(VIDEO) The Forsaken Women of the Philippines: The Hardship, Humiliation, and Hypocrisy of Unsafe Abortion

Marcy Bloom

Although perhaps not completely shocking to those of us in the reproductive health and justice movement, the encompassing newly published Forsaken Lives: The Harmful Impact of the Philippine Criminal Abortion Ban by the innovative Center for Reproductive Rights is both incredibly powerful and devastating as it discusses in detail “the human suffering caused by the criminal ban on abortion [in the Philippines] and the challenges it creates for health service providers.”

Far too often in this world the subjugation and suffering of women takes on forms that are nothing short of shocking. Although perhaps not completely shocking to those of us in the reproductive health and justice movement, the encompassing newly published Forsaken Lives: The Harmful Impact of the Philippine Criminal Abortion Ban by the innovative Center for Reproductive Rights is both incredibly powerful and devastating as it discusses in detail “the human suffering caused by the criminal ban on abortion [in the Philippines] and the challenges it creates for health service providers.” By examining and exposing “human rights violations resulting from the imposition of a criminal prohibition on abortion…based on the experiences of women who have undergone unsafe abortion procedures and survived to tell their stories,” for the first time, this important report reveals the impact of these oppressive abortion restrictions on the lives of women and their families from a human rights vantage point

The report is striking as it reveals the tremendous discrimination, hardships, hypocrisy, lies, violence, and abuse that women and girls suffer as they seek desperate solutions to their unplanned pregnancies. Globally, roughly 70,000 girls and women suffer and die from unsafe abortion procedures every year from the 20 million unsafe abortions that occur every year. Many times that number suffer debilitating health conditions resulting from the same. 

In the Philippines, the basic status of abortion is that it is illegal, banned by the rule of law in the present constitution that pronounces–among its policies–the recognition of the Filipino family as the foundation of the nation and that the state shall equally protect the life of the mother and the life of the unborn from conception. As a result of this “equal protection” ban that disallows safe and legal abortion, approximately 20 percent of all maternal deaths in the country are due to unsafe abortion. In 2008 alone, there were an estimated 560,000 abortions performed annually in the Philippines, which resulted in 90,000 hospitalizations of women from abortion-related complications and an eventual 1,000 deaths. Tragic, preventable deaths…. 

The Philippines is one of a handful of countries in the world that bans abortions in all circumstances with no clear exceptions, not even for the life of the woman. Women and girls who obtain abortions risk prosecution and a prison sentence of up to six years. This also applies to anyone providing or assisting in the procedure; medical professionals risk the loss of their licenses. The obvious public health crisis, human rights violations, and gender inequality of Filipino women are rampant as they suffer and die from their country’s extreme abortion ban. “Criminalization of abortion has not prevented abortion in the Philippines, but it has made it extremely unsafe.” This is not new–it is a well-documented global theme that we have seen time and time again in those countries with restrictive abortion laws. But it remains tragic, heart-breaking, and unnecessary when women die from preventable causes that so clearly would improve their health, save their lives, and preserve their dignity.   

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Further, a 2007 Reuters article describes abortion in the country as “a national secret” where abortion is very common, yet rarely discussed publicly and where the influence of the Catholic Church is nothing short of overwhelming. Catholic clerics have been relentless in their ability to prevent any liberalization of any reproductive health/women’s health initiatives, including contraceptive policies, which in effect prohibit access to virtually all forms of birth control that would prevent unintended pregnancies (and hence the need for abortion) in the first place. In its typical oppressive form, the Catholic hierarchy does throw women a crumb and urges the use of natural family planning rather than the birth control pill or condoms.

According to Father Melvin Castro, executive secretary of the Episcopal Commission on Family and Life: “The natural family planning method is a good option, not only a good one, but an effective one.”  How and what does he know? Talk about inaccuracy and hypocrisy. In this country of 880 inhabited islands, where the population is currently estimated at 90 million, and is expected to reach 142 million by 2040, the limited and broken societal infrastructure, the culture of corruption, and constant presence of pervasive poverty are vividly seen in the eyes of women longing for a better life and future for themselves and the children they already have.

According to an extensive 2006 Guttmacher Institute report Unintended Pregnancy and Induced Abortion in the Philippines, over 50 percent of Filipinas who have had abortions were not using any family planning. Of those who were practicing some method of birth control, three-fourths were using only the church-sanctioned methods of rhythm or withdrawal. (Did you say effective, Father Castro? That appears to be very wrong…).  Further, it is estimated that most Filipinas who have abortions are married, Roman Catholic, and have at least three children. The majority of these women terminate their pregnancies because they cannot afford another child–a well-known situation of the clear and basic human need for survival.

