Philippine Reproductive Health Law

• The Responsible Parenthood and Reproductive Health Act of 2012, or RH Law is officially designated as Republic Act No. 10354.
• This Philippine law provides universal access to contraception, fertility control, sexual education, and maternal care.
• Provisions for maternal and child health are generally agreed upon.
• The mandate that the Philippine government and private sector will fund and distribute family planning devices is highly debated.
• Family planning devices include condoms, birth control pills, and IUDs.
• The government will disseminate information on the use of family planning devices through health care centers.
• Passage of the RH Law was controversial and divisive, with support and opposition from academics, religious institutions, and political figures.
• Heated debates and rallies took place nationwide.
• The Supreme Court delayed the implementation of the law in March 2013 and ruled that the law was "not unconstitutional" in April 2014.
• Eight provisions were struck down partially or in full by the Supreme Court.
• The history of reproductive health in the Philippines dates to 1967.
• President Ferdinand Marcos was among the heads of state who signed the Declaration on Population.
• 30 countries participated in the signing of the declaration, acknowledged by the U.N.
• The Philippines agreed that the population problem should be considered as the principal element for long-term economic development.
• The Population Commission was created to push for a lower family size norm and lower fertility rates.
• USAID began shouldering 80% of the total family planning commodities of the country in 1967.
• The amount was approximately $3 million annually.
• The U.S. adopted the National Security Study Memorandum 200 (NSSM200) as its policy in 1975.
• The policy gives "paramount importance" to population control measures and the promotion of contraception among 13 populous countries, including the Philippines.
• Population control in these countries was deemed important to U.S. sociopolitical national interests.
• The U.S. economy requires large and increasing amounts of minerals from abroad.
• These countries can produce destabilizing opposition forces against the U.S.
• The U.S. was recommended to "influence national leaders".
• "Improved world-wide support for population-related efforts should be sought through increased emphasis on mass media and other population education and motivation programs by the UN, USIA, and USAID."
• Ferdinand Marcos pushed for a systematic distribution of contraceptives all over the country.
• The systematic distribution was called "coercive" by its leading administrator.
• Corazon Aquino focused on giving couples the right to have the number of children they prefer.
• Fidel V. Ramos shifted from population control to population management.
• Joseph Estrada used mixed methods of reducing fertility rates, focusing on mainstreaming natural family planning.
• The Philippine Legislators' Committee on Population and Development (PLCPD) was established in 1989.
• PLCPD dedicated to the formulation of viable public policies requiring legislation on population management and socio-economic development.
• The Philippines signed the Millennium Declaration and committed to attain the Millennium Declaration Goals by 2015, including promoting gender equality and health in 2000.
• USAID started its phase out of a 33-year-old program by which free contraceptives were given to the country in 2003.
• Aid recipients such as the Philippines faced the challenge to fund its own contraception program.
• The Department of Health (DOH) introduced the Philippines Contraceptive Self-Reliance Strategy, arranging for the replacement of donated contraceptives with domestically provided contraceptives in 2004.
• The government announced a collaborative work with the USAID in implementing a comprehensive marketing and communications strategy in favor of family planning called May Plano Sila (They Have a Plan) in August 2010.

Consolidated Reproductive Health Bill Sections

• The Responsible Parenthood and Reproductive Health Act of 2012
• Declaration of Policy
• Guiding Principles
• Definition of Terms
• Midwives for Skilled Attendance
• Emergency Obstetric Care
• Access to Family Planning
• Maternal and Newborn Health Care in Crisis Situations
• Maternal Death Review
• Role of the Food and Drug Administration
• Procurement and Distribution of Family Planning Supplies
• Integration of Family Planning and Responsible Parenthood Component in Anti-Poverty Programs
• Roles of Local Government in Family Planning Programs
• Benefits for Serious and Life-Threatening Reproductive Health Conditions
• Mobile Health Care Service
• Mandatory Age-Appropriate Reproductive Health and Sexuality Education
• Additional duty of the local population officer
• Certificate of Compliance
• Capability Building of Barangay Health Workers
• Pro Bono Services for Indigent Women
• Sexual and Reproductive health
• Right to Reproductive Health Care Information
• Implementing Mechanisms
• Reporting Requirements
• Congressional Committee
• Prohibited Acts
• Penalties
• Appropriations
• Implementing Rules and Regulations
• Separability Clause, Repealing Clause, Effectivity

