Doria Flores with two of her children in her home.

MANILA, Philippines (WOMENSENEWS)–Doria Flores, a scavenger in the Payatas dumpsite in the Philippines’ capital city, almost died while giving birth a few years ago. She didn’t, but she lost her seventh child.

That was the day she decided to have her fallopian tubes tied to make sure she does not get pregnant again. That was the day she realized enough is enough.

“How can one keep on having children? We don’t earn enough to feed them, much less send them to school,” said Flores, a 48-year-old mother of six.

The Philippines has a population of about 90 million people, the 12th largest in the world. If the annual growth rate of just over 2 percent persists, the population is expected to balloon to about 177.2 million by 2041.

Women from the poorest households have six children on average, while the national average is 3.5 children, according to the Manila-based University of the Philippines Population Institute.

This puts women such as Flores at the epicenter of a heated debate over a bill under debate here since September 2008 to create the Philippines’ first national reproductive health and family planning program.

Last May legislators, led by Rep. Edcel Lagman, a five-term congressman, proposed the bill to create the program, which would cost the government about $42 million annually to distribute information and contraceptives. The costs would average about one cent per woman of reproductive age daily.

Optimism and Worry

Similar bills have failed in the past, but this time supporters are optimistic. A vote is expected in February and the bill has 113 co-authors and needs 120 votes to pass.

But supporters also worry that the Catholic Church–which has scuttled previous efforts–still has time to whittle away lawmakers’ support. With national elections scheduled in 2010, delays in approval could mean that more politicians shy away from it.

“If the bill drags on, many of our politicians will play safe again and stay silent,” says Beth Angsioco, secretary-general of the Manila-based Reproductive Health Action Network, a coalition of approximately 40 pro-choice groups lobbying to support the bill.

The Reproductive Health and Population Development Act of 2008 will promote maternal and infant health, Lagman says. The bill would also implement sex education for students beginning in the 5th grade and implement a national policy on contraception and make birth control more accessible to low-income women by distributing it through government-run clinics.

But more than contraceptives and sex education, Lagman says the bill is about rights, health and sustainable human development.

“Central to this would be the idea that women and couples should have informed freedom of choice to adapt what kind of family planning method they would like to use depending on their needs and religious convictions,” he said.

Sixty-three percent of Filipinos support the bill, according to a Jan. 19 survey conducted by Pulse Asia, a research firm in Manila.

But in a country that is 80 percent Catholic, the church’s opposition remains a formidable obstacle.

Denounced in Sermons

Bishops and priests are denouncing the bill in sermons. The church has been putting up posters and taking out full-page newspaper ads. Prayer rallies are being held. Although it does not openly fund political campaigns, the church has 500,000 names so far for a petition against the bill. One bishop threatened to deny communion to lawmakers who support it.

A church urges a no vote on health bill.

With the national election approaching, church leaders have been talking privately with congressmen, said the Rev. Melvin Castro, executive secretary of the Episcopal Commission on Family and Life of the Catholic Bishops’ Conference of the Philippines. “We don’t want to exert too much effort on them as if we’re blackmailing them. But we have to convince them that this is not the proper course.”

Castro says the church considers some contraceptives to be tantamount to abortions because they prevent a fertilized egg from implanting in the uterus.

The bill explicitly states that abortion will remain illegal. Although the United Nations recognizes that abortion is permitted when the woman’s life is in danger, that exception is not specified in Philippine law.

An estimated 473,000 women undergo illegal abortions each year in the country, and the majority of the women are poor, married and Catholic, according to the University of the Philippines Population Institute. About 800 women die from botched abortions annually.

“The Catholic Church is committing something that is bordering on a crime of encouraging abortion unwittingly by opposing family planning and reproductive health,” said Lagman. “If we are able to prevent unwanted and unplanned pregnancies, then we would be able to reduce considerably the abortion rate.”

High Maternal Death Rates

What is equally alarming, though, is that at least 10 Filipino women die every day because of pregnancy and childbirth complications, says Angsioco, from the Reproductive Health Action Network.

“That alone should make the whole nation raise our voices in protest. Any which way you look at it, it’s unacceptable.”

Angsioco attributes high maternal mortality rates–162 deaths per 100,000 live births–to the absence of family planning programs and lack of access to medical care. Over 50 percent of women give birth at home.

But the Catholic Bishops’ Conference’s Castro says the answer is not the Reproductive Health Bill. “If many women die because of pregnancy, then they should have a program addressing the health care during their pregnancy,” he said.

Flores, the mother of six, says family planning is needed as a matter of family economics. “When you have many children, they’re the ones who will suffer. You can’t feed them, you can’t send them to school. Some people even sell their children.”

Ernesto Pernia, head of the School of Economics at the University of the Philippines in Manila, compares the country to its Southeast Asian neighbor, Thailand.

“In the 1970s, the Philippines and Thailand both had a population of about 37 million, growing at an average of 3 percent a year,” said Pernia.

But Thailand pursued a strong family planning policy, and it now has 22 million fewer people than the Philippines and a 0.8 percent population growth rate. Thailand produces less rice but it is a net exporter; the Philippines is the world’s largest rice importer.

Barnaby Lo is a Manila-based producer/reporter for CBS News. He graduated from New York University with an MA in broadcast journalism. He has covered war in the Philippines, the aftermath of the cyclone in Myanmar and last year’s presidential elections in Taiwan, among others.

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