Less than 25 percent of these women who have an abortion obtain a surgical procedure. The rest (30 percent) either ingest herbs, other concoctions, or drugs such as the anti-ulcer Cytotec/misoprostol without medical supervision; insert catheters or other objects in their vaginas; drink alcohol or use hormonal drugs (20 percent); starve themselves or throw themselves down stairs; or find a traditional midwife–known as a hilot–to violently pound/crush their lower abdomens in the hopes of inducing what is an extraordinarily painful and horrific abortion. Most Filipinas only succeed in ending their pregnancies after multiple and dangerous attempts–once again, demonstrating yet another universal truth: That when a woman has decided that she must have an abortion–that it is truly the only choice given the conditions of her life–she will literally do anything and everything to obtain one, even risking her life and health.

And in the Philippines, even when women are able to seek out help for the life-threatening medical complications that are caused by such desperate and brutal measures, far too many are treated harshly by the doctors and nurses who seek to punish them. In fact, pain-killers are often withheld because

some “doctors feel that women need to feel the pain [resulting from the unsafe abortions] so that they will remember it and not do it again.”

Did we say ignorant, punitive, cruel, and a total lack of compassion and understanding of women’s needs, lives, and realities as to why they need the abortion in the first place? 

Forsaken Women reminds us:

“As is the case, most women who are forced to resort to unsafe abortion in the Philippines belong to the lower economic rungs of society, although even more affluent women with better access to health care are known to turn to unsafe abortion…”

The report skillfully goes on to discuss the horrific impact of stigmatizing abortion; making the procedure inaccessible in any and all situations, including pregnancy dangers to the life and health of the woman; the governmental denial of access to effective birth control; the degrading and violent treatment of women seeking post-abortion care; the marginalization of post-abortion care in the health care system (due to lack of resources, lack of training, and negative attitudes); gender-based violence and the denial of women’s full equality; as well as the pervasive power of the Catholic hierarchy that transcends the government’s obligation to guarantee the separation of church and the resultant brutal sacrificing of women’s health needs and lives as a result.

These key findings are illustrated by the heart-breaking stories of Maricel, Haydee, Mercedes, Isabel, Mylene, Cieo, Ana, and Lisa, some of whom died and all of whom suffered from the violence of illegal abortion and the misogynist policies of their country. Their stories and voices cry out for true societal change and full recognition as complete human beings needing compassion and support and with full moral agency to make ethical decisions about their pregnancies that are right and necessary for their lives and survival.

Nancy Northup, the president of the Center for Reproductive Rights, stated unequivocally (August 2nd, 2010 New York Times):

“Manila [the capital of the Philippines and seat of the federal government] has created a dire human rights crisis” with hundreds of thousands of women resorting to unsafe abortion “to protect their health, their families, and their livelihood. Yet, the government sits idly by, refusing to tackle the issue or reform the policies that exacerbate it.” The Philippine government … [has] an obligation to break the silence around the issue of unsafe abortion and enable the voices of women to become a basis for change…”

In closing, Lisa’s story of seeking out post-abortion care in a hospital and her powerful words noted below cry out for so much: her health, dignity, justice, compassion, confidentiality, equality, and a complete end to legal, judicial, medical, and societal harassment, neglect, stigmatization, discrimination, and humiliation:

“In the morning, around 7 a.m., a nurse put a [large sign] at the foot of my bed. Written on it was the word  ‘abortion.’ They put that sign for me. Every patient who had a D &C had an abortion sign…There were only two of us who had a D&C… with the abortion sign…There was no chart with my name, only the word abortion…”

So…this is the standard scenario in the Philippines…a modern day scarlet letter designed to punish and frighten.  Lisa greeted her at the hospital where she reluctantly and desperately needed medical attention.  I mentioned at the beginning that this report contained shocking information…and the shock may remain with you for a long time as you read through it. I may have heard these tragic and heavy stories before, but I always remember that each one represents a terrified woman and I still become angry and impassioned. I hope to never become accustomed to any of them.

Lisa speaks for the 1,000 Filipinas and the nearly 70,000 women who die from illegal abortions each year and the 20 million who suffer from the brutality of illegal abortions. She is one of them…and so are we all.

ADDENDUM: The CRR report has provoked this reaction by a women’s rights advocate who is calling for the legalization of abortion, in at least some circumstances in the Philippines, as noted today in the Manila Standard…

Culture & Conversation Family

‘Abortion and Parenting Needs Can Coexist’: A Q&A With Parker Dockray

Carole Joffe

"Why should someone have to go to one place for abortion care or funding, and to another place—one that is often anti-abortion—to get diapers and parenting resources? Why can’t they find that support all in one place?"

