Reproductive Health Bill

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Intrauterine device (IUD): The Reproductive Health Bill provides for universal distribution of family planning devices, and its enforcement. The Reproductive Health bills, popularly known as the RH Bill, are Philippine bills aiming to guarantee universal access to methods and information on birth control and maternal care. The bills have become the center of a contentious national debate. There are presently two bills with the same goals: House Bill No. 4244 or An Act Providing for a Comprehensive Policy on Responsible Parenthood, Reproductive Health, and Population and Development, and For Other Purposes introduced by Albay 1st district Representative Edcel Lagman, and Senate Bill No. 2378 or An Act Providing For a National Policy on Reproductive Health and Population and Development introduced by Senator Miriam Defensor Santiago. While there is general agreement about its provisions on maternal and child health, there is great debate on its key proposal that the Philippine government and the private sector will fund and undertake widespread distribution of family planning devices such as condoms, birth control pills (BCPs) and IUDs, as the government continues to disseminate information on their use through all health care centers. The bill is highly divisive, with experts, academics, religious institutions, and major political figures supporting and opposing it, often criticizing the government and each other in the process. The issue is so divisive that at one point, the Catholic Bishops Conference of the Philippines threatened to excommunicate the President, Benigno Aquino III if he supported the bill. Debates and rallies for and against the bill, with tens of thousand participating, have been happening all over the country.

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[edit] Background

The first time the Reproductive Health Bill was proposed was in 1998. During the present 15th Congress, the RH Bills filed are those authored by (1) House Minority Leader Edcel Lagman of Albay, HB 96; (2) Iloilo Rep. Janette Garin, HB 101, (3) Akbayan Representatives Kaka Bag-ao & Walden Bello; HB 513, (4) Muntinlupa Representative Rodolfo Biazon, HB 1160, (5) Iloilo Representative Augusto Syjuco, HB 1520, (6) Gabriela Rep. Luzviminda Ilagan. In the Senate, Sen. Michael Angelo F. Perolina has filed her own version of the RH bill which, she says, will be part of the countrys commitment to international covenants. On January 31, 2011, the House of Representatives Committee on Population and Family Relations voted to consolidate all House versions of the bill, which is entitled An Act Providing for a Comprehensive Policy on Responsible Parenthood, Reproductive Health and Population Development and for Other Purposes.[1][2]

[edit] Stated purpose

One of the main concerns of the bill, according to the Explanatory Note, is that the population of the Philippines makes it the 10th most populous nation in the world today, that the Filipino womens fertility rate is at the upper bracket of 606 countries. It states that studies and surveys show that the Filipinos are responsive to having smaller-sized families through free choice of family planning methods. It also refers to studies which show that rapid population growth exacerbates poverty while poverty spawns rapid population growth. And so it aims for improved quality of life through a consistent and coherent national population policy.

[edit] History
According to the Senate Policy Brief titled Promoting Reproductive Health, the history of reproductive health in the Philippines dates back to 1967 when leaders of 12 countries including the Philippines' Ferdinand Marcos signed the Declaration on Population.[3][4] The Philippines agreed that the population problem be considered as the principal element for long-term economic development. Thus, the Population Commission (Popcom) was created to push for a lower family size norm and provide information and services to lower fertility rates.[5] Starting 1967, the USAID started shouldering 80% of the total family planning commodities (contraceptives) of the country, which amounted to US$ 3 Million annually.[5]

