When a Country Cracks Down on Contraception: Grim Lessons from the Philippines

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Ted Aljibe / AFP / Getty Images

Young women shout pro-reproductive-health slogans during a protest march to the parliament building to mark the 100th International Women's Day in Manila on March 8, 2011

The U.S. is once again at battle over birth control. It started with President Barack Obama’s “compromise” on mandatory coverage for contraceptives and has evolved into national shouting match about faith, family and fundamental rights. At the center of it all is Republican presidential hopeful Rick Santorum, a conservative Catholic who is against abortion — yes, even in cases of rape and incest — and says he “personally” opposes birth control. Poll data suggest that when it comes to contraception, Santorum is out of step with his would-be constituents; the vast majority of Americans, including Catholics, do not oppose birth control. Many do, however, back his ultra-conservative stance on abortion, making this a good time to reflect on what the U.S. can learn from the global campaign for reproductive rights.

Those who cast contraception as a private, personal matter ought to consider the case of the Philippines.Over the past few decades, as most of the world has embraced family planning, the majority-Catholic nation has waged war on reproductive rights. There, abortion is strictly prohibited and crackdowns on contraception are common. Church officials promote what they call “natural” family planning: women are advised to track their cycle and abstain from sex on all but their least fertile days. They cast “artificial” contraception as an affront to God’s will, a gateway to abortion and a threat to public health. In their minds, condoms are “abortifacients” and family-planning campaigners are, as Archbishop Paciano Aniceto told me in 2008, “propagandists of a culture death.”

(MORE: The Philippines Cracks Down on Contraception)

This type of thinking has led several jurisdictions to try to curb the use of modern contraception. For much of the past decade, for instance, the city of Manila kept birth control from city-funded clinics. The architects of the plan told me that it was designed to discourage promiscuity and, as much as possible, keep public funds away from private vice. The evidence suggests the bill did little to promote abstinence (what Aniceto called “self-mastery”) and did much to hurt women’s health. A report by the Center for Reproductive Rights documented a relative rise in maternal mortality, a slew of unwanted pregnancies and evidence of injury caused by clandestine abortions.

And it’s not just Manila. The church’s decades-old campaign against modern contraception has led to an epidemic of unsafe abortions in the Philippines. The country’s high unmet need for contraception means that almost half of pregnancies are unwanted and about 500,000 per year result in abortion. All too often, these procedures are unsafe. Every year, an estimated 60,000 Filipinas are injured trying to terminate a pregnancy. About 1,000 die from abortion-related complications.

(MORE: Santorum Doesn’t Shy Away from Social Issues)

Clearly, the Philippines is not the U.S. But I do think it offers a striking example of how a restrictive approach to reproductive rights can — and has — hurt women. Behind the Manichaean religious rhetoric espoused by some conservative Catholics hide plain truths about public health: access to contraception decreases maternal mortality and lowers the number of abortions. This is true in the Philippines and it is true in the U.S., as TIME Ideas contributor Erika Christakis outlines in her standout piece on the birth control battle:

An estimated half of all pregnancies in the U.S. are unintended according to an analysis by researchers at the Guttmacher Institute and published in the journal Perspectives on Sexual and Reproductive Health, and of those unplanned pregnancies, a further half end in abortion. That’s an awful lot of unwanted children and fetuses. By age 45, more than 40% of all American women will have had at least one abortion, a rate almost twice that of Western Europe. A comprehensive study by the World Health Organization confirmed that abortion rates in countries that prohibit or restrict legal abortion are no different than abortion rates in countries with liberal abortion laws; the only reliable way to reduce abortion is through the provision of affordable, accessible contraception. To cap off last week’s debate came the news that there has been a surge in births outside marriage, the fastest growth being among white women in their 20s with some college education. More than half of births to women under 30 now occur outside of marriage. Is this really a time to try to limit contraception? What about the reckoning of the reality of human lives?

And there it is: reckoning with the reality of human lives, and saving them too.

MORE: Philippines: Hope, Finally, for a Family-Planning Law

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