From the Medical Viewpoint
(updated version) Melissa Poblete, DMD, MHPEd

Why do we say no to the RH bill?
1)We are against all forms of contraception that kill a conceived life! The RH bill will make sure all forms of contraceptive products, devices and medicines, are included with purchase of ESSENTIAL MEDICINES in LGUs Through mandatory sex education, it will teach our young people about these contraceptives.

When does life begin?
Medical science tells us when a new life begins ± (Embryology) Advances in technology enable us to see or witness fetal development like never before ± 3-D and 4-D Ultrasound, Intra-uterine 4IntraPhotography, fetal monitors, fetal doppler

When does life begin?

From A.D.A.M. Medical Encyclopedia

Science Lesson!
Prior to fertilization: You have haploid cells (the sperm and the egg) Haploid=containing half (23) of the number of chromosomes in other cells of the body (46) only for reproductive cells (gametes)

At fertilization: Haploid gametes combine together to form a diploid zygote, a genetically different individual from the mother and father The zygote now has 46 chromosomes(that¶s a new life!) All the cells in his or her body will have 46 chromosomes except his or her future gametes (sperm cells or eggs)

What Medical Textbooks Say
³Each human being starts his life, his very being, as an ordinary cell called the zygote, measuring less than 0.2 mm in diameter.´ Essentials of Human Embryology, S.M. Bhatnagar et. al., 1983, Orient Longman, India

What Medical Textbooks Say
³The male and female sex cells or gametes«unite at fertilization to initiate the embryonic development of a new individual.´ ³Fertilization takes place in the oviduct (fallopian tubes)... resulting in the formation of a zygote containing a single diploid nucleus.´ ³Embryonic development is considered to begin at this point.´ ³This moment of zygote formation may be taken as the beginning or zero time point of embryonic development." development." Essentials of Human Embryology (pp. 1-17) 1Larsen, W.J. 1998. Churchill Livingstone, New York.

What Medical Textbooks Say
"Zygote: this cell results from the union of an oocyte(egg) and a sperm. A zygote is the beginning of a new human being (i.e., an embryo). Human development begins at fertilization, the fertilization, process during which a male gamete or sperm ... unites with a female gamete or oocyte(egg) ... to form a single cell called a zygote. This highly specialized, totipotent(multi-potential) cell marks the totipotent(multibeginning of each of us as a unique individual. individual. The Developing Human: Clinically Oriented Embryology by Moore, K. and T.V.N. Persaud. 1998. (6th ed.), W.B. Saunders Company, Philadelphia. (pp 2-18) 2-

Development of the Baby
There are different terms for the new baby. But these are just terms describing the stage of development : zygote, morula, blastocyst, embryo, fetus But it is the very same baby! And when the baby is born he or she is called a neonate, infant, toddler, etc. He or she is still the very same baby!

What Medical Textbooks Say
How does the cell (zygote) develop? ³Through a chronicle of development, characterized by the gradual and sequential development of a wide variety of structures, nowhere present to start structures, with, with, by cellular processes of multiplication, migration, differentiation, and assembly of diverse cell types, leading to the formation of organs and systems.´ Essentials of Human Embryology, S.M. Bhatnagar et. al., 1983, Orient Longman, India

Your existence started at the point of conception Fetal Development is part of the continuous timeline of your growth as a human being Therefore, any contraceptive that works after fertilization or conception kills a human being or is called an abortifacient (causes abortion, even though an early one) If something stopped you from implanting in your mother¶s womb, YOU WOULD NOT BE HERE!

What the Medical Professionals Say
The critical event that assigns humanness is conception. All subsequent changes are those of increased size and complexity, not an alteration of the essential nature of the fetus. Dr. D. Brady-West, DM BradyMedical Practitioner, Jamaica

What Medical Textbooks Say
Embryology is the study of the prenatal period of creation of an individual starting from conception to the birth of a child. Growth in the prenatal and postnatal periods is a continuous process. The event of birth marks the process. difference between the two periods and entails sudden and drastic changes in respiration and circulation. Obstetrics is essentially applied embryology. The embryology. problems of normal and abnormal labor, antenatal and postnatal care can be readily tackled with an understanding of embryology. Essentials of Human Embryology, S.M. Bhatnagar et. al., 1983, Orient Longman, India

