The Heat is On: Reproductive Health as an Electoral Agenda in the Philippines

Carolina Austria

Editor's note: Today we welcome Carolina S. Ruiz-Austria, writing from the Philippines. She has experience in women's rights, law and journalism, and will be reporting on reproductive health in Southeast Asia.

In the tropics, where year-round warm weather is expected, summer temperatures hitting 33-36 degrees (Celsius) in Manila is still considered extreme.

But the summer heat isn't the only thing approaching fever like extremes. It is also the height of a mid-term electoral campaign. Politicians of every color and persuasion are making rounds to win votes.

Editor's note: Today we welcome Carolina S. Ruiz-Austria, writing from the Philippines. She has experience in women's rights, law and journalism, and will be reporting on reproductive health in Southeast Asia.

In the tropics, where year-round warm weather is expected, summer temperatures hitting 33-36 degrees (Celsius) in Manila is still considered extreme.

But the summer heat isn't the only thing approaching fever like extremes. It is also the height of a mid-term electoral campaign. Politicians of every color and persuasion are making rounds to win votes.

Who would think that something as mundane as condoms and pills, would ever figure as electoral issues? In a country with a Catholic hierarchy growing ever more conservative and influential in government policy-making, those seeking re-election have been known to conveniently change their positions on "reproductive health policy" at a drop of a hat.

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While previous and current surveys about family planning and contraception consistently demonstrate that Catholics aren't influenced by what the Catholic hierarchy dictates, Filipino politicians are an entirely different story.

In 2003, after coming out at one time strongly in support of the International Conference on Population and Development (ICPD) and at another time flatly refusing to fund family planning commodities in the national budget, President Gloria Macapagal Arroyo finally laid out her real position on Family Planning. The Department of Health and the Population Commission are now spearheading what is the exclusively Natural Family Planning (NFP) focused program of the Arroyo administration.

A city health administrator in a province just outside Metro Manila told me two weeks ago that the Mayor (who is the President's political ally and seeking re-election) has followed suit proclaiming himself "Pro-Life." In 2006, he defeated a local initiative (this time supported by the Vice Mayor, his political opponent), which could have funded the local demand for family planning commodities.

Her mayor wasn't the first to do so. Manila's mayor is the National President of Pro-Life Philippines and in 2001 he adopted a policy "discouraging" the use of modern family planning methods, labeling all of them as abortifacients. In turn, local government officials dependent on the city for funds interpreted it as a ban. In 2004 he was among those interviewed by the BBC and he unabashedly proclaimed his policy as such: a ban on modern contraception.

Here however, the "Pro-Choice/Pro-Life" distinction doesn't quite aptly sum up how the battle lines are drawn across the "official Catholic position" and the rest of what might be considered "liberal" positions. Apart from the vocal sections of the Catholic Bishop's conference, Catholics in politics, media, the health professions and even those leading the women's movement can be found on the other side of the debacle.

Like others working at the level of community health provision or the barangay, the city health administrator complained about the effects of the "stock-out " in pills and condoms brought about by the USAID phase out of donations, which began in 2001.

Yet the contest to fund family planning commodities isn't entirely due to just fickle individual politicians nor the USAID phase out. In 1991, the Philippines embarked on what was supposed to usher a shift in the mode of governance through an emphasis on "local autonomy." When the local government code was adopted, it was supposed to decentralize government services including the provision of basic health care. It fell in line with budget cuts across state provided services.

From 1992-2000, politics enjoyed a brief respite from the influential Catholic hierarchy when neither President Fidel V. Ramos (a protestant) and his successor in 1998, Joseph Estrada (a movie actor), gave the Catholic Bishops any special favors as far as health or population and development policy were concerned.

In turn, the Department of Health in those days outlined programs reflecting the Reproductive Health framework based on the ICPD. Years later, though none of those previous administrative orders were withdrawn, they have been overtaken by the current administration's insistence on NFP and with the President herself insisting that she is leaving it up to the local governments.

Stepping up to meet these challenges head on, is Abanse Pinay!, currently the only "feminist " political partylist which has a stated women's health and reproductive health centerpiece agenda. Along with broad movements pushing for the adoption of clear-cut reproductive health policy, Abanse's line-up includes Tessie Banaynal Fernandez (a women's rights activist from Lihok Pilipina in Cebu), Kalayaan Pulido (former Chief of Staff of Abanse elected representative Pat Sarenas), and Yasmin Lao (a Muslim feminist and peace activist).

Abanse Pinay (literally meaning "Forward, Filipino Women!") held office in the 11th and 12th Congress but failed to capture a seat in the last 2004 elections.

Yet the partylist system with all the egalitarian visions behind its adoption has certainly gone a long way from what the framers of the 1987 constitution intended it to be. A far cry from Abanse Pinay and other reputable partylists, a multitude of fake partylists have sprouted espousing all sorts of dubious agendas. Indeed the system which was supposed to allow for representation of erstwhile, marginalized sectors is under fire having been flooded by spawns of the traditional elite parties many of them allegedly funded by the President herself.