In May 2015, the longstanding and well-regarded pregnancy support talkline Backline launched a new venture. The Oakland-based organization opened All-Options Pregnancy Resource Center, a Bloomington, Indiana, drop-in center that offers adoption information, abortion referrals, and parenting support. Its mission: to break down silos and show that it is possible to support all options and all families under one roof—even in red-state Indiana, where Republican vice presidential candidate Gov. Mike Pence signed one of the country’s most restrictive anti-abortion laws.

To be sure, All-Options is hardly the first organization to point out the overlap between women terminating pregnancies and those continuing them. For years, the reproductive justice movement has insisted that the defense of abortion must be linked to a larger human rights framework that assures that all women have the right to have children and supportive conditions in which to parent them. More than 20 years ago, Rachel Atkins, then the director of the Vermont Women’s Center, famously described for a New York Times reporter the women in the center’s waiting room: “The country really suffers from thinking that there are two different kinds of women—women who have abortions and women who have babies. They’re the same women at different times.”

While this concept of linking the needs of all pregnant women—not just those seeking an abortion—is not new, there are actually remarkably few agencies that have put this insight into practice. So, more than a year after All-Options’ opening, Rewire checked in with Backline Executive Director Parker Dockray about the All-Options philosophy, the center’s local impact, and what others might consider if they are interested in creating similar programs.

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Rewire: What led you and Shelly Dodson (All-Options’ on-site director and an Indiana native) to create this organization?

PD: In both politics and practice, abortion is so often isolated and separated from other reproductive experiences. It’s incredibly hard to find organizations that provide parenting or pregnancy loss support, for example, and are also comfortable and competent in supporting people around abortion.

On the flip side, many abortion or family planning organizations don’t provide much support for women who want to continue a pregnancy or parents who are struggling to make ends meet. And yet we know that 60 percent of women having an abortion already have at least one child; in our daily lives, these issues are fundamentally connected. So why should someone have to go to one place for abortion care or funding, and to another place—one that is often anti-abortion—to get diapers and parenting resources? Why can’t they find that support all in one place? That’s what All-Options is about.

We see the All-Options model as a game-changer not only for clients, but also for volunteers and community supporters. All-Options allows us to transcend the stale pro-choice/pro-life debate and invites people to be curious and compassionate about how abortion and parenting needs can coexist .… Our hope is that All-Options can be a catalyst for reproductive justice and help to build a movement that truly supports people in all their options and experiences.

Rewire: What has been the experience of your first year of operations?

PD: We’ve been blown away with the response from clients, volunteers, donors, and partner organizations …. In the past year, we’ve seen close to 600 people for 2,400 total visits. Most people initially come to All-Options—and keep coming back—for diapers and other parenting support. But we’ve also provided hundreds of free pregnancy tests, thousands of condoms, and more than $20,000 in abortion funding.

Our Hoosier Abortion Fund is the only community-based, statewide fund in Indiana and the first to join the National Network of Abortion Funds. So far, we’ve been able to support 60 people in accessing abortion care in Indiana or neighboring states by contributing to their medical care or transportation expenses.

Rewire: Explain some more about the centrality of diaper giveaways in your program.

PD: Diaper need is one of the most prevalent yet invisible forms of poverty. Even though we knew that in theory, seeing so many families who are struggling to provide adequate diapers for their children has been heartbreaking. Many people are surprised to learn that federal programs like [the Special Supplemental Nutrition Program for Women, Infants, and Children or WIC] and food stamps can’t be used to pay for diapers. And most places that distribute diapers, including crisis pregnancy centers (CPCs), only give out five to ten diapers per week.

All-Options follows the recommendation of the National Diaper Bank Network in giving families a full pack of diapers each week. We’ve given out more than 4,000 packs (150,000 diapers) this year—and we still have 80 families on our waiting list! Trying to address this overwhelming need in a sustainable way is one of our biggest challenges.

Rewire: What kind of reception has All-Options had in the community? Have there been negative encounters with anti-choice groups?

PD: Diapers and abortion funding are the two pillars of our work. But diapers have been a critical entry point for us. We’ve gotten support and donations from local restaurants, elected officials, and sororities at Indiana University. We’ve been covered in the local press. Even the local CPC refers people to us for diapers! So it’s been an important way to build trust and visibility in the community because we are meeting a concrete need for local families.

While All-Options hasn’t necessarily become allies with places that are actively anti-abortion, we do get lots of referrals from places I might describe as “abortion-agnostic”—food banks, domestic violence agencies, or homeless shelters that do not have a position on abortion per se, but they want their clients to get nonjudgmental support for all their options and needs.

