[Trigger warning: this article contains subjects and themes on abortion and related activities. Reader discretion is advised – Ed.]
By Henrylito D. Tacio
During the recent Senate plenary debate for the 2024 budget of the Commission on Human Rights (CHR), a heated discussion ensued when the issue of abortion was brought up by Senator Alan Peter Cayetano, due to the stand of CHR executive director Atty. Jacqueline Ann de Guia on it. Director De Guia advocates for the decriminalization of abortion.
Responding to Cayetano, De Guia said she was only pushing for the decriminalization of abortion particularly when the life of the mother is in danger.
But that’s a “weak excuse,” Cayetano responded. “Pag dine-criminalize mo, [para mong sinabi na] pwede na ‘yun. How can you protect the unborn if you’re not going to put any penalty on people who abort the fetus or baby?”
According to Cayetano, while the employees of CHR may express their personal opinions, abortion is not one of the issues they should be advocating for. “I do not mind opinions, it is their right, especially on contemporary human rights issues,” he said. “But as far as abortion is concerned, it is settled in our Philippine Constitution,” he added, citing Article 2 Section 12 of the 1987 Constitution. The said article emphasizes, “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.”
Therapeutic and selective abortion
Around the world, the status of abortion varies from being legally banned, to being available on request. Since 1930, abortion has been a crime under Philippine law. Some lawyers consider the Philippine law on abortion as “among the most restrictive in the world.” The reason: “it contains no express provision for any kind of exemption from criminal liability.”
There are actually two types of abortion: therapeutic and selective. Therapeutic abortion means terminating the pregnancy of a woman if it threatens her life, and the fetus is not viable ex utero.
Generally, therapeutic abortion is reportedly done in any of these situations: when there is a risk of maternal survival caused by the embryo, and when the pregnancy impairs maternal life.
“One situation that I can think of, wherein the life of the mother is in danger, is ectopic pregnancy,” Dr. Nelly Quintin-Dela Cruz, a consultant in Obstetrics and Gynecology at the Manila Doctors Hospital, was quoted as saying. “This may endanger the life of the mother especially if it ruptures inside and causes profuse internal bleeding.”
Selective abortion, on the other hand, is terminating a pregnancy due to the fetus having undesirable characteristics. The reasons for the abortion are due to the following: the fetus being defective, the fetus is a product of a rape, the parent is not ready to have a child, and other cultural, societal reasons (for example, in societies where having a female child is frowned upon, such a female fetus may be elected for abortion, while a male fetus would ensure that the pregnancy will be carried out to term).
Articles 256, 258 and 259 of the Revised Penal Code
The United Nations considered therapeutic abortion as acceptable, but the Philippines stands firm in its anti-abortion stand. Articles 256, 258 and 259 of the Revised Penal Code of the Philippines mandate imprisonment for the woman who undergoes the abortion, as well as for any person who assists in the procedure, even if they are the woman’s parents, a physician, or a midwife.
Article 258 further imposes a higher prison term on the woman or her parents if the abortion is undertaken “in order to conceal (the woman’s) dishonor.”
Because abortion is criminalized in the Philippines, a culture of stigma and impunity prevails. “Filipino women who seek treatment for complications from unsafe abortion have repeatedly reported [on the prevalent stigma around abortion]… this means that healthcare workers are unwilling to provide care, or only treat women [after ‘punishing’ those who have undergone abortions by threatening to report them to the police], harassing women verbally and physically, or delaying care,” the Center for Reproductive Rights pointed out.
In a perfect world, no one would prefer to undergo an abortion. But we are living in an imperfect world.
In the Philippines, studies show that two-thirds of women who have undergone abortions attempted to self-induce abortion, or sought solutions from those who practiced folk medicine or hilot. “About 1,000 die each year from abortion complications, which contributes to the nation’s high maternal mortality ratio,” Lawrence B. Finer and Rubina Hassain wrote in their 2013 report for Guttmacher Institute. “Ten of thousands of women are hospitalized each year for complications from unsafe abortion.”
Dr. Michael L. Tan, author of Abortion: Realities and Responsibilities, says that there are many different abortion methods used in the Philippines, to wit:
· Plants and plant preparations. Many of these plants probably induce contractions of smooth muscles, such as those in the uterus. Sometimes, people think the plants work because their menstruation “returns.” In reality, the menstruation was probably only delayed.
· Physical methods. Massage and abdominal pressure are applied by the hilot, or sometimes by the pregnant woman herself. This is a terrible painful method and is dangerous, especially in more advanced pregnancies. Physical pressure is used to induce uterine contractions but these may not be enough to expel the fetus.
· Insertion of catheters. Women have been known to insert hangers, brooms, walis tingting. These often lead to infections.
· Dilation and currettage. Usually, this is done with women who had already started the abortion, in which case it is called completion currettage. There are, however, clandestine clinics that use raspa (as it is called locally) to induce an abortion.
· Menstrual regulation. This involves the use of suction or vacuum aspiration to terminate a very early pregnancy (usually in the first few weeks).
· Drugs. There are many Western drugs that people use to attempt to induce an abortion. These include medicines such as quinine, an anti-malarial; methylergometrin, a uterine stimulant, and methotrexate, an anti-cancer drug. With some of these drugs, an abortion is actually a side effect. In other cases, the drug used may even have the opposite effect on a pregnancy. Bricanyl (generic name: terbutaline) is perceived as an abortifacient in large doses, but the drug actually delays labor rather than inducing an abortion. One widely used drug, misoprostol (Cytotec), is actually a drug used to prevent ulcers, but has abortion as a side effect. Because its use as an abortifacient is illegal, the drug is used on a trial-and-error basis, which then creates problems.
Complications of unsafe abortions
“The risk of complications from an abortion is related to the length of the pregnancy and the abortion method used,” explains The Merck Manual of Medical Information. “The longer a woman has been pregnant, the greater the risk.”
The manual cites the following complications: “The uterus is perforated by a surgical instrument in 1 of 1,000 abortions. Sometimes, the intestine or another organ is also injured. Severe bleeding occurs during or immediately after the procedure.
“Some techniques can tear the cervix, especially during the second trimester of pregnancy. Later, infections or blood clots in the legs may develop. Bleeding can occur if part of the placenta is left in the uterus.”
But all these complications could be avoided if and when abortion is done in a hospital. “Complications are uncommon when an abortion is performed by a trained health care practitioner in a hospital or clinic,” the Merck manual notes.
“Unsafe abortion is a very serious public health issue, a silent scourge,” commented a health officer, who oversees the monitoring of abortion cases and maternal deaths for the health department. He explained that there were attempts to address unsafe abortion through initiatives like more vigorous family planning but is almost always opposed by the church and anti-abortion groups. – ###
