescent and youth health (6) Prevention and management of

reproductive tract infections, HIV/AIDS and STDs (7) Elimination of violence against women (8) Counseling on sexuality and sexual and reproductive health (9) Treatment of breast and reproductive tract cancers (10) Male involvement and participation in RH; (11) Prevention and treatment of infertility and (12) RH education for the youth. There is general agreement on the health provisions of the RH bill, except for the provisions on contraception and family planning devices that have moral and health implications, and provisions on sex education done in schools. The Department of Health states that family planning can reduce maternal mortality by about 32 percent.[13] The bill is "meant to prevent maternal deaths related to pregnancy and childbirth," said Clara Padilla of Engender Rights. She reported that "Daily, there are 11 women dying while giving birth in the Philippines. These preventable deaths could have been avoided if more Filipino women have access to reproductive health information and healthcare." Regarding these figures, Francisco Tatad of the International Right to Life Federation and former Senator wrote that "If correct, experience has shown (as in Gattaran, Cagayan and Sorsogon, Sorsogon) that the incidence of maternal death arising from such complications could be fully mitigated and brought down to zero simply by providing adequate basic and emergency obstetrics care and skilled medical personnel and services," without any need for a law on the distribution of contraceptives.[24] The key to solving maternal deaths, according to the Senate Policy Brief on reproductive health, is the establishment of birthing centers.[1] [edit]Family planning

Catholic Church: A large family is a sign of God's blessings (CCC2373)

The majority of Filipinos are in favor of family planning. The Catholic Church teaches the necessity of responsible parenthood and correct family planning (one child at a time depending on one's circumstances), while at the same time teaching that large families are a sign of God's blessings. It teaches that modern natural family planning, a method

of fertility awareness, is in accord with God's design, as couples give themselves to each other as they are. The RH bill intends to help couples to have government funded access to artificial contraception methods as well.[citation needed] [edit]Unmet

need

Using data from the 2008 National Demographic and Health Survey, Lagman stated that "Twenty-two percent of married Filipino women have an unmet need for family planning services, an increase by more than one-third since the 2003 National Demographic and Housing Survey." "Our women are having more children than they desire, as seen in the gap between desired fertility (2.5 children) and actual fertility (3.5 children), implying a significant unmet need for reproductive health services," state some Ateneo de Manila University professors. The Bill provides that "The State shall assist couples, parents and individuals to achieve their desired family size within the context of responsible parenthood for sustainable development and encourage them to have two children as the ideal family size."[9][38] Basing itself on demographic surveys, Likhaan, a non-government organization for women's health, stated that the most common reasons why women with unmet need in the Philippines do not practice contraception are health concerns about contraceptive methods, including a fear of side effects. 44% reported these reasons in 2008. The second largest category of reasons is that many believe they are unlikely to become pregnant41% in 2008. Their specific reasons include having sex infrequently, experiencing lactational amenorrhea (temporary infertility while nursing) and being less fecund than normal.[44] Writing against the bill, Bernardo Villegas wrote about the Myth of Unmet Family Planning Needs, citing development economist Lant Pritchett who said that the term "unmet need" is an elitist construct, an imposition of a need on the poor, disrespectful of their real preferences. Pritchett said that it is "based on a discrepancy...identified by the analyst through the comparison of responses to items in separate blocks of the questionnaire" and is "an inference on the part of the researcher, not a condition reported by the respondents themselves." Pritchett argued this term is applied to women who are not sexually active, are infecund, whose husband is absent, etc., thus bloating the numbers to favor the pharmaceutical companies and those with a population control agenda. Villegas stressed: "Because [the poor] have been deprived of the infrastructures they need, such as farm-to-market roads, irrigation systems, postharvest facilities and other support services that the State neglected to provide them,

the only economic resources they have are their children." He also challenged that he is willing to bet that if the government will provide cash money to the poor to buy condoms, the poor will use the cash for food and basic needs, thus exploding the myth.
[45]

