Country Profile - Philippines
Law related to Abortion
:

Abortion in the Philippines is legally prohibited. Criminal liability for abortion is provided for in the Revised Penal Code (Act 3815), as follows:

Art. 256. Intentional abortion. - Any person who shall intentionally cause an abortion shall suffer:

The penalty of reclusion temporal1 , if he shall use any violence upon the person of the pregnant woman.
The penalty of prision mayor if, without using violence, he shall act without the consent of the woman.
The penalty of prision correccional in its medium and maximum periods, if the woman shall have consented.

Art. 257. Unintentional abortion. - The penalty of prision correccional in its minimum and medium period shall be imposed upon any person who shall cause an abortion by violence, but unintentionally.

Art. 258. Abortion practiced by the woman herself or by her parents. - The penalty of prision correccional in its medium and maximum periods shall be imposed upon a woman who shall practice abortion upon herself or shall consent that any other person should do so.

Any woman who shall commit this offense to conceal her dishonor, shall suffer the penalty of prision correccional in its minimum and medium periods.

If this crime be committed by the parents of the pregnant woman or either of them, and they act with the consent of said woman for the purpose of concealing her dishonor, the offenders shall suffer the penalty of prision correccional in its medium and maximum periods.

Art. 259. Abortion practiced by a physician or midwife and dispensing of abortives. - The penalties provided in Article 256 shall be imposed in its maximum period, respectively, upon any physician or midwife who, taking advantage of their scientific knowledge or skill, shall cause an abortion or assist in causing the same.

Any pharmacist who, without the proper prescription from a physician, shall dispense any abortive shall suffer arresto mayor and a fine not exceeding 1,000 pesos.

Brief history of the law

:

The Revised Penal Code, had been effective in the Philippine islands since December 1930. The RPC merely revised the Penal Code which was then in effect in Spain, the colonizer. A royal order dated December 17, 1886 directed the execution of the royal decree of September 4, 1884 wherein it was ordered that the Penal Code in force in the Peninsula be published and applied in the Philippines. In short, the Revised Penal Code is a mere reproduction of the old laws of Spain that has been effective thereat since the 1870s. While the laws of Spain, the colonizer, had changed liberalizing abortion, the Philippines laws on the matter has remained the same for more than a century now.

Short summary of conditions within the law
:
To save the life of the woman 
:
No express provision in the law, although may be implied from the principle of necessity in criminal law.            
To preserve physical health
:
NO
To preserve mental health
:
NO
Rape or incest
:
NO
Foetal impairment
:
NO
Economic or social reasons
:
NO
Available on request
:
NO
Analysis of it being restrictive if at all
:
The Philippine law on abortion is among the most restrictive in the world, as it contains no express provision for any kind of exemption from criminal liability. Nevertheless, although the Penal Code does not list specific exceptions to the general prohibition on abortion, under the general criminal law principles of necessity as set forth in article 11(4) of the Code, an abortion may be legally performed to save the pregnant woman’s life.2 A decision of the Supreme Court also impliedly recognized abortion to save the mother’s life.3 The United Nations recognizes that abortion in the Philippines is permitted only in instances in which the pregnant woman's life is endangered.4

This silence of the law on any exception, even if to save the mother’s life, however, may have a chilling effect to medical practitioners and thus imperil women’s lives.

Nonetheless, despite the restrictive legal regime, abortion is widely resorted to by women faced with unplanned pregnancies and while they are arrested by police and maltreated by medical practitioners, women, however, rarely get prosecuted.
Policy
:
(Government policy enabling for the law, enabling beyond the law in practice etc such as population control policy, pro- natalist policy, anti sex selection policy, two child family norm)

The national policy relevant to the issue of abortion is found in Section 12, Article II, of the 1987 Philippine Constitution, which states, as follows:

Article II. DECLARATION OF PRINCIPLES AND STATE POLICIES Section 12. The State recognizes the sanctity of family life and shall protect and strengthen the family as a basic autonomous social institution. It shall equally protect the life of the mother and the life of the unborn from conception. The natural and primary right and duty of parents in the rearing of the youth for civic efficiency and the development of moral character shall receive the support of the Government (emphasis added).

The present Philippine Constitution took effect in 1987. The provision concerning the equal protection of the life of the mother and the life of the unborn from conception, Art. II Section 12, was courtesy of the Catholic faction in the Constitutional Commission.