US National Security Memorandum: paramount importance of world population control through programs of UN and USAID. In 1975, the United States adopted as its policy the National Security Study Memorandum 200: Implications of Worldwide Population Growth for U.S. Security and Overseas Interests (NSSM200). The policy gives "paramount importance" to population control measures and the promotion of contraception among 13 populous countries, including the Philippines to control rapid population growth which they deem to be inimical to the socio-political and economic

growth of these countries and to the national interests of the United States, since the "U.S. economy will require large and increasing amounts of minerals from abroad", and these countries can produce destabilizing opposition forces against the United States.[6] It recommends the US leadership to "influence national leaders" and that "improved world-wide support for population-related efforts should be sought through increased emphasis on mass media and other population education and motivation programs by the U.N., USIA, and USAID."[6] Different presidents had different points of emphasis. President Marcos pushed for a systematic distribution of contraceptives all over the country, a policy that was called "coercive," by its leading administrator.[4] The Cory Aquino administration focused on giving couples the right to have the number of children they prefer, while the Ramos presidency shifted from population control to population management. Estrada used mixed methods of reducing fertility rates, while Arroyo focused on mainstreaming natural family planning, while stating that contraceptives are openly sold in the country.[5] In 1989, the Philippine Legislators Committee on Population and Development (PLCPD) was established, "dedicated to the formulation of viable public policies requiring legislation on population management and socio-economic development." In 2000, the Philippines signed the Millennium Declaration and committed to attain the MDG goals by 2015, including promoting gender equality and health. In 2003, USAID started its phase out of a 33 year old program by which free contraceptives where given to the country. Aid recipients such as the Philippines faced the challenge to fund its own contraception program.[5] In 2004, the Department of Health introduced the Philippines Contraceptive Self-Reliance Strategy, arranging for the replacement of these donations with domestically provided contraceptives.[5] In August 2010, the government announced a collaborative work with the USAID in implementing a comprehensive marketing and communications strategy in favor of family planning called "May Plano Ako" (I Have a Plan).

[edit] Key definitions

House Bills 101 and 513, and Senate Bill 2378 define the term "reproductive health care" as follows: Reproductive Health Care - refers to the state of complete physical, mental and social well-being and not merely the absence of disease or infirmity, in all matters relating to the reproductive system and to its functions and processes. This implies that people are able to have a satisfying and safe sex life, that they have the capability to reproduce and the freedom to decide if, when and how often to do so, provided that these are not against the law. This further implies that women and men attain equal relationships in matters related to sexual relations and reproduction.
[7]

House Bill 96 replaces "have a satisfying and safe sex life" with "enjoy responsible and safe sex" but is otherwise identical in its definition. House Bill 1160 omits "a satisfying and" but is

otherwise identical. House Bill 3387 omits the word "complete" before physical, and replaces "attain" with "are afforded," but is otherwise identical.[7] Reproductive Rights are defined by House Bills 101, 513, 1160, 3387, and Senate Bill 2378 as follows: the rights of individuals and couples, to decide freely and responsibly whether or not to have children; the number, spacing and timing of their children; to make other decisions concerning reproduction free of discrimination, coercion and violence; to have the information and means to do so; and to attain the highest standard of sexual and reproductive health.[7] House Bill 96 replaces "other decisions" with "allied decisions," but is otherwise identical.[7] The opposition says that by supporting such definitions, the country will guarantee this same right of having "a satisfying and safe sex life" and the freedom of decision to unmarried children and teenagers, since they are "people" and "individuals." They argue that this will lead to promiscuity among the young.[8] They say that the terminology is part of deceptive "verbal engineering" since RH is not in favor of reproduction, and contraceptives are not healthy, but RH is presented as something good.[citation needed]

[edit] Bill content

[edit] Sections

Philippine Population Density Map. Darker areas mean more population. The basic content of the Consolidated Reproductive Health Bill is divided into the following sections. 1. Title 2. Declaration of Policy 3. Guiding Principles