[edit]Access One of the main concerns of the proponents is the perceived lack of access to family planning devices such as contraceptives and sterilization. The bill intends to provide universal access through government funding, complementing thus private sector initiatives for family planning services, such as those offered by the International Planned Parenthood Federation (IPPF) which supports the Family Planning Organizations of the Philippines and the 97 organizations of the Philippine NGO Council. The opposition argues that "Access to contraceptives is free and unrestricted" and that the proposed law is pushing an open door.[24] They say that these family planning items are available to the citizens and many local government units and NGOs provide these for free. Congressman Teddyboy Locsin argued, echoed by a Business Mirror editorial, that the poor can afford condoms since they can pay for other items such as cellphone load. Opponents also argue that Philippine government is not a welfare state, and taxpayers are not bound to provide for all the wants and desires of its citizenry, including their vanity needs, promiscuous actions and needs artificially created by elitist, imperialist and eugenicist forces; nor should taxpayers pay for drugs that are objectively dangerous (carcinogenic) and immoral. They argue that the Philippines should give priority to providing access to medicines that treat real diseases.[19][24]

Birth control pill

The UP School of Economics argues, in contrast, that there is lack of access especially for poor people, because contraceptive use is extremely low among them and "Among the poorest families, 22% of married women of reproductive age express a desire to avoid pregnancies but are still not using any family planning method."[9] They say that lack of access leads to a number of serious problems which demand attention: (1) "too

many and too closely-spaced children raises the risk of illness and premature deaths (for mother and child alike)," (2) "the health risks associated with mistimed and unwanted pregnancies are higher for adolescent mothers, as they are more likely to have complications during labor," (3) women who have mistimed pregnancies are "constrained to rely more on public education and health services and other publicly provided goods and services," further complicating limited public resources, (4) families are not able to achieve their desired family size. Thus the UP economists "strongly and unequivocally support" the thrust of the bill to enable "couples and individuals to decide freely and responsibly the number and spacing of their children and to have the information and means to carry out their decisions.[9] Proponents argue that government-funded access is the key to breaking the inter-generational poverty that many people are trapped in.[9][38] [edit]Abortion One of the bill's components is "prevention of abortion and management of postabortion complications." It provides that "the government shall ensure that all women needing care for post-abortion complications shall be treated and counseled in a humane, non-judgmental and compassionate manner." It also states that "abortion remains a crime and is punishable," as the Constitution declares that the State shall equally protect the life of the mother and the life of the unborn from conception.[46] Opposing the bill, the Faculty of Medicine of the catholic University of Santo Tomas, the Philippine Nurses Association (with at least 368,589 members), the Bioethics Society of the Philippines, Catholic Physicians Guild of the Philippines stated that the antiabortion stance of the bill is contradicted by the promotion of contraceptive agents (IUD and hormonal contraceptives) which actually act after fertilization and are potentially abortifacient agents.[47] Opposition refers to a 2000 study of a scientific journal of the American Medical Association, in which a meta-analysis of 94 studies provides evidence that when a common birth control pill fails to prevent ovulation, "postfertilization effects are operative to prevent clinically recognized pregnancy."[20] They also point to the American Journal of Obstetrics and Gynecology (2005), which concluded that the IUD brings about the "destruction of the early embryo,"[21] thus is deemed to kill five-day old babies.[8] Jo Imbong, founder of the Abay Pamilya Foundation, reported that "Lagman said in a House hearing that the bill would protect human life 'from implantation,'"[48] and not from fertilization, noting at the same time that the Records of the Constitutional Commission

state that Human life begins at fertilization.[48][49] After referring to many standard textbooks of medicine and human embryology to affirm this as true,[50] the anti-RH bill citizens argue that the human embryo already has the complete genetic code and is thus a distinct human life beginning its own new life cycle. They say that the embryo is an individual, self-coordinated and self-organizing subject belonging to the species homo sapiens: a human being by nature and thus a person equally worthy of respect.[22]

