(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…

Analysis Human Rights

El Salvador Bill Would Put Those Found Guilty of Abortion Behind Bars for 30 to 50 Years

Kathy Bougher

Under El Salvador’s current law, when women are accused of abortion, prosecutors can—but do not always—increase the charges to aggravated homicide, thereby increasing their prison sentence. This new bill, advocates say, would heighten the likelihood that those charged with abortion will spend decades behind bars.

Abortion has been illegal under all circumstances in El Salvador since 1997, with a penalty of two to eight years in prison. Now, the right-wing ARENA Party has introduced a bill that would increase that penalty to a prison sentence of 30 to 50 years—the same as aggravated homicide.

The bill also lengthens the prison time for physicians who perform abortions to 30 to 50 years and establishes jail terms—of one to three years and six months to two years, respectively—for persons who sell or publicize abortion-causing substances.

The bill’s major sponsor, Rep. Ricardo Andrés Velásquez Parker, explained in a television interview on July 11 that this was simply an administrative matter and “shouldn’t need any further discussion.”

Since the Salvadoran Constitution recognizes “the human being from the moment of conception,” he said, it “is necessary to align the Criminal Code with this principle, and substitute the current penalty for abortion, which is two to eight years in prison, with that of aggravated homicide.”

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The bill has yet to be discussed in the Salvadoran legislature; if it were to pass, it would still have to go to the president for his signature. It could also be referred to committee, and potentially left to die.

Under El Salvador’s current law, when women are accused of abortion, prosecutors can—but do not always—increase the charges to aggravated homicide, thereby increasing their prison sentence. This new bill, advocates say, would worsen the criminalization of women, continue to take away options, and heighten the likelihood that those charged with abortion will spend decades behind bars.

In recent years, local feminist groups have drawn attention to “Las 17 and More,” a group of Salvadoran women who have been incarcerated with prison terms of up to 40 years after obstetrical emergencies. In 2014, the Agrupación Ciudadana por la Despenalización del Aborto (Citizen Group for the Decriminalization of Abortion) submitted requests for pardons for 17 of the women. Each case wound its way through the legislature and other branches of government; in the end, only one woman received a pardon. Earlier this year, however, a May 2016 court decision overturned the conviction of another one of the women, Maria Teresa Rivera, vacating her 40-year sentence.

Velásquez Parker noted in his July 11 interview that he had not reviewed any of those cases. To do so was not “within his purview” and those cases have been “subjective and philosophical,” he claimed. “I am dealing with Salvadoran constitutional law.”

During a protest outside of the legislature last Thursday, Morena Herrera, president of the Agrupación, addressed Velásquez Parker directly, saying that his bill demonstrated an ignorance of the realities faced by women and girls in El Salvador and demanding its revocation.

“How is it possible that you do not know that last week the United Nations presented a report that shows that in our country a girl or an adolescent gives birth every 20 minutes? You should be obligated to know this. You get paid to know about this,” Herrera told him. Herrera was referring to the United Nations Population Fund and the Salvadoran Ministry of Health’s report, “Map of Pregnancies Among Girls and Adolescents in El Salvador 2015,” which also revealed that 30 percent of all births in the country were by girls ages 10 to 19.

“You say that you know nothing about women unjustly incarcerated, yet we presented to this legislature a group of requests for pardons. With what you earn, you as legislators were obligated to read and know about those,” Herrera continued, speaking about Las 17. “We are not going to discuss this proposal that you have. It is undiscussable. We demand that the ARENA party withdraw this proposed legislation.”

As part of its campaign of resistance to the proposed law, the Agrupación produced and distributed numerous videos with messages such as “They Don’t Represent Me,” which shows the names and faces of the 21 legislators who signed on to the ARENA proposal. Another video, subtitled in English, asks, “30 to 50 Years in Prison?

International groups have also joined in resisting the bill. In a pronouncement shared with legislators, the Agrupación, and the public, the Latin American and Caribbean Committee for the Defense of the Rights of Women (CLADEM) reminded the Salvadoran government of it international commitments and obligations:

[The] United Nations has recognized on repeated occasions that the total criminalization of abortion is a form of torture, that abortion is a human right when carried out with certain assumptions, and it also recommends completely decriminalizing abortion in our region.

The United Nations Committee on Economic, Social, and Cultural Rights reiterated to the Salvadoran government its concern about the persistence of the total prohibition on abortion … [and] expressly requested that it revise its legislation.

The Committee established in March 2016 that the criminalization of abortion and any obstacles to access to abortion are discriminatory and constitute violations of women’s right to health. Given that El Salvador has ratified [the International Covenant on Economic, Social and Cultural Rights], the country has an obligation to comply with its provisions.