Photo caption: Campaign posters and paraphernalia litter every conceivable nook and cranny of the city streets despite the prohibition against posting campaign materials outside the designated areas. "Buhay" in Filipino literally means "life." A partylist running on a Catholic Church supported Pro-Life agenda it is seeking a second term in Philippine Congress. CSRA. 2007

Culture & Conversation Media

Abortion in ShondaLand: How the TV Producer Is Flipping the Script on Reproductive Health-Care Storytelling

Gretchen Sisson

As there have been more and more abortion stories on television in the past few years, it’s important to recognize how groundbreaking Shonda Rhimes’ work truly has been. Rhimes is a board member of Planned Parenthood of Los Angeles, and is clearly invested in how abortion is portrayed in our popular entertainment. Indeed, her shows are unique in these portrayals.

On Thursday night, a Shonda Rhimes show once again created waves for a storyline about abortion. And it wasn’t just a passing political mention or a detail of a peripheral character’s history. It was a full episode of Scandal, with the show’s primary protagonist, Olivia Pope, getting her own abortion, paired with former First Lady Mellie Grant, now a junior United States senator, filibustering a spending bill in support of Planned Parenthood.

As there have been more and more abortion stories on television in the past few years, it’s important to recognize how groundbreaking Rhimes’ work truly has been. Rhimes is a board member of Planned Parenthood of Los Angeles, and is clearly invested in how abortion is portrayed in our popular entertainment. Indeed, her shows are unique in these portrayals.

Our Abortion Onscreen research at Advancing New Standards in Reproductive Health has found that a notable proportion of television characters face adverse outcomes after their abortions. Rhimes’ characters don’t. We found that 87 percent of characters seeking abortions are white. Rhimes’ aren’t. And we found the characters that provided abortions were all either one-time providers or peripheral characters. The only exception was Addison Montgomery from Rhimes’ shows Grey’s Anatomy and Private Practice. While depicting abortion decision-making and provision is still somewhat novel in its own right, Rhimes is not only depicting it, but she’s depicting it in critically new, realistic ways.

Rhimes’ abortion stories have evolved, from Cristina Yang’s first abortion decision on Grey’s Anatomy to this week’s Scandal. In that early Grey’s Anatomy episode from 2005, the surgical intern planned an elective abortion only to discover that her pregnancy was ectopic and needed to be removed surgically. As Rhimes told TIME magazine, the plot twist “bugged [her] for years.” When Yang faced another unplanned pregnancy in 2011, she did get an elective abortion. The character, played by Sandra Oh, was determined and unapologetic about her abortion, and she directly challenged the commonly held idea that while abortion is often regrettable, parenthood never is.

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Later, on the Grey’s Anatomy spin-off Private Practice, abortion would become a recurring theme. Obstetrician Addison Montgomery (played by Kate Walsh) was an abortion provider, and proud to be. In one episode, she passionately proclaimed, “It is not enough just to have an opinion, because in a nation of over 300 million people, there are only 1,700 abortion providers. And I’m one of them.” This was a personal and political statement, acknowledging Montgomery’s commitment to providing abortions and recognizing the scarcity of providers in the United States. Montgomery also defended another doctor’s right to perform abortions within their practice, continually challenged her anti-choice colleague’s stance, and repeatedly mentioned anti-abortion violence and barriers to care. Beyond that, she disclosed her own history with abortion—and she was not the only physician on Private Practice to do so. On both Grey’s Anatomy and Private Practice, the lines blurred between those providing abortion care and those in need of it, showing viewers that women of all backgrounds face such decisions.

But Scandal has broken barriers that even these previous Rhimes shows did not. In an episode last May, character Olivia Pope (Kerry Washington) helped a young naval officer have an abortion after a sexual assault. In this storyline, viewers watched the abortion on-screen. Viewers saw the doctor’s hand turn the aspirator on, and the patient’s face and the doctor’s back during the procedure.

This was new territory. With few exceptions, previous abortion storylines—on Rhimes’ shows, and elsewhere—had almost always cut away as the procedure was about to begin. (The exceptions seemed to be ectopic pregnancy removals: Yang’s surgery was shown, as was a similar surgery on House. Interestingly, in both of these surgeries, the women intended to have elective terminations before they knew they had extrauterine pregnancies. However, on both of these medical shows, which featured other elective terminations, the procedures happened off-screen.) But Scandal showed the abortion directly—and it did again last week. In fact, the Scandal abortion scene depicted even more detail, showing the doctor at work. The doctor inserts the curette and the vacuum aspirator; then the viewer sees the doctor’s arm moving deliberately. Through her shows, Rhimes seems to represent the final veil on abortion care, putting the actual procedure on primetime network television.

In the accompanying filibuster plotline, Rhimes flips the script on reproductive health-care storytelling in two ways: She has a highly visible Republican senator filibustering and shutting down the Senate in support of Planned Parenthood, rather than in opposition to it. This suggests that support for reproductive health care should be a bipartisan issue, and that progressive values could, perhaps, be as dramatically showcased on the national level in a way viewers of the show have not yet seen in real life.