8-cell human embryo, 3 days after fertilization

Proponents argue that research by the Guttmacher Institute, involved in advancing international reproductive health, reveals that the use of contraceptives can reduce abortion rates by 85%. Proponents such as 14 Ateneo de Manila University professors, argued thus: "Studies show that the majority of women who go for an abortion are married or in a consensual union (91%), the mother of three or more children (57%), and poor (68%) (Juarez, Cabigon, and Singh 2005). For these women, terminating a pregnancy is an anguished choice they make in the face of severe constraints. When women who had attempted an abortion were asked their reasons for doing so, their top three responses were: they could not afford the economic cost of raising another child (72%); their pregnancy occurred too soon after the last one (57%); and they already have enough children (54%). One in ten women (13%) who had attempted an abortion revealed that this was because her pregnancy resulted from forced sex (ibid.). Thus, for these women, abortion has become a family planning method, in the absence of information on and access to any reliable means to prevent an unplanned and unwanted pregnancy."[38] The bill, said Clara Padilla of EnGender Rights Inc, will "help reduce the number of abortions by providing increased access to information and services on modern contraceptive methods, that in turn will reduce the number of unwanted --and often aborted-- pregnancies."[51] Opponents of the bill argue that the Guttmacher Institute is the research arm of International Planned Parenthood and that the latter is "the largest promoter of artificial

birth control and abortion worldwide."[19] Opponents argue that new data thwarts the "myth" that contraception lowers abortions.[52] Ang Kapatiran Party (AKP) in their Position Paper stated that "The Guttmacher Institute's own study in 2003 showed simultaneous increases both abortion rates and contraceptive use in the United States, Cuba, Denmark, Netherlands, Singapore, and South Korea."[53] The AKP argues that "Since contraceptives will not reduce unplanned pregnancy, they will not reduce abortion rates either and may increase them."[53] Both sides of the debate accuse the other side of deception and misleading the public. The pro-RH people accuse the anti-RH group of misleading the public by calling the bill an abortion bill, when the bill states that abortion remains a crime and is punishable. The anti-RH advocates accuse the RH supporters of deceiving the public regarding the true meaning of reproductive health, since US Secretary Hillary Clinton said that RH includes abortion,[54] and that RH includes the pill where "postfertilization effects are operative"[21] and the IUD which brings about the "destruction of the early embryo," according to the American Medical Association and the American Journal of Obstetrics and Gynecology.[21] [edit]Contraceptives [edit]Morality

and social effects

Another central issue is the morality of contraception. Around 81% of Filipinos are Catholics, and the Catholic Church teaches that extramarital sex and contraception are moral evils, since they desecrate sex which is intrinsically linked to new human beings whose lives are sacred. Contraception, says the church, also makes spouses lie about their total self gift to their spouse, by not surrendering their personal fertility.[55]

Prolifers refer to economy Nobel prize winner George Akerlof who found that wide use of contraceptives led to premarital sex, illegitimate children, undomesticated men, crimes and abortions.

However, 14 professors from Ateneo de Manila University, a prominent Catholic University, considering the empirical evidence of the dire socio-economic conditions of the Filipino poor, urged that the bill be passed to help them. They argued: "As Catholics and Filipinos, we share the hope and mission of building a Church of the Poor. We are thus deeply disturbed and saddened by calls made by some members of the Catholic Church to reject a proposed legislation that promises to improve the wellbeing of Filipino families, especially the lives of women, children, adolescents, and the poor." They announced that "Catholic social teachings recognize the primacy of the well-formed conscience over wooden compliance to directives from political and religious authorities," urging Catholic authorities to withdraw their opposition the bill.[38] Citing Catholic documents and scientific studies, they reasoned that "the RH Bill is pro-life, pro-women, pro-poor, pro-youth, and pro-informed choice." They emphasized that the bill "promotes quality of life, by enabling couples, especially the poor, to bring into the world only the number of children they believe they can care for and nurture to become healthy and productive members of our society."[38] Thus, they entitled their paper as "Catholics Can Support the RH Bill in Good Conscience."[38] In response, the Ateneo administration announced its unity with Catholic teaching and that it had "serious objections to the present bill."[56] The catholic University of Santo Tomas's student paper, The Varsitarian expressed shock about what they see as the professors' "erroneous conscience", and ignorance of economic science and medicine. [42] 42 prominent international Catholic scholars, including Janet E. Smith, Peter Kreeft, William E. May, and Joseph W. Koterski, S.J., responded to the faculty of the Ateneo, saying that It is never lawful, even for the gravest reasons, to do evil that good may come of it," that the bill disrespects poor people, and "focuses primarily on providing services to curb the number of children of the poor, while doing little to remedy their situation."[57] Proponents such as Lagman also stressed that official Catholic teaching itself, expressed in the Encyclical Humanae Vitae issued only forty years ago in 1964, is not infallible.[15] He said that the Papal Commission on Birth Control, which included ranking prelates and theologians, recommended that the Church change its teaching on contraception as it concluded that the regulation of conception appears necessary for many couples who wish to achieve a responsible, open and reasonable parenthood in