Amnesty International, meanwhile, described the proposal as “scandalous.” Erika Guevara-Rosas, Amnesty International’s Americas director, emphasized in a statement on the organization’s website, “Parliamentarians in El Salvador are playing a very dangerous game with the lives of millions of women. Banning life-saving abortions in all circumstances is atrocious but seeking to raise jail terms for women who seek an abortion or those who provide support is simply despicable.”

“Instead of continuing to criminalize women, authorities in El Salvador must repeal the outdated anti-abortion law once and for all,” Guevara-Rosas continued.

In the United States, Rep. Norma J. Torres (D-CA) and Rep. Debbie Wasserman Schultz (D-FL) issued a press release on July 19 condemning the proposal in El Salvador. Rep. Torres wrote, “It is terrifying to consider that, if this law passed, a Salvadoran woman who has a miscarriage could go to prison for decades or a woman who is raped and decides to undergo an abortion could be jailed for longer than the man who raped her.”

ARENA’s bill follows a campaign from May orchestrated by the right-wing Fundación Sí a la Vida (Right to Life Foundation) of El Salvador, “El Derecho a la Vida No Se Debate,” or “The Right to Life Is Not Up for Debate,” featuring misleading photos of fetuses and promoting adoption as an alternative to abortion.

The Agrupacion countered with a series of ads and vignettes that have also been applied to the fight against the bill, “The Health and Life of Women Are Well Worth a Debate.”

bien vale un debate-la salud de las mujeres

Mariana Moisa, media coordinator for the Agrupación, told Rewire that the widespread reaction to Velásquez Parker’s proposal indicates some shift in public perception around reproductive rights in the country.

“The public image around abortion is changing. These kinds of ideas and proposals don’t go through the system as easily as they once did. It used to be that a person in power made a couple of phone calls and poof—it was taken care of. Now, people see that Velásquez Parker’s insistence that his proposal doesn’t need any debate is undemocratic. People know that women are in prison because of these laws, and the public is asking more questions,” Moisa said.

At this point, it’s not certain whether ARENA, in coalition with other parties, has the votes to pass the bill, but it is clearly within the realm of possibility. As Sara Garcia, coordinator of the Agrupación, told Rewire, “We know this misogynist proposal has generated serious anger and indignation, and we are working with other groups to pressure the legislature. More and more groups are participating with declarations, images, and videos and a clear call to withdraw the proposal. Stopping this proposed law is what is most important at this point. Then we also have to expose what happens in El Salvador with the criminalization of women.”

Even though there has been extensive exposure of what activists see as the grave problems with such a law, Garcia said, “The risk is still very real that it could pass.”

Analysis Law and Policy

Indiana Court of Appeals Tosses Patel Feticide Conviction, Still Defers to Junk Science

Jessica Mason Pieklo

The Indiana Court of Appeals ruled patients cannot be prosecuted for self-inducing an abortion under the feticide statute, but left open the possibility other criminal charges could apply.

The Indiana Court of Appeals on Friday vacated the feticide conviction of Purvi Patel, an Indiana woman who faced 20 years in prison for what state attorneys argued was a self-induced abortion. The good news is the court decided Patel and others in the state could not be charged and convicted for feticide after experiencing failed pregnancies. The bad news is that the court still deferred to junk science at trial that claimed Patel’s fetus was on the cusp of viability and had taken a breath outside the womb, and largely upheld Patel’s conviction of felony neglect of a dependent. This leaves the door open for similar prosecutions in the state in the future.

As Rewire previously reported, “In July 2013 … Purvi Patel sought treatment at a hospital emergency room for heavy vaginal bleeding, telling doctors she’d had a miscarriage. That set off a chain of events, which eventually led to a jury convicting Patel of one count of feticide and one count of felony neglect of a dependent in February 2015.”

To charge Patel with feticide under Indiana’s law, the state at trial was required to prove she “knowingly or intentionally” terminated her pregnancy “with an intention other than to produce a live birth or to remove a dead fetus.”

According to the Indiana Court of Appeals, attorneys for the State of Indiana failed to show the legislature had originally passed the feticide statute with the intention of criminally charging patients like Patel for terminating their own pregnancies. Patel’s case, the court said, marked an “abrupt departure” from the normal course of prosecutions under the statute.

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“This is the first case that we are aware of in which the State has used the feticide statute to prosecute a pregnant woman (or anyone else) for performing an illegal abortion, as that term is commonly understood,” the decision reads. “[T]he wording of the statute as a whole indicate[s] that the legislature intended for any criminal liability to be imposed on medical personnel, not on women who perform their own abortions,” the court continued.

“[W]e conclude that the legislature never intended the feticide statute to apply to pregnant women in the first place,” it said.