Which contraceptives can stop a fertilized egg from implanting?
Intrauterine device (IUD)- has both pre(IUD)prefertilization and post-fertilization effect postOral contraceptive pills and injectables (as a third effect)
± First effect: stops ovulation (not all of the time) ± Second effect : prevents sperm from migrating to the fallopian tube ± Third effect: prevents implantation of fertilized egg (when breakthrough ovulation occurs, as prevention of ovulation is not 100% foolproof)

Emergency contraceptives- prevent implantation contraceptives; rejection of an implanted embryo

IUD ±mechanism of action-there is actiona post-fertilization effect postThere are many potential mechanisms of action for the intrauterine device (IUD), which vary by type of IUD (inert, copper, or hormonal). On the basis of available data for fertilization rates and clinical pregnancy rates, the relative contribution of mechanisms acting before or after fertilization were quantitatively estimated. These estimates indicate that, although prefertilization effects are more prominent for the copper IUD, both prefertilization and postfertilization mechanisms of action contribute significantly to the effectiveness of all types of intrauterine devices. Mechanisms of action of intrauterine devices: update and estimation of postfertilization effects. Am J Obstet Gynecol. 2002; 187(6):1699-708 187(6):1699Stanford JB; Mikolajczyk RT Department of Family and Preventive Medicine, University of Utah Health Research Center, Salt Lake City 84108, USA.

Plus: Hormonal contraceptives are not safe for women!
They increase the risk for venous thrombosis (blood clotting in the veins) They increase the relative risk of developing breast cancer, according to cancer research journals (not the reproductive health journals)- because journals)breast cells are affected by synthetic hormones

Netherlands: 1524 OC users vs 1760 non-users nonCurrently available oral contraceptives increased the risk of venous thrombosis fivefold compared with non-use nonThe venous thrombotic risk of oral contraceptives, effects of oestrogen dose and progestogen type: results of the MEGA case-control study caseBritish Medical Journal. 2009 Aug 13;339:b2921

US study of 116,608 women from 1989 to 2001
Current use of oral contraceptives carries an excess risk of breast cancer. Levonorgestrel used in triphasic preparations may account for much of this elevation in risk. Oral contraceptive use and breast cancer: a prospective study of young women. Hunter, DJ et al Cancer Epidemiology, Biomarkers & Prevention Journal ; 2010 Oct;19(10):2496-502. Epub 2010 Aug 27. Oct;19(10):2496(American Association for Cancer Research)

Synthetic progestins increase risk of developing breast cancer
There is now considerable evidence that using a combination of synthetic progestins and estrogens in hormone replacement therapy (HRT) increases the risk of breast cancer compared with estrogen alone. Furthermore, the World Health Organization has recently cited combination contraceptives, which contain synthetic progestins, as potentially carcinogenic to humans, particularly for increased breast cancer risk. Disruption of androgen receptor signaling by synthetic progestins may increase risk of developing breast cancer.
FASEB(Federation of American Societies for Experimental Biology) Journal. 2007 Aug;21(10):2285-93. Epub 2007 Apr 5.Birrell SN, et al Aug;21(10):2285.Dame Roma Mitchell Cancer Research Laboratories, The University of Adelaide, Hanson Institute, PO Box 14, Rundle Mall, South Australia, 5000, Australia.

Continued: Disruption of androgen action by synthetic progestins may have serious deleterious side effects in the breast, breast, where the balance between estrogen signaling and androgen signaling plays a critical role in breast homeostasis. Here, we review the role of androgen signaling in the normal breast and in breast cancer and present new data demonstrating that androgen receptor function can be perturbed by low doses of MPA(medroxyprogesterone acetate), similar to MPA(medroxyprogesterone doses achieved in serum of women taking HRT. We propose that the observed excess of breast malignancies associated with combined HRT may be explained, in part, by synthetic progestins such as MPA acting as endocrine disruptors to negate the protective effects of androgen signaling in the breast.