todays circumstances. The editorial of the Philippine Daily Inquirer, moreover, stated that Catholic teaching is "only" a religious teaching and should not be imposed with intolerance on a secular state. Responding to the Inquirer, opponents of the bill said that science and secular moral reasoning show the objective truth that contraception is evil and disastrous for society, and therefore a secular state should stand by this evidence. Thus they cite the 15 nonreligious reasons against contraception provided by the Ethics Guide of the secular BBC which includes the loss of potential beneficent human life, causing widespread moral promiscuity, weakening family life, being unnatural and anti-life. [58] They stress that it is the errors of conscience pushed by the "dictatorship of relativism" --rather than the objective truth and the good--- that is imposing itself on people. They say that Catholic Church doctrine on contraception has been the same since its beginning,[58] taught by bishops around the world, thus part of infallible ordinary magisterium.[59] Prestigious secular and anti-Catholic social scientists are also reported to have found empirical evidence linking contraception and a variety of social ills: more premarital sex, fatherless children, and abortion; decline of marriage, crimes by unmarried men, poverty, social pathology (George Akerlof, Nobel prize winner); [25] heightened spread of AIDS (Edward C. Green, Harvard Director for AIDS); [27] breakdown of families, female impoverishment, trouble in the relationship between the sexes, and single motherhood (Lionel Tiger).[26][60] Opponents argue that misery is not the result of the church which they say is the largest charitable organization in the world, but of a breakdown in moral sense that gives order to society, nor does misery come from parents who bring up children in faithfulness, discipline, love and respect for life, but from those who strip human beings of moral dignity and responsibility, by treating them as mere machines, which they believe contraception does.[61] [edit]Health

reasons

In Medical Issues in the Reproductive Health Bill, Dr. Angelita Miguel-Aguirre refers to meta-analyses at scientific journals that show oral contraceptives (OCs) are unsafe. [19] A meta-analysis of theStroke Journal concluded that OCs confer "risk of first ischemic stroke."[31] The World Health Organization (WHO) announced the findings of The International Agency for Research on Cancer (IARC) in 2007 that "there is sufficient evidence in humans for the carcinogecity of combined estrogenprogestogen contraceptives."[28][29] The Journal of Clinical Endocrinology & Metabolism also concluded in 2005 that "a rigorous meta-analysis of the literature suggests that current use of low-dose OCs significantly increases the risk of both

cardiac and vascular arterial events."[30] In its list of essential medicines, WHO stated that these drugs "have been questioned" and "will be reviewed" by its Expert Committee.[14]

The World Health Organizationannounced scientific findings that the pill causes cancer and kept it in its list of essential medicines