None of this is to say that these shows portrayed abortion without reflecting our culture’s stigma. Montgomery described abortion as “the most difficult and personal decision that there is.” On another occasion, before performing a second-trimester procedure, she said: “I hate what I’m about to do.” These lines communicate that abortion is hard and heartbreaking, while for many women it is not. On last week’s Scandal, Vice President Susan Ross used the talking point in the debate on the Senate floor that abortion “only makes up 3 percent of all Planned Parenthood business.” This fact, while true, stigmatizes and marginalizes abortion within other reproductive health care, suggesting that it is less appropriate than Planned Parenthood’s other services. Additionally, it promotes the “safe, legal, and rare” argument that abortion should only happen in a narrow set of specific circumstances deemed acceptable by others.

Furthermore, Rhimes’ depictions aren’t always the most realistic. Pope gets her abortion at an ambulatory surgical center (instead of an abortion clinic, where 70 percent of abortions are performed, according to the Guttmacher Institute), and the details such as Pope’s hairnet or the surgical lights seem to visually imply that an ASC setting is the expected standard for abortion care. Indeed, portraying the scene in such a way might convey to viewers that ASCs are necessary and appropriate for abortion care, ceding ground to aggressive anti-choice measures that force clinics to needlessly comply to ASC standards, which professional health networks have argued are not medically necessary.

Ultimately, though, it seems that Rhimes’ on-screen abortion stories do more work contesting abortion stigma than producing it. Last Thursday, on network primetime television, over eight million viewers watched a Republican senator and a vice president theatrically stand up for Planned Parenthood. They watched a woman of color have an abortion, and they saw a depiction of an abortion procedure. They saw Olivia Pope do this, without fear, without hesitation. Shonda Rhimes and her shows are pioneering how our popular culture represents abortion care—and these shows aren’t going away anytime soon. It remains to be seen which taboos she’ll break next.

Commentary Human Rights

Silencing Debate on Women’s Lives: It’s Happening in Wisconsin, Too, and the Catholic Church Is an Accomplice

Lon Newman

Victims and witnesses to reproductive coercion, intimidation, and bullying must try to speak up, seek help, or intervene as the situation requires. When it comes to public and political behavior, calling reproductive coercion what it is the first step to ending it.

Redux – The personal is political

Teaching children to understand and cope with bullies is essential, but bullying isn’t limited to elementary school. Bullying may not be physical or direct. It is persistent, intimidating, and it flourishes when victims and witnesses are afraid to speak up or speak out. It is time to identify reproductive coercion for what it is and call the bullies what they are.

Reproductive coercion” includes sabotage of birth control by abusive partners and occurs in all social and economic groups and most frequently to unmarried sexually active women. Male partners seek control over their partner’s reproductive options, even whether and when to have sex, to assert and maintain power.

Just as the pattern of intimidation, harassment, aggression and control is not limited to schools, reproductive coercion is not limited to interpersonal relations. It is ubiquitous at public forums, health care settings, legislative discourse, and campaign politics. This bullying is intended to intimidate, to silence people who disagree, to deny people access to health care they want or need, to pass legislation that denies reproductive justice, and to maintain power by opposing reproductive rights and justice.

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Last week, one of Family Planning Health Services’ (FPHS) employees was participating in a health fair sponsored by our local United Way and county health department. It happened to be hosted at a Catholic hospital. One of the medical directors required the employee to remove information on emergency contraception. The doctor then used post-it notes to obscure “prescription contraception” and “non-prescription contraception” on the FPHS display.

The hospital has been recognized for its work with sexual assault victims and the hospital president is on the state attorney general’s sexual assault task force. We can assume the hospital is in compliance with state law to provide emergency contraception in the emergency room and we know that many of the physicians provide prescription and non-prescription contraception to their patients. But, like the classic elementary school bully, the physician used position and status to censor and deny information to participants.

Victims and bystanders might excuse the bully; “I should have known this would provoke him,” or “I should have known better than to be in this neighborhood,” but motivation does not excuse intimidation, bullying and harassment.  On a public level we may understand religious objections, but using status, position, power, volume or force to control someone else’s reproductive health and behavior must be challenged and condemned if the culture of sexual coercion is to change.

Several days ago, Wisconsin’s State Senator Mike Ellis used the power of the majority and the gavel to silence debate and fast-track a bill that requires women to undergo a medically unnecessary ultrasound procedure and morality message before they can have an abortion. In our state assembly, our state representative shared her experience as a child rape victim and spoke very personally to how she felt as a victim and as the mother of three daughters, to a law requiring victims to undergo a re-invasion of privacy and self-control. On-line bullies vilified and harassed her for speaking out as a victim against the “pro-life” legislation.

There are self-styled “prayer warriors” standing outside our family planning clinics for a few months each year. They know that many of our patients and WIC participants/children are intimidated by their presence, but they justify the bullying on the basis of their religious beliefs about abortion, which we do not provide.

Victims and witnesses to reproductive coercion, intimidation and bullying must try to speak up, seek help, or intervene as the situation requires. When it comes to public and political behavior, calling reproductive coercion what it is the first step to ending it.