September 26 is World Contraception Day. It is a day to highlight the enormous benefit that contraception brings to millions of lives worldwide.
I was invited to speak today at a World Contraception Day event held at the University of the Philippines campus in Diliman. I had been asked to speak about the challenges that Filipinas face in accessing contraception. To illustrate my points, I shared the story of Annabelle.
Annabelle is 15 and has a 23 year old boyfriend named Jonas. They’ve been together for a while, and Jonas has started talking about wanting to have sex.
Annabelle doesn’t know much about sex.
She does go to school, but she lives in the Philippines, so her school does not have a comprehensive sexuality education curriculum. All she knows about sex is that her mom says it’s bastos and bawal (vulgar and forbidden), and she’s supposed to wait until she’s married.
When young people don’t get accurate information from trusted adults like parents or teachers, they will look for answers among their friends. So Annabelle asks her closest girlfriends what they know about sex.
Her friends also live in the Philippines and also haven’t had comprehensive sex ed, so Annabelle gets bad information. Her friends tell her that if it’s her first time to have sex, she can’t get pregnant. They tell her if she jumps up and down after sex, she won’t get pregnant.
So Annabelle and her boyfriend have sex once. She thinks she’s protected since it’s her first time. But then Jonas wants to have sex again. Annabelle is worried she might get pregnant. Luckily she has a young cousin who already has a baby. Her cousin tells her if she doesn’t want to get pregnant, she should use contraception.
Annabelle doesn’t know anything about contraception and has only heard that it can make people sick, but she’s willing to try.
If she was rich, Annabelle would be able to go to a private clinic or go to a pharmacy and buy her own condoms. But Annabelle is poor, so she has to find a place where she can get contraceptives for free.
So she goes to a health center. When she gets there, she finds out that the health center does not have any supplies of pills and condoms, only the injectable DMPA. But she’ll have to pay 100 pesos for them to give her that, because supplies are limited.
What usually happens at government health centers happens to Annabelle – before she can get any more information, the nurse asks her how old she is. She says she’s 15. The nurse immediately starts scolding her and shaming her, telling her she shouldn’t be having sex, and that she’s going to tell Annabelle’s mother what she’s doing. The nurse also tells her that she can’t have contraceptives anyway until she’s 18 unless she has parental consent.
This happens to most young girls who try to access contraceptives, especially if they are unmarried or don’t have a baby yet.
But let’s pretend for a minute that Annabelle found a health center that’s more progressive, and that has a resident doctor or social worker who believes in helping youth help themselves. Let’s say the social worker or doctor gives proxy consent for Annabelle for contraception, and let’s pretend the health center has all contraceptive methods available. Annabelle knows she doesn’t want a baby for a long time, so she asks for an implant.
Annabelle leaves the health center pretty happy. She’s glad she can now have sex with Jonas without worrying about having a baby. When she and Jonas are together again, she excitedly tells him about her implant.
There are two ways Jonas could react. He could be happy that his girlfriend is responsible and that now they can have sex without concerns for unplanned pregnancy.
But this is the Philippines, and Jonas is like many guys who have much younger girlfriends. He is furious that Annabelle has done this. He calls her a slut and accuses her of cheating on him and having lots of sex with other guys, saying that is the real reason for getting an implant. Maybe he slaps her – intimate partner violence is very common in unequal relationships like these. He forbids her from using contraception and demands that she go back to the health center to get her implant removed, or else they are through.
Annabelle could see that Jonas is a jerk and be happy that they are breaking up. But she’s in love, and believes Jonas is her forever, and so she does as he tells her, and has her implant removed.
Because this is the Philippines, which has the one of the highest teen pregnancy rates in Asia, within a few months, she is pregnant. A few months after her baby is born, Jonas leaves her.
This, unfortunately, is the stark reality for hundreds of thousands of women and girls who are unable to access contraception each year.
I used the example of a young girl, but the same hurdles and challenges are present for older girls and women as well.
To recap: the challenges a Filipina faces in gaining access to contraception include: Lack of support for youth, religious conservatism, poverty, inadequate government support and the patriarchal society.
What can we do to help change our situation? We can:
- Educate our young people and provide information to older women so they understand what contraception is, and how it works.
- Provide access to contraception!!
- Pressure government leaders to ensure that budgets include ample funds for all forms of contraception so that those relying on government health centers can choose the form they prefer, and get it regularly.
- Orient health workers to be more sympathetic to young people and to help those who are trying to be responsible, rather than shame them.
- And finally, we need to get our heads out of the sand and face reality. Filipino youth are having sex. A majority of women and girls of all ages report having more children than they’d wanted. Rather than pretend we don’t have these problems, we should face the issues head on so we can solve them once and for all. This includes suspending our judgmental attitudes and instead showing empathy and compassion, and a real desire to protect our youth and our women so that they can have the best futures possible.
As we say at Roots of Health, Para sa Magandang Kinabukasan.