Opponents also say that being pregnant with a child is not a disease but a blessing, and that there are real diseases among the leading causes of mortality that should take on a higher priority, given the limited budget. They refer to data from the Department of Health as to the leading causes of death in the Philippines, and the daily death toll per 100,000 women are: (1) Heart diseases - 80; (2) Vascular diseases - 63; (3) Cancer 51; (4) Pneumonia - 45; (5) Tuberculosis - 23; (6) Diabetes - 22; (7) Lower chronic respiratory diseases 16.[24][62] Dr. Aguirre of the Makati Medical Society also said that "The health risks of the pill actually outweighs by far the risks of pregnancy and childbirth to a woman's health."[19] Proponents such as E. Ansioco of Democratic Socialist Women of the Philippines argued that "The World Health Organization (WHO) includes contraceptives in its Model Lists of Essential Drugs" and thus are safe medicines.[13][14] "Medical and scientific evidence," says the main proponent, "shows that all the possible medical risks connected with contraceptives are infinitely lower than the risks of an actual pregnancy and everyday activities...The risk of dying within a year of using pills is 1 in 200,000. The risk of dying from a vasectomy is 1 in 1 million and the risk of dying from using an IUD is 1 in 10 million. ... But the risk of dying from a pregnancy is 1 in 10,000."[15] In Facts on Barriers to Contraceptive Use in the Philippines, Likhaan made the following projection: "If all women who wanted to avoid pregnancy used modern methods, there would be 1.6 million fewer pregnancies each year in the Philippines. Unintended births would drop by 800,000, abortions would decline by 500,000 and miscarriages would decline by 200,000. Expanding modern contraceptive use to all women at risk for unintended pregnancy would prevent 2,100 maternal deaths each year. It would also

reap savings on medical care for pregnant women and newborns that would more than offset the additional spending on modern contraception." [edit]HIV/AIDS The RH bill provides for "prevention and treatment of HIV/AIDS and other, STIs/STDs," especially since the number of HIV cases among the young nearly tripled from 41 in 2007 to 110 in 2008.[51]Primary among the means is distribution of condoms. The proponents applauded government efforts last February 2010 when it distributed condoms in some areas of Manila. On the other side of the debate, Dr. Rene Josef Bullecer, Director of AIDS-Free Philippines, said that in 1987, Thailand had 112 AIDS cases, more or less the same number as the Philippines (135). By the year 2003, there were around 750,000 cases in Thailand, where there was an intense campaign for the "100% Condom Use Program", while there were only 1,935 cases in the Philippines, whose population is around 30% greater than Thailand's.[63][64] Pro-life groups refer to the Director of Harvard's Aid Prevention Center, Edward C. Green, who said that the "best evidence" agrees with Benedict XVI's statement that condom distribution risked exacerbating the spread of the virus, because availability of condoms leads to riskier sexual behavior.[27] [edit]Sex Education To achieve its goals, the bill provides for mandatory reproductive health education and that it be taught in "an age-appropriate manner... by adequately trained teachers starting from Grade 5 up to Fourth Year High School." Opposition to the bill is concerned about early sexualization of the youth and say that sex education promoters themselves state that it has led to more teenage pregnancies and illegitimacy. They stressed that what is needed is chastity education, especially taught by their parents, rather than sex education in school. Proponents refer to the latest UNESCO study dated December 2009 which concluded that sexuality education did not encourage early initiation into sex.[65] [edit]Opinion polls Proponents refer to many surveys conducted by two prominent locally based organizations (SWS and Pulse Asia) which show majority support for the bill. A survey conducted in 2008 by the Social Weather Stations, commissioned by the Forum for Family Planning and Development (FFPD), a non-government advocacy group, showed that 68 percent of Filipinos agree that there should be a law requiring government to

