Defunding implants: Sotto vs. women

"Is this a case of not knowing all the facts about contraceptives?"

 

 

Senate President Vicente Sotto III, the foremost anti-women’s rights legislator, strikes again. This time, he hit women, particularly poor Filipino women, by removing the P195 million from the Department of Health’s proposed 2020 budget for the purchase of subdermal implants.

The subdermal implant is a contraceptive that has been approved by the Food and Drug Administration as safe, legal, and non-abortifacient. Since its introduction some years back, it has become popular with Filipino women because it is easy to use and long-acting. It only takes about five minutes to insert, yet is effective for three years. After insertion, women can go back to their usual routine and there is no restriction in terms of what they can do.

Moreover, it is reversible, meaning if at anytime within the three years that it is effective the woman with the implant decides that she wants to get pregnant, the contraceptive can easily be removed.

A report quoted Sotto as saying that the Senate “removed an unauthorized provision from the 2020 budget of the DOH for purchase of P195 million worth of abortifacients.” Wow. This statement is loaded and so WRONG.

First, the subdermal implant does NOT cause abortion. In a Senate deliberation on the health budget, Sotto mentioned that this contraceptive is abortifacient, quoting Donna Harrison’s opinion criticizing the FDA for approving its use by Filipino women.

But who is Donna Harrison? She is an American obstetrician/gynecologist who is also the Executive Director of the American Association of Pro-Life Obstetricians and Gynecologist. She also serves as an Adjunct Professor of Trinity International University, an evangelical Christian university. Clearly, Dr. Harrison is anti-contraceptives, and her opinion is not surprising, being a pro-lifer. 

What is surprising is that a senator of a secular State would choose to side with Harrison’s bigoted opinion over those of international medical and health experts. The subdermal implant is among the most recently developed contraceptives and was approved in the United States in 1990. Despite it being new, it has already been approved as a contraceptive by regulatory agencies of more than 60 countries worldwide, including the Philippines’ FDA.

Contraceptives do not induce abortion. They prevent, not terminate pregnancy. Contraceptives act BEFORE pregnancy occurs and thus, are not abortifacient. As former Health Secretary Esperanza Cabral often says, contraceptives cannot abort pregnancy because there is nothing to abort.

The World Health Organization in its 2019 List of Essential Medicines has clearly made this distinction. In the list, number 22 is Medicines for Reproductive Health and Perinatal Care. 22.1. is Contraceptives and under this, 22.1.5. is Implantable Contraceptives, which means subdermal implant. Item 22.3. is Uterotonics and under this are the medicines that may be used for abortion (which is legal in a good number of countries).

Clearly, the WHO has categorized contraceptives like subdermal implant separately from those that may be used to for abortion. Surely, the WHO is more authoritative than Dr. Harrison.

In removing the budget for implants, Sotto tried to appease the women who will be adversely affected by saying that anyway, other methods are available. Did he mean the so-called “natural” family planning methods? If yes, it should be emphasized here that the NFP is the least liked by women because these are quite difficult to use, and requires the full cooperation of their male partners. The latter is hard to achieve because of the inequality that exists in many relationships.

If, however, Sotto was referring to birth control pills and injectables, well, we have news for him. Implants contain the SAME hormones found in other hormonal contraceptives. Why then would Sotto single implants out, and curtail Filipino women’s access to it? Why did he not remove the budgets for the other contraceptives? Is this a case of not knowing all the facts about contraceptives?

Thus, there is no truth to Sotto’s assertion that the P195-million budget he removed was unauthorized because it was for abortifacient supplies.

Removing the budget for implants means that poor women will not have access to this highly effective and long-acting family planning method. The cut does not mean that implants will no longer be available. It means that government will not be able to provide the service to the women who want and need it, but it may be available through private medical providers.

The problem is, only government provides this important and needed service to economically marginalized women. Implants are not cheap. If one gets this from a private doctor, one should be ready to shell out between P8,000 to P15,000. This amount is way beyond the means of poor women. Only rich women will not wince in paying this amount. When I checked a few years back, government bought the supplies at a wholesale price of P500 per implant. This is equivalent to three years of protection from unwanted pregnancies per woman.

Outside of the DOH, NGOs like ours also provide family planning services, including implants to poor women for free. However, our supplies also come from the DOH. Therefore, Sotto’s budget cut will deprive poor women of their right to choose which method they want to use. Consequently, this will impact on the implementation of the RH law because family planning is a vital program.

Based on the 2017 National Demographic and Health Survey, we have a situation where Filipino women, on the average only want two children. The richest women are able to achieve this because their average number of children is 1.7. The poorest women, however, have 4.3 children on the average.

Also, the demand for family planning and the unmet need for these services remain high with the latter at 36.3 percent. The highest unmet need (37.5 percent) is among the 15 to 19 year olds.  It is not surprising then that teen pregnancy is now a national crisis. Around 24 babies are born to teen mothers every hour or 576 babies a day.

The situation is problematic and must be addressed. Tito Sotto is not helping any. There is still hope because the Bicameral Conference Committee on the budget can still restore the P195 million that Sotto deleted. We are hoping that RH champions in the bicam will succeed in putting back the resources for subdermal implants. Sotto must be defeated.

@bethangsioco on Twitter; Elizabeth Angsioco on Facebook