Major Provisions Summary

• The government must "promote, without biases, all effective natural and modern methods of family planning that are medically safe and legal."
• Although abortion is illegal and punishable by law, the government shall ensure that all women needing care for post-abortion complications shall be treated and counseled in a humane, non-judgmental and compassionate manner.
• Incorporates family planning and responsible parenthood into government anti-poverty programs.
• Requires age-appropriate reproductive health and sexuality education from grade five to fourth year high school.
• The Department of Labor and Employment must guarantee the reproductive health rights of female employees.
• Companies with fewer than 200 workers must partner with health care providers for reproductive health services.
• Employers with more than 200 employees shall provide reproductive health services to all employees in their own respective health facilities.
• Employers must inform employees of family planning availability and monitor pregnant working employees, providing paid half-day prenatal medical leaves for each month of the pregnancy.
• The national and local governments will ensure the availability of reproductive health care services like family planning and prenatal care.
• Persons or public officials who prohibit or restrict the delivery of legal and medically safe reproductive health care services will be penalized by imprisonment or a fine.
• Free choice regarding reproductive health enables people, especially the poor, to have the number of children they want and can feasibly care for.
• Rapid population growth and high fertility rates, especially among the poor, exacerbate poverty and make it harder for the government to address it.
• Smaller families and wider birth intervals could allow families to invest more in each child's education, health, nutrition and eventually reduce poverty and hunger at the household level.
• Studies show that 44% of the pregnancies in the poorest quintile are unanticipated.
• Among the poorest women who would like to avoid pregnancy 41% do not use contraception.
• 22% of married women in the poorest families express a desire to avoid pregnancies but are still not using any family planning method.
• Contraception, listed as essential medicines by the World Health Organization, will lower the rate of abortions.
• An SWS survey of 2008 showed that 71% of the respondents are in favor of the bill.
• President Aquino stated he was not an author of the bill, but he gives full support to a firm population policy, educating parents to be responsible, providing contraceptives to those who ask for them, but he refuses to promote contraceptive use and deems his position responsible parenthood.

Economic and Demographic Premises

• The Philippines is the 39th most densely populated country, with a density over 335 per square kilometer.
• The population growth rate is 1.9% (2010 Census), 1.957% (2010 est. by CIA World Factbook), or 1.85% (2005-2010 high variant estimate by the UN Population Division, World Population Prospects: The 2008 Revision) coming from 3.1 in 1960.
• The 2013 total fertility rate (TFR) is 3.20 births per woman, from a TFR of 7 in 1960.
• total fertility rate for the richest quintile of the population is 2.0, about one third the TFR of the poorest quintile (5.9 children per woman).
• The TFR for women with college education is 2.3, about half that of women with only an elementary education (4.5 children per woman).
• Congressman Lagman states that the bill "recognizes the verifiable link between a huge population and poverty. Unbridled population growth stunts socioeconomic development and aggravates poverty".
• Rapid population growth and high fertility rates, especially among the poor, do exacerbate poverty and make it harder for the government to address it.
• It would be "extreme" to view "population growth as the principal cause of poverty that would justify the government resorting to draconian and coercive measures to deal with the problem (e.g., denial of basic services and subsidies to families with more than two children)".
• Comparing the economic growth and population growth rates of Thailand, Indonesia, and the Philippines illustrate the connection between rapid population growth and poverty.
• The first two grew more rapidly than the Philippines due to lower population growth rates.
• "The experience from across Asia indicates that a population policy cum government-funded [family planning] program has been a critical complement to sound economic policy and poverty reduction."
• 57.3% of Filipino families with seven children are in poverty.
• 23.8% of families who have two children live below the poverty threshold.
• Smaller families and wider birth intervals resulting from the use of contraceptives allow families to invest more in each child's education, health, nutrition and eventually reduce poverty and hunger at the household level.
• Fertility reduction cuts the cost of social services with fewer people attending school or seeking medical care and eases demand for resources.
• The Asian Development Bank listed a large population as one of the major causes of poverty in the country along with other issues in 2004.

Maternal Health and Deaths

• Maternal deaths in the Philippines, is at 5.7 per day.
• Passage of the RH Bill would mean access to information on natural and modern family planning, improvement of maternal, infant, and child health and nutrition, promotion of breast feeding, prevention of abortion and management of post-abortion complications, improvement of adolescent and youth health, prevention and management of reproductive tract infections, HIV/AIDS and other STDs, elimination of violence against women, counseling on sexuality and sexual and reproductive health, treatment of breast and reproductive tract cancers, male involvement and participation in reproductive health issues, prevention and treatment of infertility, reproductive health education for the youth.
• The Department of Health states that family planning can reduce maternal mortality by about 32%.
• According to Clara Padilla of Engender Rights, the bill is "meant to prevent maternal deaths related to pregnancy and childbirth.".
• 11 women die while giving birth in the Philippines every day and these deaths could have been avoided if more Filipino women have access to reproductive health information and healthcare.
• The Senate Policy Brief on reproductive health deems the establishment of birth centers as a key solution to solving maternal deaths.
• The Philippine Medical Association (PMA) stated in their Position Paper that improvements to maternal and child health care is the goal of reducing maternal and child deaths.
• The millions of funds intended for the contraceptive devices may just well be applied in improving the skills of our health workers in reducing maternal and child mortality in the Philippines.
• Senator Tito Sotto said that the RH Bill is redundant to a 2009 law referred to as the Magna Carta for Women, asking the Senate to drop the bill.