distribute legal contraceptives.[66] SWS President and RH Bill proponent, Mahar Mangahas reported that the "survey found 71 percent in favor [of the RH Bill], 21 percent undecided, and a mere 8 percent opposed. Among those who originally knew of the bill, the score is 84 percent in favor, and 6 percent opposed. Among those who learned of the bill for the first time because of the survey, the score is 59 percent in favor, versus 11 percent opposed.[16][66] Pulse Asia reported that in an October 2008 survey "most Filipinos are aware of the reproductive health bill pending at the House of Representatives (68%) and are in favor of the bill (63%)."[67] In December 2010, Pulse Asia announced based on the results of an October 2010 survey, 69% of the Filipinos are in favor of the bill. Saying that nation-wide surveys are financed by wealthy, foreign-funded political lobby groups to create a bandwagon effect, Senator Tatad remarked that an objective measure of Filipino preference is the consistent top electoral success of the prolife party-list, Buhay Hayaan Yumabong (Let Life Flourish).[24] President of Prolife Philippines, Lito Atienza, said that the surveys conducted by SWS and Pulse Asia were misleading, because the participants were not fully informed of the bill, were merely aware of it, and informed that it was about health and "modern methods". Instead he referred to the Filipino Family survey of December 2009 conducted by the HB&A International (an affiliate of Louis Harris & Associates) together with the personnel of Asia Research Organization (the Philippine affiliate of Gallup International). The survey concluded that 92% of people in Metro Manila rejected the bill, and that many did not know what its provisions were.[32] While Mangahas acknowledged that the SWS surveys did not include the penalties,[68] advocates of the bill state that the December 2009 survey used leading questions. [edit]Penalties One of the strongest criticism against the bill, even from its supporters, centers on the penal provisions, which have been called "coercive," a violation of free choice and conscience, and "totalitarian" in its approach to dissenters.[69] There is "mandatory" sex education starting grade 5, and malicious "disinformation" is penalized.[7] All health care service providers, including faith-based hospital administrators, may be imprisoned or fined if they fail to provide reproductive health care services such as providing services like ligation and vasectomy. The same may happen to employers who do not provide free services to employees.[7] Imprisonment ranges from (1) month to six (6) months or a fine ranging from Ten Thousand Pesos (P10,000.00) to Fifty Thousand Pesos

(P50,000.00).[7] Former Finance Secretary, Roberto de Ocampo, stated that these punitive provisions "are tantamount to an affront to civil liberties and smack of religious persecution."[33] Defending the bill, Dr. Felipe Medalla, former dean of the School of Economics of UP, said that "Although the poors access to family planning services can be improved even without the law, the absence of the law makes it easier to block the program." [edit]Separation of church and state Because 81% of Filipinos are Catholics, the Catholic Church exerts a strong influence in public life. Its staunch opposition to the bill has drawn the ire of non-Catholics and Catholics alike who support the bill, and they invoke the principle of separation of church and state to stop the church. Fr. Joaquin Bernas, S.J, one of the drafters of the Philippine Constitution and a prominent lawyer and writer, explained that the concept of separation of church and state is directed towards the state, rather than the church, as it is a political concept. Technically it means non-establishment of religion, as the Constitution stated that No law shall be passed respecting an establishment of religion ... It means that the state should be guided by the principle that it should support no specific religion. This means that government funding should not be allocated for building churches or mosques, and not favor any particular religion. It does not prevent the church, parents, supervisors, teachers and other moral educators from expressing their views and educating their wards on the morality of their personal and social actions. Proponents, on the other hand, state that the church should not meddle in matters of the state, and should focus on religious matters, not political matters. [edit]Culture war and its implications

Millenium Development Goals at the UN

The national debate is seen as part of a wider culture war.[70][71] Passage or nonpassage of the bill have negative implications depending on the views. Proponents state that the non-passage of the bill will mean keeping the Philippines in a backward state and unable to achieve the Millennium Development Goals, especially the points on poverty alleviation and maternal health. It will mean reneging on international commitments and will slow down modernization. Also the poor will not have free access to family planning support that many have expressed desires to have, and thus will have more children than they can care for, and will not have the money to invest in education to break the intergenerational poverty they are trapped in. Proponents also accuse the Catholic Church of holding the Philippines "hostage" and violating the separation of church and state.[72] They argue that a decreased population growth will lead to improved quality of life and economic development. Opponents of the bill see the bill as allowing the Filipinos to be fooled by the deceptive manipulations of American imperialism and eugenicist control, using United Nations Agencies for its own national interests, and to use Philippines' own national funds to kill the youngest Filipinos, harm its own mothers, and encourage immorality. They see the bill as an act of disrespect and ingratitude to the Catholic Church that works for the poor and the sick, and for the education and development of Filipinos.[24][71] They accuse the Philippine Legislator's Committee on Population and Development as "essentially a foreign body" that has drafted the bills, and that its "2008 lobbying fund of two billion pesos comes from the David and Lucile Packard Foundation, IPPF and UNFPA the latter two both well known for their global agenda to legalize abortion."[71] They say that a two-child policy will make the country fail to cash in on a possible demographic dividend of rapid economic growth, and great reduction of poverty, a chance for complete modernization without destruction of human life and promotion of immorality.
[39][40]

[edit]Status [edit]Legislature On January 31, 2011, six different bills were consolidated into a single RH Bill which was then unanimously approved for plenary debate by the House Committee on Population and Family Relations. On February 7, 2011, the bill was scheduled to go before the House Appropriations Committee. February 16, 2011 the bill was endorsed by the House Appropriations Committee with amendment and referred back to the Population Committee for finalizing the language.

