MANILA, Philippines – She heard metal clanking, but anesthesia dulled the clang.
She laid in bed, with someone tinkering below. Today she was supposed to enroll for her junior year at high school, but she was having an abortion.
It lasted an hour and felt nothing. Mary* was accompanied by her mother to an abortion clinic disguising itself as an employment agency, less than an hour from Manila.
It was the new millennium, Mary was 15, and the procedure cost P15,000.
“When mom found out [I'm pregnant], she asked me what I wanted to do,” Mary said. “I didn’t want [a baby]. I was young, I didn’t want to stop school.”
“My mom was holding my hand throughout the process,” Mary recalled. Everything was in secret since the Philippines outlaws abortion.
Three years later, Mary was once again pregnant.
Not all adolescents have what Mary had. She is thankful for having resources and an open-minded family, however. Mary hoped that after her first pregnancy, someone had sat her down and lectured her on safe sex.
“They knew I was sexually active, but there was still no talk, no advice.”
Ignorance is bliss?
What Mary didn’t learn at home, she didn’t learn in school either.
Already in college during her second pregnancy, Mary still did not understand sex.
“I was clueless about birth control,” she admitted. “There’s stigma, it’s hard to ask questions when you’re young. Tataasan ka ng kilay ‘pag bibili ka pills nang naka-college uniform.” (They’ll raise eyebrows when you buy pills while wearing your college uniform.)
Mary decided to go through with her second pregnancy, and today she is successfully raising her child.
She does not regret her abortion, saying that if she continued her first pregnancy, she probably would not have finished college.
“How would a 15-year-old raise a kid? You may say I’m selfish, but that decision saved me from committing more bad decisions in my life,” said Mary. “Whatever you say, I wouldn't feel bad about a decision I’m so sure of, that I was brave enough to do.”
“Despite advances in RH law, many Filipino women experience unintended pregnancies,” the Guttmacher Institute, an international non-profit organization, reported in 2013. “And because abortion is highly stigmatized in the country, many who seek abortion undergo unsafe procedures” done by unqualified people.
Mary did not experience post-abortion problems, but others do. In 2008, around 1,000 maternal deaths in the Philippines were attributed to abortion complications, Guttmacher reported.
Mary hopes the Philippines could start talking about abortion openly, a plea shared by women’s rights advocates. “But it all comes back to how the Philippines handles reproductive health (RH)," she stressed, adding, "People should first be educated about RH.”
Knowing more, not less, is a safer bet.
The United Nations defines RH as a “state of complete physical, mental and social well-being in all matters relating to the reproductive system,” including the ability to have a "satisifying and safe sex life, and the freedom to decide if, when, and how often to do so.”
However, such freedom is often challenged, mostly by ignorance. To protect one’s RH, the UN emphasizes the need for:
In fact, more than half of college-educated Filipino youths had unprotected sex during their first time, the 2013 Young Adult Fertility and Sexuality showed, with the percentage increasing with lower educational attainment. And regardless of education level, not more than 36% of young Filipinos answered these basic questions correctly:
The lack of access to information and services are the most common problems among pregnant teenagers, observed Dr Gumersinda Javier of the Philippine Society of Maternal and Fetal Medicine, "Some don't even understand ovulation."
Javier stressed how Filipinos in far-flung areas have the least access to such needs.
"Why we don't reach our Millennium Development Goals? Because a lot of our people don't have access to health. We have in Metro Manila and some major cities, but not far south," she added.
Advocates are also pushing for RH and sexuality education to be mandatory.
"[RH law] Having that clause saying it's going to be just optional for private schools, that's not enough," said Marevic Parcon of the Women's Global Network for Reproductive Rights.
Contraceptives, church, cancer
More than half of Filipino women use contraception, either traditional or modern, the 2013 National Demographic and Health Survey (NDHS) revealed.
This means the other half do not.
Contraception is least among 15-19-year-olds at only 4.4%. And among unmarried sexually active women, "withdrawal" was most common.
While individuals could choose whatever method they prefer, the World Health Organization noted that withdrawal is "one of the least effective methods," while the rhythm method strictly requires knowledge, consistency, and partner cooperation – things not all couples have.
But others have fewer choices.
“The Church is against [artificial] contraceptives,” said Fr Dave Clay of the Catholic Bishops Conference of the Philippines (CBCP). “When the husband uses condoms, he’s putting his wife in danger because condoms are dangerous. They cause cervical cancer.”
Clay is assistant executive secretary of the CBCP Commission on Family and Life. He added that pills “cause cancer and homosexuality,” citing news about “feminized” fish resulting from waterways contaminated with urine from women on pills. This, however, was disproved by the University of California-San Francisco alongside other health advocates.
The CBCP agrees that schools should provide sexuality education, but says it should not go into too much details. "Don't have to teach intercourse or [artificial] contraceptives, but we can teach natural family planning," Clay explained.
The CBCP's sentiments, however, were countered by Parcon, stressing that "the youth have the right to understand and care for their bodies."
Instead of just telling students "not to have sex because sex is bad," Parcon advised schools to explain what safe sex is. Sexuality education should focus on providing two things: the right information and rights-based information.
"There's nothing wrong if you want to wait. That’s [abstinence] your choice, but that choice should be informed," Parcon said.
But the priest is firm in his beliefs: “Learn chastity. Don’t masturbate. Don’t have sex with people not your husband or wife.”
Some young Filipinos will learn about safe sex, others will not. Some will turn to the Internet for information, some to friends, and some to men in robes echoing the word of god.
Just like Mary, some learn about safe sex only after having several unsafe encounters. – Rappler.com
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*Mary is not her real name. She requested an alias to protect her and her child's privacy