Republic Act No. 10354 - An Act Providing For a National Policy on Responsible Parenthood and Reproductive Health

• State recognizes and guarantees the human rights of all persons including their right to equality, nondiscrimination, sustainable human development, health (includes reproductive health), education, information, and the right to choose and make decisions in accordance with religious convictions, ethics, cultural beliefs, responsible parenthood.
• The State will protect and strengthen the family as a basic autonomous social institution, protect the life of the mother and the unborn from conception, protect and promote the right to health of women and the people, instill health consciousness, protect and advance the right of families and the people to a balanced and healthful environment, promote and guarantee the equal protection of the welfare and rights of children, the youth, andThe unborn.
• The State recognizes marriage as an inviolable social institution and will defend the right of spouses to found a family, the right of children to assistance and protection, the right of the family to a family living wage and income, and The right of families to participate in the planning of policies.
• The State guarantees access to medically-safe, non-abortifacient, effective, legal, affordable, and quality reproductive health care services, methods, devices, supplies which do not prevent the implantation of a fertilized ovum, and relevant information and education, giving preferential access to those identified through the NHTS-PR.
• The State shall eradicate discriminatory policies that infringe reproductive health rights and promote openness to life as long as the parents can provide.

Guiding Principles for Implementation

• Guarantee the right to make free and informed decisions without coercion.
• Promote the welfare of every adult, couple, woman and adolescent.
• Effective and quality reproductive health care services must be given primacy to ensure maternal and child health, the health of the unborn, safe delivery and birth of healthy children, and sound replacement rate.
• The provision of ethical, medically safe, legal, accessible, affordable, non-abortifacient effective reproductive health care services is essential.
• The State shall promote and provide information and access, without bias, to all methods of family planning, including effective natural and modern methods.
• State shall promote programs that enable couples to have the number of children they desire, achieve equitable allocation of resources, ensure effective partnership among government and the private sector, conduct studies to analyze demographic trends, and conduct scientific studies to determine the safety and efficacy of alternative medicines.
• Giving reproductive health care priority to poor beneficiaries must be the primary responsibility of the national government.
• The State shall respect individuals' preferences and choice of family planning methods.
• Active participation by NGOs, women's and people's organizations, civil society, faith-based organizations, the religious sector and communities is crucial.
• While this Act recognizes that abortion is illegal, the government shall ensure that all women needing care for post-abortive complications are treated in a humane manner.
• Each family shall have the right to determine its ideal family size: Provided, however, That the State shall equip each parent with the necessary information on all aspects of family life.
• There shall be no demographic or population targets and the mitigation, promotion and/or stabilization of the population growth rate is incidental to the advancement of reproductive health.
• Gender equality and women empowerment are central elements of reproductive health and population and development.
• The resources of the country must be made to serve the entire population, especially the poor, and allocations thereof must be adequate and effective.
• Development is a multi-faceted process that calls for the harmonization and integration of policies, The program must address needs of the people throughout their life cycle.