[edit]President

and Cabinet

President Noynoy Aquinowill provide contraceptives to parents who ask, but will not promote its use.

President Noynoy Aquino during the presidential campaign said that it confounds him why he is always associated with the RH Bill and reiterated that he is neither an author nor a co-author, much less did he sign the committee report regarding the bill. He said that "he will fully support the crafting of a firm policy that will address the serious problem on population."[34] At the same time, Aquino said that "artificial contraception was a matter of choice and conscience and that health professionals who fool people into using artificial contraceptives should be penalized. As a Catholic, Aquino said he himself was not promoting artificial contraception but believes that the government should be able to provide it to Filipinos who ask for it." Aquino stressed: "Im a Catholic, Im not promoting it. My position is more aptly called responsible parenthood rather than reproductive health."[35] According to Rina Jimenez David who is pro-RH, during the Women Deliver Philippines Conference held September 2010, Dinky Soliman, Aquino's Secretary of Social Welfare and Development, said that "choice and access constituted the keystone of the Aquino governments policy, reiterating the administrations support for the pending reproductive health bills.[73] The Cabinet and the CBCP have agreed to have a joint campaign providing full information on the advantages and risks of contraceptives, natural and artificial family planning and responsible parenthood. They have established a technical working group for this purpose. They also agreed that government will not be an "instrument to enforce or violate the conscience of the people about these issues." [edit]Compromise

and alternatives

Senate PresidentJuan Ponce Enrile, Congressman Roilo Golez and Buhay party-list separately filed bills that seek to restrict abortion and birth control use. These bills have been seen either as a nullification of the RH Bill, its alternative, or as a way of achieving unity among the populace, since the RH Bill proponents have stated their concern in preventing abortion. Presidential candidate Gilbert Teodoro or Gibo suggested a cash transfer from the government to individuals wanting access to family planning methods, whether natural or artificial. The individuals can then make use of the cash they receive to purchase birth control devices they may choose, thus guaranteeing freedom of choice.[74] The Loyola School of Theology and the John J. Carroll Institute on State and Church Issues issued 9 "Talking Points" on the RH Bill. Among other points, they proposed a study on the meaning of conception in the Constitution, and if it means fertilization, abortifacients "are to be banned even now and regardless of whether the RH Bill is passed". They also proposed "parallel programs for providing information and training, one for Natural Family Planning (NFP) and another for artificial methods of family planning".[75] Columnist Jose Sison of the Philippine Star criticized this: a Catholic School of theology has actually proposed in public, the use of tax payers money to train Filipinos to employ methods that are objectively and intrinsically evil and cites "empirical evidence and scientific proofs confirming the harmful and evil effects of contraceptives to individuals and to society."[76] [edit]Recent

Events

In September 2010, Aquino during this visit to the US reiterated his stand that he is in favor of responsible parenthood and respects the decision of each couple as to the number of children they want, and if they need the government support for contraception, then the government will provide it. This statement has created a furor as Catholic church leaders say that Aquino has sold out the Filipino soul in exchange for some "measly" aid from the United States. The President of the Catholic Bishops Conference said that there can possibly be an excommunication of the President if he continues on with his stance. Pro RH Bill Senators encouraged the President to be steadfast to do his duties towards the state. The President's spokesperson Edwin Lacierda explained that the President "has not changed his stand" and is reaching out to the prelates and said that the President himself has not made any decision in support of the Reproductive Health Bill as he is still studying the document. Lacierda said that