Philippine data-UP Manila study dataWomen who are currently on combined oral contraceptives or who have used them in the last 10 years are at a slightly increased risk of having breast cancer diagnosed and additional cancers diagnosed tend to be localized to the breast. There is no evidence of an increased risk 10 or more years after stopping use PostPost-menopausal women are at an increased risk of having breast cancer diagnosed while on hormone replacement therapy (HRT) and in the 5 years after stopping use, relative risk was increased by 2.7% for each year of use. There is no evidence of an increased risk of breast cancer 5 or more years after stopping HRT Cancer and the Philippine Cancer Control Program Ngelangel,CA and Wang, EHM Japanese Journal of Clinical Oncology (2002) 32(suppl 1): S52S52S61.doi: 10.1093/jjco/hye126

On the Philippine Breast Cancer Network: "Some of the causes of breast cancer ... can only be controlled by political and social action aimed at reducing the production, use, transport and disposal of agents that directly or indirectly affect breast cancer risks." risks."- Environmental Health Perspectives, September 1998 Following this recommendation above, logically, the government ³must reduce the production, use, transport and disposal of hormonal contraceptives.´-because contraceptives.´hormonal contraceptives directly increase breast cancer risk. Yet the RH bill will include these breast-cancer-riskbreast-cancer-riskincreasing hormonal contraceptives together with the purchase of essential medicines (Section 10) for all national and local hospitals!

Also,IUDs can cause puncturing of body parts and life-threatening lifebacterial infections

IUD in large intestine
from Journal of the Society of Laparoendoscopic Surgeons 2010 Jul-Sep Jul-

IUD in bladder

Canadian Urology Association Journal 2010 Oct;4(5):E141-3. Oct;4(5):E141Intravesical migration of an intrauterine device detected in a pregnant woman. Tosun M, Celik H, Yavuz E, Cetinkaya MB. Department of Obstetrics and Gynecology, Ondokuz Mayis, Samsun, Turkey.

IUD: Penetration into the descending colon (large intestine)
Case: a patient visited our hospital and complained of a vague lower abdominal pain that had been present for three months. She had an intrauterine device (IUD) inserted five years earlier. The abdominal X-ray, Xcomputed tomography and colonoscopy revealed that the IUD had penetrated into the descending colon. We tried to remove the IUD by colonoscopy but failed due to pain, so we removed the IUD surgically. Penetration of the descending colon by a migrating intrauterine contraceptive device. J Korean Soc Coloproctology. 2010 Dec;26(6):433-6. Epub Dec;26(6):4332010 Dec 31.Park JM, et al. Department of Internal Medicine, Good Gang-An Hospital, GangBusan, Korea.

IUD: Ovarian abscess from actinomycosis
Case: a 35-year-old female with an intrauterine 35-yeardevice (IUD) who appeared in the emergency department with clinical characteristics of appendicitis. Ultrasound and computed tomography were performed, revealing an ovarian tumor formation and acute appendicitis. The patient underwent exploratory laparotomy, unilateral ovarectomy due to acute abscess and finally appendectomy. The role of IUD as a factor in the dissemination of the infection is very important. Actinomycosis of the appendix and pelvis: a case report. J Reprod Med. 2008; 53(9):711-3 53(9):711Peitsidis P et al Department of Obstetrics and Gynecology, Alexandra General Hospital, Athens, Greece.

IUD: Pseudomonas: abscesses of ovary and fallopian tube and pelvis
Case: a 35-year-old woman with an IUD for 6 years 35-yearwith pelvic inflammatory disease (PID) . Authors implemented antibiotic therapy. Her clinical course worsened, and exploratory surgery revealed a right tubotubo-ovarian abscess with multiple loculated pelvic abscesses. Culture of the IUD found heavy growth of Pseudomonas aeruginosa. Pseudomonas aeruginosa-infected IUD associated with aeruginosapelvic inflammatory disease. A case report. J Reprod Med. 2002; 47(12):1035-7 47(12):1035King JA; Olsen TG; Lim R; Nycum LR Department of Obstetrics and Gynecology, David Grant Medical Center, Travis Air Force Base, CA 94535, USA

Pelvic actinomycosis from IUD ->death
Case: 49-year-old woman who had been using an intrauterine 49-yearcontraceptive device for 20 years. The pelvic actinomycosis in her case led to sepsis and consequently to her death. Colonisation with Actinomyces israeli in women using IUD may amount up to even 20%. 20%. [Pelvic actynomycosis as the result of a long standing use of an intrauterine device. Case report] Ginekol Pol. 2007; 78(12):995-7 78(12):995Grabiec M; et al Katedra i Klinika Ginekologii Onkologicznej i Pielegniarstwa Ginekologicznego, Uniwersytetu Mikoaja Kopernika w Toruniu, Collegium Medicum im. Ludwika Rydygiera w Bydgoszczy.