4. Definition of Terms 5. Midwives for Skilled Attendance 6. Emergency Obstetric Care 7. Access to Family Planning 8. Maternal and Newborn Health Care in Crisis Situations 9. Maternal Death Review 10. Family Planning Supplies as Essential Medicines 11. Procurement and Distribution of Family Planning Supplies 12. Integration of Family Planning and Responsible Parenthood Component in Anti-Poverty Programs 13. Roles of Local Government in Family Planning Programs 14. Benefits for Serious and Life-Threatening Reproductive Health Conditions 15. Mobile Health Care Service 16. Mandatory Age-Appropriate Reproductive Health and Sexuality Education 17. Additional Duty of the Local Population Officer 18. Certificate of Compliance 19. Capability Building of Barangay Health Workers 20. Ideal Family Size 21. Employers Responsibilities 22. Pro Bono Services for Indigent Women 23. Sexual And Reproductive Health Programs For Persons With Disabilities (PWDs) 24. Right to Reproductive Health Care Information 25. Implementing Mechanisms 26. Reporting Requirements 27. Congressional Oversight Committee 28. Prohibited Acts 29. Penalties 30. Appropriations 31. Implementing Rules and Regulations 32. Separability Clause 33. Repealing Clause 34. Effectivity

[edit] Summary of major provisions

The bill mandates the government to promote, without bias, all effective natural and modern methods of family planning that are medically safe and legal.[2] Although abortion is recognized as illegal and punishable by law, the bill states that the government shall ensure that all women needing care for post-abortion complications shall be treated and counseled in a humane, non-judgmental and compassionate manner.[2] The bill calls for a multi-dimensional approach integrates a component of family planning and responsible parenthood into all government anti-poverty programs.[2]

Under the bill, age-appropriate reproductive health and sexuality education is required from grade five to fourth year high school using life-skills and other approaches.[2] The bill also mandates the Department of Labor and Employment to guarantee the reproductive health rights of its female employees. Companies with less than 200 workers are required to enter into partnership with health care providers in their area for the delivery of reproductive health services.[2] Employers are obliged to monitor pregnant working employees among their workforce and ensure they are provided paid half-day prenatal medical leaves for each month of the pregnancy period that they are employed.[2] The national government and local governments will ensure the availability of reproductive health care services, including family planning and prenatal care.[2] Any person or public official who prohibits or restricts the delivery of legal and medically safe reproductive health care services will be meted penalty by imprisonment or a fine.[2]

[edit] Summary of support and criticism

Proponents argue: (1) Economic studies, especially the experience in Asia,[9] show that rapid population growth and high fertility rates, especially among the poor, exacerbate poverty and make it harder for the government to address it.[10][11] (2) Empirical studies show that poverty incidence is higher among big families.[10][12] Smaller families and wider birth intervals could allow families to invest more in each childs education, health, nutrition and eventually reduce poverty and hunger at the household level.[5][9][10] (3) Ten to eleven maternal deaths daily could be reduced if they had access to basic healthcare and essential minerals like iron and calcium, according to the DOH; (4) Studies show that 44% of the pregnancies in the poorest quintile are unanticipated, and among the poorest women who would like to avoid pregnancy, at least 41% do not use any contraceptive method because of lack of information or access.[9][10] and "Among the poorest families, 22% of married women of reproductive age express a desire to avoid pregnancies but are still not using any family planning method,"[9] (5) use of contraception, which the World Health Organization has listed as essential medicines,[13][14] will lower the rate of abortions as it has done in other parts of the world, according to the Guttmacher Institute.[15](6) An SWS survey of 2008 showed that 71% of the respondents are in favor of the bill,[16] (7) at the heart of the bill is the free choice given to people on the use of reproductive health, enabling the people, especially the poor to have the number of children they want and can care for. Opponents of the bill argue that: (1) "The world's leading scientific experts" have resolved the issues related to the bill and show that the "RH Bill is based on wrong economics" as the 2003 Rand Corporation study shows that "there is little cross-country evidence that population growth impedes or promotes economic growth".[17][18] (2) The bill takes away limited government funds from treating many high priority medical and food needs and transfers them to fund harmful and deadly devices.[19] The latest studies in scientific journals and organizations show that the ordinary birth control pill,[20] and the IUD[21] are abortifacient to fertilized eggs: they kill young human embryos, who as such are human beings equally worthy of respect,[22] making the bill