the Executive Branch "is not involved in the passage of the RH bill, saying the measure's fate rests solely on the legislative branch." Filipino Freethinkers, an association of agnostics, atheists, progressives, etc., who have been very active in the fight in favor of the RH bill, stepped up the pressure, creating more controversy that fired up renewed interest in the bill on both sides. On 30 September 2010, one of the freethinkers, Carlos Celdran staged a protest action against the Catholic Church, holding a sign which read "DAMASO" -- a reference to the villainous, corrupt clergyman Father Dmaso of the novel Noli Me Tangere by Filipino revolutionary writer Jose Rizal -- and shouting "stop getting involved in politics!" A fan page, Free Carlos Celdran was created in Facebook, which generated 23,808 fans in 24 hours. Francisco Montalvan of the Inquirer said that in the end the Damasos are the scheming, corrupt and deceptive people, implying that the "pro-death advocates" are these, while the Cardinal Rosales who started a nationwide fund for the poor is very far from Damaso. Meanwhile, the Imam Council of the Philippines, the top leaders of the Moslem population which at 4.5 M constitutes 5% of the Philippine population, declared that they are against contraceptives since using them "underestimates God," and "makes one lose morality in the process." During the first public hearing on Nov 24, the chair of the Committee on Population handling the bill said that there is no instruction from the Speaker of the House to expedite the bill. Upon the call of anti-RH congressmen, the Committee Chair decided to refer the bill also to the Committee on Health, since the bill is about Reproductive Health. Leader of the pro-RH group, Elizabeth Ansioco, said that the bill is doomed if it is referred to the Committee on Health. Anti-RH Deputy Speaker Congressman Pablo Garcia said the members of the Committee on Health know of the WHO announcement on the carcinogenicity of combined estrogen-progestogen oral contraceptives. House Speaker Belmonte said that Congress is not likely to rush the legislation of the bill and will tackle it in plenary early next year. Belmonte said it is better that highly contentious bills be given more attention. On 3 December, the Senate cut the proposed budget of P 880M for contraceptives down to P 8M for condoms since other contraceptives violated the Constitution's ban on abortifacients, and Senator Tito Sotto III said that his constituents never asked for contraceptives. Iglesia ni Cristo (INC) has expressed support for the Reproductive Health (RH) Bill. In a letter to House population and family relations committee chairman Rep. Rogelio Espina

on October 2010, INC Executive Minister Eduardo Manalo said the bill needs to be passed. [edit]International reactions [edit]European

Union

European Union Ambassador to the Philippines Alistair MacDonald said "We have all seen the figures on illegal abortion a year in the Philippines and I very much hope that both Houses of Congress will take these issues into account in producing a reproductive health legislation which will really help people make their own choices and to provide for their families."[77] MacDonald said that lack of effective access to reproductive health services in the Philippines was 'antithetical' to the countrys struggle against poverty and "It seems to me extremely unlikely that the Philippines will be able to meet its commitment under the MDGs under the present policy."[77] MacDonald noted that the total fertility rate for the richest quintile of the population is 2.0, while the total fertility rate of the poorest quintile is 5.9. The total fertility rate for women with a college education is 2.3, about half that of women with only elementary education (4.5). He mentioned that the lack of access to RH services is anti-women, citing the slow decline in the maternal mortality ratio in the Philippines. He also said surveys suggest that the total wanted fertility rate for the Philippines is 2.4 children, or below the actual TFR of 3.3 children.[77] [edit]International

scholars

An international group of conservative catholic scholars, including George Weigel, Mary Ann Glendon, Thomas Lickona have expressed opposition to the bill in a one-page ad in the major newspapers of the Philippines, entitled Population Control Does Not Reduce Poverty. They refer to the RAND Corporation study of 2003, which states that "Most economic analysis has examined the statistical correlation between population and economic growth and found little significant connection... there is little cross-country evidence that population growth impedes or promotes economic growth... The neutralist theory has been the dominant view since the mid-1980s... population neutralism has in fact been the predominant school in thinking among academics about population growth for the last half-century."[17] The international scholars stressed that "Corruption, lack of education, and lack of opportunity cause poverty. The poor are victims of poverty, not the cause of poverty... HB 96 seeks to establish a government-managed program of population management

and demographic targets in the Philippines. This policy is based on incorrect economics assumptions."