As we gain visibility and expand to new places, we know we may see more opposition. A few of our clients have expressed disapproval about our support of abortion, but more often they are surprised and curious. It’s just so unusual to find a place that offers you free diapers, baby clothes, condoms, and abortion referrals.

Rewire: What advice would you give to others who are interested in opening such an “all-options” venture in a conservative state?

PD: We are in a planning process right now to figure out how to best replicate and expand the centers starting in 2017. We know we want to open another center or two (or three), but a big part of our plan will be providing a toolkit and other resources to help people use the all-options approach.

The best advice we have is to start where you are. Who else is already doing this work locally, and how can you work together? If you are an abortion fund or clinic, how can you also support the parenting needs of the women you serve? Is there a diaper bank in your area that you could refer to or partner with? Could you give out new baby packages for people who are continuing a pregnancy or have a WIC eligibility worker on-site once a month? If you are involved with a childbirth or parenting organization, can you build a relationship with your local abortion fund?

How can you make it known that you are a safe space to discuss all options and experiences? How can you and your organization show up in your community for diaper need and abortion coverage and a living wage?

Help people connect the dots. That’s how we start to change the conversation and create support.

This interview has been edited for length and clarity.

CORRECTION: This article has been updated to clarify the spelling of Shelly Dodson’s name.

News Abortion

Study: Telemedicine Abortion Care a Boon for Rural Patients

Nicole Knight

Despite the benefits of abortion care via telemedicine, 18 states have effectively banned the practice by requiring a doctor to be physically present.

Patients are seen sooner and closer to home in clinics where medication abortion is offered through a videoconferencing system, according to a new survey of Alaskan providers.

The results, which will be published in the Journal of Telemedicine and Telecare, suggest that the secure and private technology, known as telemedicine, gives patients—including those in rural areas with limited access—greater choices in abortion care.

The qualitative survey builds on research that found administering medication abortion via telemedicine was as safe and effective as when a doctor administers the abortion-inducing medicine in person, study researchers said.

“This study reinforces that medication abortion provided via telemedicine is an important option for women, particularly in rural areas,” said Dr. Daniel Grossman, one of the authors of the study and professor of obstetrics, gynecology, and reproductive sciences at the University of California San Francisco (UCSF). “In Iowa, its introduction was associated with a reduction in second-trimester abortion.”

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Maine and Minnesota also provide medication abortion via telemedicine. Clinics in four states—New York, Hawaii, Oregon, and Washington—are running pilot studies, as the Guardian reported. Despite the benefits of abortion care via telemedicine, 18 states have effectively banned the practice by requiring a doctor to be physically present.

The researchers noted that even “greater gains could be made by providing [medication abortion] directly to women in their homes,” which U.S. product labeling doesn’t allow.

In late 2013, researchers with Ibis Reproductive Health and Advancing New Standards in Reproductive Health interviewed providers, such as doctors, nurses, and counselors, in clinics run by Planned Parenthood of the Great Northwest and the Hawaiian Islands that were using telemedicine to provide medication abortion. Providers reported telemedicine’s greatest benefit was to pregnant people. Clinics could schedule more appointments and at better hours for patients, allowing more to be seen earlier in pregnancy.

Nearly twenty-one percent of patients nationwide end their pregnancies with medication abortion, a safe and effective two-pill regime, according to the most recent figures from the U.S. Centers for Disease Control and Prevention.

Alaska began offering the abortion-inducing drugs through telemedicine in 2011. Patients arrive at a clinic, where they go through a health screening, have an ultrasound, and undergo informed consent procedures. A doctor then remotely reviews the patients records and answers questions via a videoconferencing link, before instructing the patient on how to take the medication.

Before 2011, patients wanting abortion care had to fly to Anchorage or Seattle, or wait for a doctor who flew into Fairbanks twice a month, according to the study’s authors.

Beyond a shortage of doctors, patients in Alaska must contend with vast geography and extreme weather, as one physician told researchers:

“It’s negative seven outside right now. So in a setting like that, [telemedicine is] just absolutely the best possible thing that you could do for a patient. … Access to providers is just so limited. And … just because you’re in a state like that doesn’t mean that women aren’t still as much needing access to these services.”

“Our results were in line with other research that has shown that this service can be easily integrated into other health care offered at a clinic, can help women access the services they want and need closer to home, and allows providers to offer high-level care to women from a distance,” Kate Grindlay, lead author on the study and associate at Ibis Reproductive Health, said in a statement.

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