unconstitutional.[23][24] (3) Leading secular social scientists like Nobel prize winner, George Akerlof and US National Defense Consultant, Lionel Tiger, have shown empirical evidence that contraceptives have deleterious social effects (abortion, premarital sex, female impoverishment, fatherless children, teenage pregnancies, and poverty).[25][26] Harvard Director Edward Green concluded that the "best studies" show that more condoms promote the spread of AIDS.[27] Combined estrogen-progestogen oral contraceptives (the most common type prescribed globally) are carcinogenic,[28][29] and confers other serious health risks.[30][31] The increased usage of contraceptives, which implies that some babies are unwanted, will eventually lead to more abortion.[23](4) People's freedom to access contraceptives is not restricted by any opposing law, being available in family planning NGOs, stores, etc. The country is not a welfare state: taxpayer's money should not be used for personal practices that are harmful and immoral; it can be used to inform people of the harm of BCPs. (5) A 2009 survey showed that 92% rejected the bill when informed of its detailed provisions and penalties.[32] (6) The penal provisions constitute a violation of free choice and conscience, and establishes religious persecution.[33] President Aquino stated he was not an author of the bill. He also stated that he gives full support to a firm population policy, educating parents to be responsible, providing contraceptives to those who ask for them, but he refuses to promote contraceptive use. He said that his position "is more aptly called responsible parenthood rather than reproductive health."[34][35]

[edit] Economic and demographic premises

The Philippines is densely populated, with a density over 300 per squared kilometer, and the population growth rate is 2.04 (2007 Census), 1.957% (2010 est. by CIA World Fact Book), or 1.85% (2005-2010 high variant estimate by the UN Population Division, World Population Prospects: The 2008 Revision) coming from 3.1 in 1960. The 2010 total fertility rate (TFR) is 3.23 births per woman, from a TFR of 7 in 1960.[36] In addition, the total fertility rate for the richest quintile of the population is 2.0, which is about one third the TFR of the poorest quintile (5.9 children per woman). The TFR for women with college education is 2.3, about half that of women with only an elementary education (4.5 children per woman).[37] Congressman Lagman states that the bill "recognizes the verifiable link between a huge population and poverty. Unbridled population growth stunts socioeconomic development and aggravates poverty."[15] The University of the Philippines' School of Economics presented two papers in support of the bill: Population and Poverty: the Real Score (2004), and Population, Poverty, Politics and the Reproductive Health Bill (2008). According to these economists, which include Solita Monsod, Gerardo Sicat, Cayetano Paderanga, Ernesto M. Pernia, and Stella Alabastro-Quimbo, "rapid population growth and high fertility rates, especially among the poor, do exacerbate poverty and make it harder for the government to address it," while at the same time clarifying that it would be "extreme" to view "population growth as the principal cause of poverty that would justify the government resorting to draconian and coercive measures to deal with the problem (e.g., denial of basic services and subsidies to families with more than two children)." They illustrate the connection between rapid population growth and poverty by comparing the economic growth and population growth rates of Thailand, Indonesia, and the Philippines, wherein the first two

grew more rapidly than the Philippines due to lower population growth rates.[10] They stressed that "the experience from across Asia indicates that a population policy cum government-funded [family planning] program has been a critical complement to sound economic policy and poverty reduction."[9] In Population and Poverty, Aniceto Orbeta, Jr, showed that poverty incidence is higher among big families: 57.3% of Filipino families with seven children are in poverty while only 23.8% of families who have two children live below the poverty threshold.[12]

Percentage of population living below poverty line (2003). Darker areas mean more poverty. Proponents argue that smaller families and wider birth intervals resulting from the use of contraceptives allow families to invest more in each childs education, health, nutrition and eventually reduce poverty and hunger at the household level.[9] At the national level, fertility reduction cuts the cost of social services with fewer people attending school or seeking medical care and as demand eases for housing, transportation, jobs, water, food and other natural resources.[5][10][38] The Asian Development Bank in 2004 also listed a large population as one of the major causes of poverty in the country, together with weak macroeconomic management, employment issues, an underperforming agricultural sector and an unfinished land reform agenda, governance issues including corruption.[11]