The original provision that was sought to be introduced was actually: “The state shall equally protect the life of the mother and the life of the unborn from the moment of conception.”

The main sponsor of the provision stated in his speech that –

“The formulation … is adequate and proper.  It gives due regard to the right to life of the mother in case of ectopic pregnancies – pregnancies where the fertilized ovum is implanted in some other places except the uterus – and so-called medical delimnas. At the same time, it restraints a discontented woman from killing her unfortunately unwanted child which, although currently depending upon her, is really a distinct and separate human being. So, this argument of  few women that they should have the right to do whatever they please with their body is completely irrelevant. The fertilized ovum is already a separate body.  It is no longer the body of the woman.

What is being affirmed in this formulation is the moral right as well as the constitutional right of the unborn child to life, If this should entail the granting of presumptive personality to the unborn befinning at the moment of the conception, then so be it. Xxx Respect for the rights of the woman with child and respect for the rights of the child in her womb are by nature intimately linked such that any deliberate harm that should come upon one will doubtless effect a corresponbding harm to the other.  Conflicts of rights is fictitious. Xxx The conflict is only apparent. It is easily resolved by applying the following principle: When two rights come in conflict, the more basic right and/or the right concerning the graver matter takes precedence over rights involving the less basic or less serious matter.  It is clear that the right to life is more basic than the right to privacy or any other posterior rights. Therefore, since removal of the fetus would most certainly result in violation of its right to life, the woman has no right to evict the temporary resident of her private womb.”5

According to the sponsor, the moment of conception took place on fertilization since “it is when the ovum is fertilized by the sperm that there is human life.”6 It was also stated that “protection, that is, preservation of life, would be required even if it should appear that the child would be deformed or was the fruit of multiple rape.”7

The words “moment of” was, however later dropped and the provision as it stands now was adopted.  The intention of the majority of the Commission was to prevent the application of the doctrine of Roe vs. Wade in the Philippines. According to Constitutionalist and member of the Constitutional Commission, Catholic priest Father Joaquin Bernas, the constitutional provision on the protection od th life of the unborn, “does not assert that the life of the unborn is placed on exactly the same level as the life of the mother. It recognizes that, when necessary to save the life of the mother, it may be necessary and lefitimate to sacrifice the life of the unborn.”8

Notwithstanding this constitutional intent however, this provision had been invoked by the Bureau of Food and Drugs of the Department of Health in banning the emergency contraceptive pill (ECP). The same provision is also used by those who are vehemently opposed to the passage of the Reproductive Health (RH) Bill which provides, among others, for the complete and full-range of contraceptive methods being made available to the people, even though that the RH bill expressly states that abortion shall continue to be illegal.

Even prior to this constitutional provision, as early as 1972, the Revised Population Act referred to abortion as an unacceptable method of birth control, which should be discouraged and prevented.
Practice
:
(Providers trained, willing, enabling )

NOT APPLICABLE, NOT PRESENT
Reproductive Health Perspective
:
Signatory to ICPD, CEDAW: Yes/ No, any conditions

The Philippines is a signatory to the ICPD and CEDAW, with no reservations.

Abortion Statistics

:
In 2000, an estimated 78,900 women were hospitalized for postabortion care, 473,400 had abortions and the abortion rate was 27 per 1,000 women aged 15-44 per year. The national abortion rate changed little between 1994 and 2000; however large increase occurred in metropolitan manila (from 41-52) and Visayas (from 11 to 17). The proportions of unplanned births and unintended pregnancies increased substantially in Manila, and the use of traditional contraceptive methods increased in Manila and Visayas. ( The Incidence of Induced Abortion in the Philippines: Current Level and Recent Trends, Juarez, Cabigon, Singh, Hussain, page 140, International Family Planning Perspectives, Guttmacher Journal)

Total

:

1st TM
2nd TM
safe
unsafe
married women
unmarried women
adolescents
Septic abortions

Public sector
:

Abortion services available NONE
1st Trimester
2nd Trimester
Cost

Private sector
:

Abortion services available NONE
1st Trimester
2nd Trimester
Cost

Methods used
:

D&C, EVA, MVA, MMA with Mife Miso, MMA with Miso alone, MMA with Methotrexate Miso

2nd Trimester with Ethacridine lactate , Misoprostol, D&E, Hyterotomy

According to Anthropologist, Michael Tan, there are many different abortion methods used in the Philippines, to wit:

“Plants and plant preparations, E.g., Makabuhay, Essencia maravilosa. Many of these plants probably do induce contractions of smooth muscles, such as those in the uterus. Sometimes, people think the plants work because their menstruation “returns”. In reality, the menstruation was probably only delayed.”
Physical methods. Massage and abdominal pressure are applied by the hilot, or sometimes by the pregnant woman herself. This is a terrible painful method and is dangerous, especially in more advance pregnancies. The physical pressure is used to induce uterine contractions but these may not be enough to expel the fetus.
Insertion of catheters (sonda). Women have been known to insert hangers, brooms, walis tingting. These often lead to infections.
Dilation and currettage (D&C or raspa). Usually, this is done with women who had already began the abortion, in which case it is called completion curretage. There are, however, clandestine clinics that use D&C to induce an abortion.
Menstrual regulation (MR). This involves the use of suction or vacuum aspiration to terminate a very early pregnancy (usually the first few weeks).
Drugs. There are many western drugs that people use to attempt to induce an abortion. These include medicines such as quinine, an anti-malarial; methylergometrin, a uterine stimulant and methotrexate, an anti-cancer drug. With some of these drugs, an abortion is actually a side effect. In other cases, the western medicine used may even have the opposite effect on a pregnancy. Bricanyl (generic name: terbutaline) is perceived as an abortifacient in large doses but in reality, the drug actually delays labor rather than inducing an abortion.

One widely used drug, misoprostol (Cytotec) is actually a drug used to prevent ulcers but has abortion as a side effect. Because it’s use as an abortifacient is illegal, the drug is used on a trial and error basis, which then creates problems.

 (Abortion: Realities and Responsibilities, Michael L. Tan )

Provider level allowed for surgical and medical abortion
:

(Ob Gyn, MBBS,Nurses,Other)

Some Physician-Ob may perform the procedure only when the same is for therapeutic purposes to save the life of the woman, and with the consent of the family.

Abortion related morbidity mortality statistics
:

According to the Guttmacher Study on abortion causes and consequences in the Philippines,

Eight in 10 women who succeed in ending their pregnancy have health complications, and more than half of these women report having severe complications.

The severity of complications varies according to the abortion method women use: Some 70% of women who use massage or insertion of a catheter and 44% of those who use misoprostol suffer severe complications, compared with only 13% who undergo dilation and curettage or manual vacuum aspiration.

Poor and rural women often lack access to safer methods and providers, and thus experience higher rates of severe complications than do their wealthier and urban counterparts.

Because of the high cost of postabortion treatment and the condemnatory attitudes of some medical providers, some women who experience complications do not seek care.

An estimated 79,000 women were hospitalized because of health complications of abortion in 2000. This translates into an annual rate of 4.5 abortions for every 1,000 women of reproductive age.

An estimated 800 women per year die from complications of unsafe abortion.9
Manufacture and/or availability through import of abortion equipment (MVA syringes, EVA equipment)
:

N / A

Manufacture/ import of Mifepristone, Misoprostol
:
N / A
Facility and provider certification norms in brief
:
N / A
Information available in national service delivery standards  
:
No
Informal / illegal providers – if present who are they
:

Providers include the hilot, midwives, and doctors. In other cases, women “self-medicate”, asking friends for advice and then applying the methods on themselves. (Abortion: Realities and Responsibilities, Michael L. Tan)

Population urban/ rural - Demography of the country, with an analysis of availability of abortion services ratio to population
:
Abortions are sought by women rich and poor, old and young, educated and uneducated, rural and urban, and from all parts of the country. Abortion is most common in urban areas, such as Metro Manila, probably because women in such areas are the most highly motivated to have small families and thus to avoid unintended births. Women choose abortions for many reasons, but primarily because they believe they would not be able to provide for a child at this point in their lives as a result of their family’s financial situation; existing obligations to work, school or other children; or relationship problems.

Women who decide to terminate their pregnancies often have a difficult time obtaining abortions.

Many need to make multiple attempts before successfully ending a pregnancy, and many more give up before succeeding. Some women end their pregnancies themselves, while others seek help from friends, spouses, traditional healers and pharmacists, as well as qualified doctors, midwives and nurses. Although some abortions are safe, many more are performed by unskilled providers or under unhygienic conditions, resulting in serious medical problems. Complications are common among women who use unsafe methods and untrained providers, whether or not they actually end the pregnancy. The time spent in seeking an abortion and in recovering from injuries and ill-health keeps women from fulfilling other responsibilities, such as making a living, attending school and caring for their families. The cost of this lost time, added to the health care costs of treating complications, means that unsafe abortion takes a great toll on society as a whole, as well as on individual women and their families. Furthermore, access to abortion, the type of procedure obtained and the quality of postabortion care often correspond with how much a woman is able to pay. Thus, poor women and their families, who cannot afford safer options, bear much of the burden of unsafe abortion.