Definition of Terms

• Abortifacient refers to any drug or device that induces abortion or the destruction of a fetus inside the mother's womb or the prevention of the fertilized ovum to reach and be implanted.
• Adolescent refers to young people between 10-19 years who transition from childhood to adulthood.
• Basic Emergency Obstetric and Newborn Care (BEMONC) refers to lifesaving services for maternal and newborn conditions.
• Comprehensive Emergency Obstetric and Newborn Care (CEMONC) refers to Comprehensive BEMONC care plus the provision of surgical delivery (caesarian section) and blood bank services.
• Family planning refers to a program which enables couples and individuals to decide freely and responsibly the number and spacing of their children and to have the information and means to do so.
• Fetal and infant death review refers to a qualitative study on the causes of fetal and infant death prevents future deaths through changes to programs, plans and policies.
• Gender equality refers to the principle of equality between women and men and equal rights to contribute to, and benefit from, the results of development.
• Gender equity refers to the policies, instruments, programs and actions that address the disadvantaged position of women.
• Male responsibility refers to the involvement, commitment, accountability and responsibility of males.
• Maternal death review refers to a qualitative study on the causes of maternal death and prevents future deaths through changes to programs, plans and policies.
• Maternal health refers to the health of a woman of reproductive age.
• Modern methods of family planning include safe, effective, non-abortifacient and legal methods that are registered with the FDA, to plan pregnancy.
• Natural family planning refers to a variety of methods used to plan or prevent pregnancy based on identifying the woman's fertile days.
• Public health care service provider (1) public health care institution, which is duly licensed and accredited and devoted primarily to the maintenance and operation of facilities for health promotion, disease. prevention, diagnosis, treatment and care of individuals suffering from illness, disease, injury, disability or deformity, or in need of obstetrical or other medical and nursing care; (2) public health care professional, who is a doctor of medicine, a nurse or a midwife; (3) public health worker engaged in the delivery of health care services; or (4) barangay health worker who voluntarily renders primarily health care services in the community after having been accredited to function.
• Poor refers to members of households identified by the Department of Social Welfare and Development (DSWD).
• Reproductive Health (RH) refers to the state of complete physical, mental and social well-being and not merely the absence of disease or infirmity, in all matters relating to reproduction.
• Reproductive health care refers to the access to a full range of methods, facilities, services and supplies that contribute to reproductive health.
• The elements of reproductive health care follow: Family planning information and services, Maternal, infant and child health and nutrition, including breastfeeding, Proscription of abortion and management of abortion complications, Adolescent and youth reproductive health guidance and counseling, Prevention, treatment and management of reproductive tract infections (RTIs), HIV and AIDS and other sexually transmittable infections (STIs), Elimination of violence against women and children and other forms of sexual and gender-based violence, Education and counseling on sexuality and reproductive health, Treatment of breast and reproductive tract cancers and other gynecological conditions and disorders, Male responsibility and involvement and men's reproductive health, Prevention, treatment and management of infertility and sexual dysfunction, Reproductive health education for the adolescents, Mental health aspect of reproductive health care.
• Reproductive health care program refers to the care to all citizens prioritizing women, the poor, marginalized and those invulnerable or crisis situations.
• Reproductive health rights refers to the rights of individuals and couples, to decide freely and responsibly whether or not to have children, the number, spacing and timing of their children, to make other decisions concerning reproduction. Provided, that they do not include abortion.
• Reproductive health and sexuality education refers to a lifelong learning process of providing and acquiring info.
• Reproductive Tract Infection (RTI) refers to sexually transmitted infections (STIs), and other types of infections affecting the reproductive system.
• Responsible parenthood refers to the will and ability of a parent to respond to the needs and aspirations of the family and children and is likewise a shared responsibility between parents.
• Sexual health refers to a state of physical, mental and social well-being.
• Sexually Transmitted Infection (STI) refers to any infection that may be acquired or passed on through.
• Skilled birth attendance refers to childbirth managed by a skilled health professional.
• Skilled health professional refers to a midwife, doctor or nurse, who has been educated and trained in the skills needed to manage the health of a pregnant woman.
• Sustainable human development refers to bringing people, people, particularly the poor and vulnerable, to the center of development process.

Hiring of Skilled Health Professionals

• The LGUs shall endeavor to hire an adequate number of nurses, midwives and other skilled health professionals for maternal health care and skilled birth attendance, while adhering to the DOH targets.
• For the purposes of this Act, midwives and nurses shall be allowed to administer lifesaving drugs but only if trained.

Health Care Facilities

• Each LGU shall endeavor to establish or upgrade hospitals and facilities and must follow the same standards.

Access to Family Planning.

• All accredited public health facilities shall provide a full range of modern family planning methods, which shall also include medical consultations for poor and marginalized couples with infertility issues who desire to have children.
• Family planning services shall likewise be extended by private health facilities to paying patients with the option to grant free care and services to indigents, except in the case of non-maternity specialty hospitals and hospitals owned and operated by a religious group.
• No person shall be denied information and access to family planning services, whether natural or artificial, but the right to family services are provided through the consent of the guardian of a minor.