[edit] Criticism of premises

Opposing the bill, Former Finance Secretary Roberto de Ocampo wrote that it is "truly disingenuous for anyone to proceed on the premise that the poor are to blame for the nations poverty." He emphasized that the government should apply the principle of first things first and focus on the root causes of the poverty (e.g. poor governance, corruption) and apply many other alternatives to solve the problem (e.g. giving up pork barrel, raising tax collection efficiency).[33] They also point to the five factors for high economic growth and reduction of poverty shown by the 2008 Commission on Growth and Development headed by Nobel prize winner Michael Spence, which does not include population control.[18]

Opponents also refer to a 2003 Rand Corporation study which concluded that "there is little cross-country evidence that population growth impedes or promotes economic growth...population neutralism has in fact been the predominant school in thinking among academics about population growth for the last half-century."[17] In his Primer which critiques the bill, Economist Roberto de Vera refers to Nobel prize winner Simon Kuznets's study which concludes that no clear association appears to exist in the present sample of countries, or is likely to exist in other developed countries, between rates of growth of population and of product per capita." Julian Simon compared parallel countries such as North and South Korea, East and West Germany whose birthrates were practically the same but whose economic growth was entirely different due to different governance factors. De Vera says that "similar conclusions have been arrived at by the US National Research Council in 1986 and in the UN Population Fund (UNFPA) Consultative Meeting of Economists in 1992" and the studies of Hanushek and Wommann (2007), Doppelhoffer, Miller, Sala-I-Martin (2004), Ahlburg (1996), etc.[39] The other Nobel Prize winner who expressed the same view is Gary Becker.[40][41] De Vera also states that from 19612000, as Philippine population increased almost three times, poverty decreased from 59% to 34%. He stressed that the more probable cause of poor families is not family size but the limited schooling of the household head: 78% to 90% of the poor households had heads with no high school diploma, preventing them from getting good paying jobs. He refers to studies which show that 90% of the time the poor want the children they have: as helpers in the farm and investment for a secure old age.[39] Instead of aiming at population decrease, De Vera stressed that the country should focus through education on cashing in on a possible demographic dividend, a period of rapid economic growth that can happens when the labor force is growing faster than the dependents (children and elderly), thus reducing poverty significantly.[39] In a recent development, two authors of the Reproductive Health Bill changed their stand on the provisions of the bill regarding population and development. Reps. Emerciana de Jesus and Luzviminda Ilagan wanted to delete three provisions which state that "gender equality and women empowerment are central elements of reproductive health and population and development," which integrate responsible parenthood and family planning programs into antipoverty initiatives, and which name the Population Commission as a coordinating body. The two party-list representatives strongly state that poverty is not due to over-population but because of inequality and corruption.[42]

[edit] Maternal health and deaths

Birthing services are key to solving maternal deaths

The proponents state that RH will mean: (1) Information and access to natural and modern family planning (2) Maternal, infant and child health and nutrition (3) Promotion of breast feeding (4) Prevention of abortion and management of post-abortion complications (5) Adolescent and youth health (6) Prevention and management of reproductive tract infections, HIV/AIDS and STDs (7) Elimination of violence against women (8) Counseling on sexuality and sexual and reproductive health (9) Treatment of breast and reproductive tract cancers (10) Male involvement and participation in RH; (11) Prevention and treatment of infertility and (12) RH education for the youth. There is general agreement on the health provisions of the RH bill, except for the provisions on contraception and family planning devices that have moral and health implications, and provisions on sex education done in schools. The Department of Health states that family planning can reduce maternal mortality by about 32 percent.[13] The bill is "meant to prevent maternal deaths related to pregnancy and childbirth," said Clara Padilla of Engender Rights. She reported that "Daily, there are 11 women dying while giving birth in the Philippines. These preventable deaths could have been avoided if more Filipino women have access to reproductive health information and healthcare." Regarding these figures, Francisco Tatad of the International Right to Life Federation and former Senator wrote that "If correct, experience has shown (as in Gattaran, Cagayan and Sorsogon, Sorsogon) that the incidence of maternal death arising from such complications could be fully mitigated and brought down to zero simply by providing adequate basic and emergency obstetrics care and skilled medical personnel and services," without any need for a law on the distribution of contraceptives.[24] The key to solving maternal deaths, according to the Senate Policy Brief on reproductive health, is the establishment of birthing centers.[5]