Although abortion is legally permitted in the Philippines only to save a woman’s life, it is probably not accessible even for this reason. The law prohibits importing anything intended to be used for inducing abortion - including “any printed matter which advertises or describes or gives directly or indirectly information where, how or by whom unlawful abortion is produced.” Furthermore, abortion techniques and the social and personal implications of abortion often are not addressed in medical training. (Unintended Pregnancy and Induced Abortion in the Philippines. Guttmacher Institute)
Role of government
:

Supportive, enabling, creating barriers, provides adequate funding to run training and service delivery programmes

Not applicable.

Role of religion/ religious leaders
:

Enabling, supportive, neutral, restrictive

The Catholic Church is strongly and vocally opposed to abortion. It was the Catholic lobby, in fact, that introduced the constitutional policy about equal value to the life of the mother and the unborn from conception. 

Even measures introducing artificial methods of contraception are vehemently opposed by the Church, which exert considerable influence on national and local government officials. The lack of comprehensive contraceptive program of the government, as a result of this Catholic pressure, leads to unwanted pregnancies, which, in turn, is the root cause of abortion incidence in the country.

Local Ob Gyn societies
:

Supportive, conscientious objectors

Because of the strong influence of the Catholic Church on framing the issue of abortion merely as mortal sin, and the media’s adoption of such framing, doctors and medical practitioners are also at the forefront in condemning women who have undergone abortion. Accounts of women being labeled criminals, and maltreated in various ways in hospitals when seeking assistance for a botched abortion, or even a spontaneous abortion, are widespread.

Current status and potential of research
:

Abortion remains restrictive and continues to be a very contentious and divisive issue, even among reproductive health advocates.  While many members of reproductive rights groups are all out in advocating for modern means of contraceptive, this position does not necessarily translate to support for abortion rights. Research should be done on the general public’s knowledge on the issue of abortion and the opinions they form based on this knowledge and/or lack thereof.

Awareness amongst community members
:

Currently, there are no studies showing awareness on the issue of abortion among community members. However, anecdotal evidence show that abortion is still understood largely by the public as a mortal sin where the woman undergoing the same is a mere criminal, and no regard as to her circumstances is given.

Role of member organization/ individual
:

Women LEAD Foundation is involved in public advocacy on the issue of reproductive rights of women and girls, including abortion rights.

1 Penalties under the Revised Penal Code:
Reclusion Perpetua – 20 years & 1 day to 40 years (indivisible)
Reclusion Temporal – 12 years & 1 day to 20 years.
Periods: Minimum- 12y1d – 14y8m Medium- 14y8m1d-17y4m Maximum- 17y4m1d – 20y
Prision Mayor – 6 years and 1 day to 12 years.
Periods: Minimum- 6y1d -8y Medium- 8y1d – 10y Maximum- 10y1d – 12y
Prision Correccional – 6 months & 1 day to 6 years
Periods: Minimum- 6m1d- 2y4m Medium- 2y4m1d – 4y2m Maximum- 4y2m1d – 6y
Arresto Mayor – 1 month & 1 day to 6 months.
Periods: Minimum- 1m – 2m Medium- 2m1d – 4m Maximum-4m1d- 6m
Arresto Menor – 1 day to 30 days.
Periods: Minimum- 1d-10d Medium- 11d – 20d Maximum- 21d to 30d

2www.un.org/esa/population/publications/abortion/doc/philippines.doc, last retrieved 22 July 2008.

3
Geluz vs. CA, July 20, 1961.

4
United Nations Population Division. (2002). Abortion Policies: A Global Review.

5Bernas, J.. The Intent of the 1986 Constitution Writers (1995), p. 119.

6
Ibid. 

7
Ibid.

8
Bernas, the 1987 Constitution of the Philippines: A Commentary, 2003 edition, p. 84.

9Singh, Juarez, Cabigon, Ball, Hussain, Nadeau, Unintended Pregnancy and Induced Abortion in the Philippines: Causes and Consequences, New York: Guttmacher Institute, 2006., p.5.

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