This is an important holding, because Patel was not actually the first woman Indiana prosecutors tried to jail for a failed pregnancy outcome. In 2011, state prosecutors brought an attempted feticide charge against Bei Bei Shuai, a pregnant Chinese woman suffering from depression who tried to commit suicide. She survived, but the fetus did not.

Shuai was held in prison for a year until a plea agreement was reached in her case.

The Indiana Court of Appeals did not throw out Patel’s conviction entirely, though. Instead, it vacated Patel’s second charge of Class A felony conviction of neglect of a dependent, ruling Patel should have been charged and convicted of a lower Class D felony. The court remanded the case back to the trial court with instructions to enter judgment against Patel for conviction of a Class D felony neglect of a dependent, and to re-sentence Patel accordingly to that drop in classification.

A Class D felony conviction in Indiana carries with it a sentence of six months to three years.

To support Patel’s second charge of felony neglect at trial, prosecutors needed to show that Patel took abortifacients; that she delivered a viable fetus; that said viable fetus was, in fact, born alive; and that Patel abandoned the fetus. According to the Indiana Court of Appeals, the state got close, but not all the way, to meeting this burden.

According to the Indiana Court of Appeals, the state had presented enough evidence to establish “that the baby took at least one breath and that its heart was beating after delivery and continued to beat until all of its blood had drained out of its body.”

Therefore, the Court of Appeals concluded, it was reasonable for the jury to infer that Patel knowingly neglected the fetus after delivery by failing to provide medical care after its birth. The remaining question, according to the court, was what degree of a felony Patel should have been charged with and convicted of.

That is where the State of Indiana fell short on its neglect of a dependent conviction, the court said. Attorneys had failed to sufficiently show that any medical care Patel could have provided would have resulted in the fetus surviving after birth. Without that evidence, the Indiana Court of Appeals concluded, state attorneys could not support a Class A conviction. The evidence they presented, though, could support a Class D felony conviction, the court said.

In other words, the Indiana Court of Appeals told prosecutors in the state, make sure your medical experts offer more specific testimony next time you bring a charge like the one at issue in Patel’s case.

The decision is a mixed win for reproductive rights and justice advocates. The ruling from the court that the feticide statute cannot be used to prosecute patients for terminating their own pregnancy is an important victory, especially in a state that has sought not just to curb access to abortion, but to eradicate family planning and reproductive health services almost entirely. Friday’s decision made it clear to prosecutors that they cannot rely on the state’s feticide statute to punish patients who turn to desperate measures to end their pregnancies. This is a critical pushback against the full-scale erosion of reproductive rights and autonomy in the state.

But the fact remains that at both trial and appeal, the court and jury largely accepted the conclusions of the state’s medical experts that Patel delivered a live baby that, at least for a moment, was capable of survival outside the womb. And that is troubling. The state’s experts offered these conclusions, despite existing contradictions on key points of evidence such as the gestational age of the fetus—and thus if it was viable—and whether or not the fetus displayed evidence of life when it was born.

Patel’s attorneys tried, unsuccessfully, to rebut those conclusions. For example, the state’s medical expert used the “lung float test,” also known as the hydrostatic test, to conclude Patel’s fetus had taken a breath outside the womb. The test, developed in the 17th century, posits that if a fetus’ lungs are removed and placed in a container of liquid and the lungs float, it means the fetus drew at least one breath of air before dying. If the lungs sink, the theory holds, the fetus did not take a breath.

Not surprisingly, medical forensics has advanced since the 17th century, and medical researchers widely question the hydrostatic test’s reliability. Yet this is the only medical evidence the state presented of live birth.

Ultimately, the fact that the jury decided to accept the conclusions of the state’s experts over Patel’s is itself not shocking. Weighing the evidence and coming to a conclusion of guilt or innocence based on that evidence is what juries do. But it does suggest that when women of color are dragged before a court for a failed pregnancy, they will rarely, if ever, get the benefit of the doubt.

The jurors could have just as easily believed the evidence put forward by Patel’s attorneys that gestational age, and thus viability, was in doubt, but they didn’t. The jurors could have just as easily concluded the state’s medical testimony that the fetus took “at least one breath” was not sufficient to support convicting Patel of a felony and sending her to prison for 20 years. But they didn’t.

Why was the State of Indiana so intent on criminally prosecuting Patel, despite the many glaring weaknesses in the case against her? Why were the jurors so willing to take the State of Indiana’s word over Patel’s when presented with those weaknesses? And why did it take them less than five hours to convict her?

Patel was ordered in March to serve 20 years in prison for her conviction. Friday’s decision upends that; Patel now faces a sentence of six months to three years. She’s been in jail serving her 20 year sentence since February 2015 while her appeal moved forward. If there’s real justice in this case, Patel will be released immediately.