Other Sections

• All LGUs, national and local government hospitals, and other public health units shall conduct an annual Maternal Death Review and Fetal and Infant Death Review.
• The National Drug Formulary shall include hormonal contraceptives, intrauterine devices, injectables and other safe, legal, non- abortifacient and effective family planning products and supplies. The DOH shall procure, distribute to LGUs and monitor the usage of family planning supplies for the whole country.
• A multidimensional approach shall be adopted in the implementation of policies and programs to fight poverty and to address this, the DOH shall implement programs prioritizing full access of poor and marginalized women.
• All serious and life-threatening reproductive health conditions shall be given the maximum benefits, including the provision of Anti-Retroviral Medicines (ARVs).
• The national or local government will provide a Mobile Health Care Service (MHCS), which shall deliver health care goods and services to its constituents, those of lesser means in particular. The State shall provide age- and development-appropriate reproductive health education to adolescents is necessary.
• No marriage license shall be issued by the Local Civil Registrar unless the applicants present a Certificate of Compliance.
• The DOH shall disseminate information and provide training programs to build Capacity of Barangay Health Workers (BHWs).
• Private and nongovernment reproductive healthcare service providers are encouraged to provide at least forty-eight (48) hours annually of reproductive health services and make them free to the identified low income patients.
• Barriers to reproductive health services for PWDs are lifted by the city and the state. Pursuant to the herein declared policy, the DOH shall serve as the lead agency for the implementation of this Act
• The DOH and the LGUs shall initiate and sustain a heightened nationwide awareness on the protection and promotion of reproductive health .
• The DOH is expected to submit toThe president a consolidated repot yearly while they are at the position.
• A Congressional Oversight Committee (COC) is required for this act.

Prohibited Acts

• Any health care service provider knowingly holding information relating abortion.
• Procedures not performed if they are medically safe.
• There is no provision for abortion.
• Hospital beds shall be properly organized.
• A certificate must be provided.

Penalties

• Any violation of this Act or commission shall be Penalized by imprisonment with varying penalties for the crime.
• Appropriations for amount are allocated for these issues.
• A team of trained healthcare works is required to implement these rules.

Responsible Parenthood: 18 Family Planning Methods You Should Know About

• Parenthood is a unique experience that requires maintaining the well-being of the child.
• Not all children experience an ideal family environment.
• Intimacy is vital for a couple, but unexpected pregnancies can disrupt relationships and cause complications.
• 40% of contraceptive use in the Philippines as of 2019.

Family methods

• Abstinence: Complete disengagement from all forms of sexual activity.
• Birth Control Implant: A health professional injects progestin into the arm to prevent pregnancy.
• Birth Control Pills: Hormone medication ingested daily to stop fertility.
• Birth Control Patch: A wearable contraceptive containing estrogen and progestin that thickens the mucus of the cervix to hinder ovulation.
• Birth Control Shot: Hormonal injections that prevent ovulation and thicken cervical mucus; administered every three months.
• Birth Control Sponge: A soft plastic inserted inside the vagina before intercourse that covers the cervix and prevents the sperm from reaching the egg.
• Birth Control Vaginal Ring: A flexible ring inserted inside the vagina that stops sperm cells from merging with an egg.
• Breastfeeding: The secretion of specific hormones prevent ovulation.
• Cervical Cap: A small and soft device made out of silicone inserted inside the vagina.
• Diaphragm: A cup-shaped device designed to cover the cervix.
• Internal/Female Condom: A soft and elastic pouch inserted inside the vagina that creates a barrier against sperm.
• Intrauterine Device (IUD): A T-shaped plastic device inserted in the uterus that impairs sperm movement.
• Male Condom: A thin, elastic, and stretchable cover worn on the penis during intercourse.
• Rhythm Method: Requires couples abstinence from sexual activity during fertile periods of the female.
• Spermicide: A gel or cream that is applied to the vagina before intercourse.
• Sterilization: A surgical procedure that temporarily or permanently close the fallopian tubes to prevent ovulation.
• Vasectomy: A surgical operation performed that prevents sperm from leaving the body.
• Withdrawal: The process of pulling out the penis from the vagina before ejaculation.

Family Planning Statistics

• 62% of married women aged 15-49 use a family planning method.
• Couples who do not use contraception have an 85% chance of getting pregnant within a year.
• 40% contaceptive use in the Philipiines as of 2019.
• 51% filipinos use the pill, which is the most prevalent method of contraception.
• 200,000 out of the 2 million births that happen annually in the Philippines are from teenage pregnancies.
• Male condom use had increased from 52% in 1982 to 93% in 2005.
• Regulates population of the country.
• Education on sexual matters and responsibility.

Legal Basis of the Philippine Population Program

• Republic Act 6365, known as the “Population Act of 1971” created the Commission on Population (POPCOM) and was later amended in 1972 by Presidential Decree No. 79.
• The tandem of Responsible Parenthood and Family Planning is the basic program of the Philippine Population Program (PPP), later renamed the Philippine Population Management Program (PPMP).
• It is the only way to give proper information about the population.