[edit] Family planning

Catholic Church: A large family is a sign of God's blessings (CCC 2373) The majority of Filipinos are in favor of family planning. The Catholic Church teaches the necessity of responsible parenthood and correct family planning (one child at a time depending on one's circumstances), while at the same time teaching that large families are a sign of God's blessings. It teaches that modern natural family planning, a method of fertility awareness, is in accord with God's design, as couples give themselves to each other as they are. The RH bill intends to help couples to have government funded access to artificial contraception methods as well.[citation needed]

[edit] Unmet need

Using data from the 2008 National Demographic and Health Survey, Lagman stated that "Twenty-two percent of married Filipino women have an unmet need for family planning services, an increase by more than one-third since the 2003 National Demographic and Housing Survey." "Our women are having more children than they desire, as seen in the gap between desired fertility (2.5 children) and actual fertility (3.5 children), implying a significant unmet need for reproductive health services," state some Ateneo de Manila University professors. The Bill provides that "The State shall assist couples, parents and individuals to achieve their desired family size within the context of responsible parenthood for sustainable development and encourage them to have two children as the ideal family size."[9][38] Basing itself on demographic surveys, Likhaan, a non-government organization for women's health, stated that the most common reasons why women with unmet need in the Philippines do not practice contraception are health concerns about contraceptive methods, including a fear of side effects. 44% reported these reasons in 2008. The second largest category of reasons is that many believe they are unlikely to become pregnant41% in 2008. Their specific reasons include having sex infrequently, experiencing lactational amenorrhea (temporary infertility while nursing) and being less fecund than normal.[43] Writing against the bill, Bernardo Villegas wrote about the Myth of Unmet Family Planning Needs, citing development economist Lant Pritchett who said that the term "unmet need" is an elitist construct, an imposition of a need on the poor, disrespectful of their real preferences. Pritchett said that it is "based on a discrepancy...identified by the analyst through the comparison of responses to items in separate blocks of the questionnaire" and is "an inference on the part of the researcher, not a condition reported by the respondents themselves." Pritchett argued this term is applied to women who are not sexually active, are infecund, whose husband is absent, etc., thus bloating the numbers to favor the pharmaceutical companies and those with a population control agenda. Villegas stressed: "Because [the poor] have been deprived of the infrastructures they need, such as farm-to-market roads, irrigation systems, post-harvest facilities and other support services that the State neglected to provide them, the only economic resources they have are their children." He also challenged that he is willing to bet that if the government will provide cash money to the poor to buy condoms, the poor will use the cash for food and basic needs, thus exploding the myth.[44]

[edit] Access
One of the main concerns of the proponents is the perceived lack of access to family planning devices such as contraceptives and sterilization. The bill intends to provide universal access through government funding, complementing thus private sector initiatives for family planning services, such as those offered by the International Planned Parenthood Federation (IPPF) which supports the Family Planning Organizations of the Philippines and the 97 organizations of the Philippine NGO Council. The opposition argues that "Access to contraceptives is free and unrestricted" and that the proposed law is pushing an open door.[24] They say that these family planning items are available

to the citizens and many local government units and NGOs provide these for free. Congressman Teddyboy Locsin argued, echoed by a Business Mirror editorial, that the poor can afford condoms since they can pay for other items such as cellphone load. Opponents also argue that Philippine government is not a welfare state, and taxpayers are not bound to provide for all the wants and desires of its citizenry, including their vanity needs, promiscuous actions and needs artificially created by elitist, imperialist and eugenicist forces; nor should taxpayers pay for drugs that are objectively dangerous (carcinogenic) and immoral. They argue that the Philippines should give priority to providing access to medicines that treat real diseases.[19][24]