Are these ³medically safe´ devices? NO!
Section 2: The RH Bill says that the State shall guarantee ³universal access to medically safe, legal, affordable, effective, quality RH care services, methods, devices, supplies´. They are also not legal since our 1987 Constitution states in Article 2, Sec 12: Section 12. 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. Remember: IUDs have a post-fertilization effect! post-

Let¶s take a look at fetal development!

Intrauterine Photographs

4-week old baby in the womb

Intrauterine Photographs

6-week old baby in the womb

Intrauterine Photographs

8-week old baby in the womb

Intrauterine Photographs

Feet of 11-week old baby in the womb

Intrauterine Photographs

20-week old baby in the womb

Intrauterine Photographs

22-week old baby in the womb

Intrauterine Photographs

24-week old baby in the womb

Ordinary Ultrasound

3-D Ultrasound

4-D Ultrasound

Why we say no to the RH bill
2. Because it condones abortion The RH bill includes ³management of postpostabortion complications´ in its guiding principles (10th principle) and lists management of abortion complications as the 3rd element of reproductive health.This health.This is mentioned many times in the RH bill. In the RH bill, ³management of post-abortion postcomplications´ is considered a reproductive right.

The RH bill includes ³hazards of abortion´ in RH education(Section 16, 10th topic). Abortion is hazardous to women, yes, BUT: Remember: abortion is 100% hazardous to a baby! baby! There is no such thing as a ³safe abortion´! We cannot let abortion be condoned by a law!

In national crisis situations (devastations, calamities) while people are already suffering, the RH bill still wants ³management of post-abortion complications´. It groups post³management of post abortion complications´,which totally disregards the aborted baby¶s life,with necessary health care services like normal and complicated deliveries, pregnancy complications and miscarriage. (Section 8: Maternal and Newborn Health Care in Crisis Situations) Why are ³post-abortion complications´ bundled together ³postwith necessary maternal health care in crisis situations? Abortion is illegal. Management of post-abortion postcomplications disregards the aborted babies¶ lives.

All patients who have committed a crime, whether they are men or women, deserve compassionate and humane treatment when they have medical emergencies or complications stemming from the crime they committed. But the victim of the crime (the unborn baby) must never be forgotten!

The complication of abortion in an unborn baby is DEATH!

More than condoning: in Sec.2 in its Declaration of Policy the RH bill states: ³The State shall eradicate discriminatory practices, laws and policies that infringe on a person¶s exercise of reproductive rights.´ In countries where abortion is legal, abortion IS part of ³reproductive rights´ ³Eradicate laws´? ± this paves the way for legalization or decriminalization of abortion even if the Bill states that abortion remains illegal

How is abortion done?
Babies die through abortion by: Chemical abortion- taking /placing abortion³pampalaglag´; taking chemotherapy drugs; contraceptive pills and emergency contraceptives that prevent implantation; emergency contraceptives that cause the implanted embryo to die Surgical abortion- by doctors with no conscience abortionTrauma to the womb/baby- by ³hilot´ womb/baby-

Why is Abortion Wrong?
Because it is a sin against God Because it is murder in God¶s eyes ± Killing another human life shows contempt for God, who created that life ± The 6th Commandment: ³You shall not murder´ (Exodus 20:13) ± Abortion takes away another human life that is made in the image of God ± Abortion is the ultimate power grab- to choose grabbetween life and death.

