Manila’s Abortion Ban Is Killing Women

Several U.S. states including Alabama, Georgia, and Missouri have recently passed draconian abortion laws. In Alabama, the new rules effectively ban abortion unless the life of the mother or the fetus is at risk and make no exceptions for rape or incest. The law has drawn damning comparisons to countries such as Bangladesh and Romania.

But the most relevant example may be a country whose religious and political history is closely tied to the United States. In the Philippines, a former U.S. colony, abortion has been banned entirely for over a century. Philippine law mandates prison terms of up to six years for people who have abortions and for anyone who assists in the procedure. Arrests and convictions of women and abortion providers are commonly reported in local media, and United Nations committees repeatedly note that the abortion ban disproportionately harms socioeconomically disadvantaged women and members of other vulnerable groups. In practice, abortion is allowed in cases where the pregnant person’s life is at risk, but no law explicitly states this.

Opposition to abortion in the United States is principally driven by the religious right, in a rare alliance between evangelical Protestants and the Catholic Church. Kay Ivey, the governor of Alabama and a Southern Baptist, proclaimed that “every life is a sacred gift from God” as she signed her state’s law on May 15. In the Philippines, where over 90 percent of the population identifies as Christian, proposals to change abortion laws are consistently opposed by the highly influential Catholic Church. President Rodrigo Duterte often finds himself at odds with the church—he has called bishops “sons of bitches” and in February said the Catholic Church would “disappear” in 25 years—but he is on record as saying he hates abortion.

Catholicism’s impact on sexual life and health goes beyond just abortion, including its opposition to contraception. While Duterte has expressed support for expanded family planning initiatives—although he’s also told Filipinos not to use condoms as “they don’t feel good”—nationwide access to reproductive health services remains severely limited. Public health advocates pinpoint this as a key reason new HIV cases in the country surged by over 3,000 percent between 2007 and 2017.

The Philippines is also the only country in the world that does not allow divorce. A bill that would make divorce legal passed the country’s House of Representatives last year, but it has stalled in the Senate. Filipinos who want to end their marriages must get an annulment that deems their marriage to have never been valid in the eyes of the church—a long, painful, and expensive process that’s out of reach for most people, heavily biased in favor of men, and highly dependent on church connections. That keeps women, in particular, trapped in abusive marriages — and helps erode any sense of sexual independence.

These measures have caused huge pain for ordinary Filipinos. The new U.S. laws have inspired a long look into America’s past, before Roe v. Wade established the right to abortion in 1973, when women seeking abortions often relied on dangerous self-induction methods or turned to underground abortion providers. Scholars estimate up to 25 percent of pregnancies in the United States ended in abortion during that time—that number was 19 percent in 2014.

The Philippine abortion ban has likewise not stopped the practice, it’s just made it far more dangerous for those who choose to end their pregnancies. About 600,000 Filipino women get abortions every year, and many turn to unlicensed doctors, use folk medicine, or attempt to self-induce. It is estimated that as many as 100,000 women are hospitalized annually due to abortion complications, and about 1,000 women die each year after getting abortions, according to the Guttmacher Institute, a think tank which supports expanded access to abortion and reproductive health.

Those seeking abortions in the Philippines face not only imprisonment but also “the constant danger of death” as free and accessible services are out of reach, said Tinay Palabay, the secretary-general of the rights group alliance Karapatan and a co-convener of the women’s human rights association Tanggol Bayi. “Information and knowledge on availing safe abortions is largely not available,” she said. “In the most slim instance that these are available, facilities for safe abortions are very few.”

Some trained doctors in the Philippines secretly offer safe abortions in clinics, risking their careers out of their belief that women should have the right to ensure their own well-being. But these clandestine procedures are cost-prohibitive, in the first trimester ranging from $56 to $225 for medical abortions and $188 to $470 for surgical abortions, and getting increasingly costly in the second and third trimesters and in cases of complications, according to an investigative report by the digital media platform Rappler. That’s tough in a country with a gross national income per capita of $3,660 in 2017, according to World Bank data—but four in five Filipino women who do seek an abortion say they cannot shoulder the cost of raising a child.

Meanwhile, the general state of sexual education and health has suffered. In 2012, the Philippines passed the Responsible Parenthood and Reproductive Health Act, or the RH Law, which mandates the government distribute free birth control pills and condoms and provide sexual education. Despite its intended wide remit, the RH Law has failed to spark a sea change in access to contraceptives. Some provisions of the law have been struck down, and public health advocates say the government has not prioritized funding for the new programs.

The Philippines has suffered for this: Up to 38 Filipinos, mostly men, are diagnosed every day with HIV, according to the Department of Health. While the RH Law has made some free services available, stigma still keeps Filipinos, especially gay men, from getting tested, seeking information, or learning about safe sexual practices.

Wanggo Gallaga, a Filipino writer and HIV-positive activist, said restrictions on abortion, contraception, and divorce in the Philippines are “remnants of a conservative society that has yet to free itself from the shackles of our colonial history … the 333 years of Spanish occupation and the religious indoctrination of the people.” Gallaga noted that conservative interpretations of the Bible still govern much of Filipino society—while Pope Francis has supported condom use in some cases, such as for preventing the spread of the Zika virus, the Catholic Bishops’ Conference of the Philippines still opposes it entirely.

While the presence of these bans has made such debate an inevitability, there are signs that public opinion is starting to favor allowing divorces and liberalizing access to contraceptives. Younger Filipinos are becoming more willing to question the country’s conservative orthodoxy, Gallaga said, even as many still identify as Catholics themselves.

In Ireland, where over 75 percent of the population identifies as Catholic, an abortion ban was overturned by referendum in 2018. On May 24, the country overwhelmingly voted to liberalize its divorce laws by removing a clause that had previously restricted divorce to spouses who had been separated for four of the previous five years. The changes come following a steady erosion of the Catholic Church’s political power in Ireland, influenced heavily by decades of child sex abuse scandals. In the Philippines, abuses by the clergy have largely remained under wraps due to church guidelines giving bishops leeway to delay investigations, and priests are rarely charged in criminal courts. The church, which Filipinos trust more than any other institution, remains immensely powerful.

Palabay, the human rights organizer, said that the recently passed U.S. abortion laws only remind her to remain vigilant, even if the Philippines begins to make progress in overturning some of its more destructive barriers to the human rights of women. The pushback against Roe v. Wade “should make us all realize that the struggle for women’s rights is far from over,” she said. “It is work that is never done as long as structures of patriarchy and inequality remain.”