Birth control pill The UP School of Economics argues, in contrast, that there is lack of access especially for poor people, because contraceptive use is extremely low among them and "Among the poorest families, 22% of married women of reproductive age express a desire to avoid pregnancies but are still not using any family planning method."[9] They say that lack of access leads to a number of serious problems which demand attention: (1) "too many and too closely-spaced children raises the risk of illness and premature deaths (for mother and child alike)," (2) "the health risks associated with mistimed and unwanted pregnancies are higher for adolescent mothers, as they are more likely to have complications during labor," (3) women who have mistimed pregnancies are "constrained to rely more on public education and health services and other publicly provided goods and services," further complicating limited public resources, (4) families are not able to achieve their desired family size. Thus the UP economists "strongly and unequivocally support" the thrust of the bill to enable "couples and individuals to decide freely and responsibly the number and spacing of their children and to have the information and means to carry out their decisions.[9] Proponents argue that government-funded access is the key to breaking the intergenerational poverty that many people are trapped in.[9][38]

[edit] Abortion
One of the bill's components is "prevention of abortion and management of post-abortion complications." It provides that "the government shall ensure that all women needing care for post-abortion complications shall be treated and counseled in a humane, non-judgmental and compassionate manner." It also states that "abortion remains a crime and is punishable," as the Constitution declares that the State shall equally protect the life of the mother and the life of the unborn from conception.[45] Opposing the bill, the Faculty of Medicine of the catholic University of Santo Tomas, the Philippine Nurses Association (with at least 368,589 members), the Bioethics Society of the Philippines, Catholic Physicians Guild of the Philippines stated that the antiabortion stance of the bill is contradicted by the promotion of contraceptive agents (IUD and hormonal

contraceptives) which actually act after fertilization and are potentially abortifacient agents.[46] Opposition refers to a 2000 study of a scientific journal of the American Medical Association, in which a meta-analysis of 94 studies provides evidence that when a common birth control pill fails to prevent ovulation, "postfertilization effects are operative to prevent clinically recognized pregnancy."[20] They also point to the American Journal of Obstetrics and Gynecology (2005), which concluded that the IUD brings about the "destruction of the early embryo,"[21] thus is deemed to kill five-day old babies.[8] Jo Imbong, founder of the Abay Pamilya Foundation, reported that "Lagman said in a House hearing that the bill would protect human life 'from implantation,'"[47] and not from fertilization, noting at the same time that the Records of the Constitutional Commission state that Human life begins at fertilization.[47][48] After referring to many standard textbooks of medicine and human embryology to affirm this as true,[49] the anti-RH bill citizens argue that the human embryo already has the complete genetic code and is thus a distinct human life beginning its own new life cycle. They say that the embryo is an individual, self-coordinated and self-organizing subject belonging to the species homo sapiens: a human being by nature and thus a person equally worthy of respect.[22]

5-day old human embryo called a blastocyst, which comprises 70-100 cells. Proponents argue that research by the Guttmacher Institute, involved in advancing international reproductive health, reveals that the use of contraceptives can reduce abortion rates by 85%. Proponents such as 14 Ateneo de Manila University professors, argued thus: "Studies show that the majority of women who go for an abortion are married or in a consensual union (91%), the mother of three or more children (57%), and poor (68%) (Juarez, Cabigon, and Singh 2005). For these women, terminating a pregnancy is an anguished choice they make in the face of severe constraints. When women who had attempted an abortion were asked their reasons for doing so, their top three responses were: they could not afford the economic cost of raising another child (72%); their pregnancy occurred too soon after the last one (57%); and they already have enough children (54%). One in ten women (13%) who had attempted an abortion revealed that this was because her pregnancy resulted from forced sex (ibid.). Thus, for these women, abortion has become a family planning method, in the absence of information on and access to any reliable means to prevent an unplanned and unwanted pregnancy."[38] The bill, said Clara Padilla of EnGender Rights Inc, will "help reduce the number of abortions by providing increased access to information and services on modern contraceptive methods, that in turn will reduce the number of unwanted --and often aborted-- pregnancies."[50] Opponents of the bill argue that the Guttmacher Institute is the research arm of International Planned Parenthood and that the latter is "the largest promoter of artificial birth control and