Why Is Abortion Wrong?
Because it is the shedding of innocent blood and God hates the shedding of innocent blood ± Prov 6:16-19 There are six things the LORD 6:16hates, seven that are detestable to him: haughty eyes, a lying tongue, hands that shed innocent blood«

Why is Abortion Wrong?
Because it is ethically wrong EthicsEthics- a set of moral principles adopted by a profession or a society; defines right or wrong It is immoral to kill, that¶s why it¶s a crime to murder or kill another human being after he is born, from birth to natural death. In the same way, it is immoral to kill another human being before he or she is born, when he or she is still in the womb. It is immoral to choose who may live and who may not. Ex. Holocaust- Nazis chose death for the Jews Holocaust-

What the Medical Professionals Say
If the fetus is a human being, then the killing of the fetus (abortion) is homicide. Dr. D. Brady-West, DM BradyMedical Practitioner, Jamaica

Why is abortion wrong?
Because our Constitution upholds life In the Philippines, the State protects the life of its citizens from conception ± The State shall equally protect the life of the mother and the life of the unborn from conception. (Article II, Sec. 12 of the
1987 Constitution)

Why is abortion wrong?
Because in the Philippines, abortion is a crime The Revised Penal Code punishes abortion as a crime with fines and imprisonment both for the woman and the health professional who committed the crime of abortion
± Revised Penal Code, Book Two,Title EightEightCRIMES AGAINST PERSONS, Chapter OneOneDESTRUCTION OF LIFE, Section Two- Infanticide Twoand abortion. Article 255-259 255-

Why is abortion wrong?
Because abortion kills babies and hurts women PostPost-abortion syndrome= post-traumatic stress disorder: postguilt-->major guilt-->major depression, anger, nightmares, hallucinations Why is there guilt? Because a life was killed. Why don¶t we feel guilt when we have a mole, a gallbladder or an appendix removed? Because they are part of our bodies. But a baby is a different life from ours. Chemical and surgical abortion cause many complications in women: uterine perforation, lifelifethreatening bleeding, infertility, septicemia or lifelifethreatening infection of the blood There is no such thing as a ³safe abortion´ because abortion is 100% fatal to babies. Abortion tears apart bodies of children! Abortion is never an act of compassion.

Abortion promises power « brings powerlessness. Abortion promises freedom « brings lifelong bondage. Abortion promises a better role for women « brings destruction. Abortion promises to save relationships « destroys them instead. Abortion promises "reproductive health" « brings infertility and death. From a speech by Dr. Janice Crouse At the January Life Breakfast, Jan.22, 2008 Illinois, USA

How do we uphold the sanctity of life?
As human beings created by God We must oppose abortion, because we are all former fetuses.

How do we uphold the sanctity of life?
As Christians who love and follow Christ PRAY
± for women and their babies ± abortion will stop ± that God would expose those who commit the crime of abortion

Speak up for the defenseless (Proverbs 31:8) Rescue the dying who are being dragged to their deaths (Proverbs 24:11)

How do we uphold the sanctity of life?
As health professionals We must not view pregnancy as a disease or epidemic. We must always consider the fetus as a patient. We must never consider abortion as a part of health care. Abortion takes away a human life and therefore can never be an act of caring. It must not be part of health care. We must never recommend the use of abortifacient drugs (drugs that cause abortion). We must never recommend an abortion.

How do we uphold the sanctity of life?
As a Filipino: Actively support pro-life laws proSpeak up against abortion in our country Actively resist the legalization of abortion or the decriminalization of abortion Actively resist charter change that will seek to strike out protection of the unborn from conception Actively resist the use of abortifacient or abortionabortioncausing methods of artificial contraception Consider our large population a blessing Prevent the development of collective blindness of our society to the humanity of the unborn and to the evil of abortion .This blindness is pervasive in most Western societies.

How do we uphold the sanctity of life?
As a young person Teach your generation about the sanctity of human life Rescue the unborn generation Teach the next generation about the sanctity of human life

We say no to the RH bill! But not because we are antiantihealth or anti-women. We want women and children to antibe healthy, but not through the RH bill with all its oppressive and immoral provisions. We reject the RH bill because we believe life begins at conception. The RH bill will promote and uphold abortifacient contraceptives, contraceptives that are also harmful to women. We reject the RH bill because of its utter disregard for the life of the aborted baby through the oft-repeated oftphrase ³management of post-abortion complications´. post-

We uphold the sanctity of life, Because we fear God. Because we are made in God¶s image. Because we love our country. Because we love women and children. Because we value health of the born and the unborn.


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