abortion worldwide."[19] Opponents argue that new data thwarts the "myth" that contraception lowers abortions.[51] Ang Kapatiran Party (AKP) in their Position Paper stated that "The Guttmacher Institute's own study in 2003 showed simultaneous increases both abortion rates and contraceptive use in the United States, Cuba, Denmark, Netherlands, Singapore, and South Korea."[52] The AKP argues that "Since contraceptives will not reduce unplanned pregnancy, they will not reduce abortion rates either and may increase them."[52] Both sides of the debate accuse the other side of deception and misleading the public. The proRH people accuse the anti-RH group of misleading the public by calling the bill an abortion bill, when the bill states that abortion remains a crime and is punishable. The anti-RH advocates accuse the RH supporters of deceiving the public regarding the true meaning of reproductive health, since US Secretary Hillary Clinton said that RH includes abortion,[53] and that RH includes the pill where "postfertilization effects are operative"[21] and the IUD which brings about the "destruction of the early embryo," according to the American Medical Association and the American Journal of Obstetrics and Gynecology.[21]

[edit] Contraceptives
[edit] Morality and social effects
Another central issue is the morality of contraception. Around 81% of Filipinos are Catholics, and the Catholic Church teaches that extramarital sex and contraception are moral evils, since they desecrate sex which is intrinsically linked to new human beings whose lives are sacred. Contraception, says the church, also makes spouses lie about their total self gift to their spouse, by not surrendering their personal fertility.[54]

Prolifers refer to economy Nobel prize winner George Akerlof who found that wide use of contraceptives led to premarital sex, illegitimate children, undomesticated men, crimes and abortions. However, 14 professors from Ateneo de Manila University, a prominent Catholic University, considering the empirical evidence of the dire socio-economic conditions of the Filipino poor, urged that the bill be passed to help them. They argued: "As Catholics and Filipinos, we share

the hope and mission of building a Church of the Poor. We are thus deeply disturbed and saddened by calls made by some members of the Catholic Church to reject a proposed legislation that promises to improve the wellbeing of Filipino families, especially the lives of women, children, adolescents, and the poor." They announced that "Catholic social teachings recognize the primacy of the well-formed conscience over wooden compliance to directives from political and religious authorities," urging Catholic authorities to withdraw their opposition the bill.[38] Citing Catholic documents and scientific studies, they reasoned that "the RH Bill is pro-life, prowomen, pro-poor, pro-youth, and pro-informed choice." They emphasized that the bill "promotes quality of life, by enabling couples, especially the poor, to bring into the world only the number of children they believe they can care for and nurture to become healthy and productive members of our society."[38] Thus, they entitled their paper as "Catholics Can Support the RH Bill in Good Conscience."[38] In response, the Ateneo administration announced its unity with Catholic teaching and that it had "serious objections to the present bill."[55] The catholic University of Santo Tomas's student paper, The Varsitarian expressed shock about what they see as the professors' "erroneous conscience", and ignorance of economic science and medicine.[41] 42 prominent international Catholic scholars, including Janet E. Smith, Peter Kreeft, William E. May, and Joseph W. Koterski, S.J., responded to the faculty of the Ateneo, saying that It is never lawful, even for the gravest reasons, to do evil that good may come of it," that the bill disrespects poor people, and "focuses primarily on providing services to curb the number of children of the poor, while doing little to remedy their situation."[56] Proponents such as Lagman also stressed that official Catholic teaching itself, expressed in the Encyclical Humanae Vitae issued only forty years ago in 1964, is not infallible.[15] He said that the Papal Commission on Birth Control, which included ranking prelates and theologians, recommended that the Church change its teaching on contraception as it concluded that the regulation of conception appears necessary for many couples who wish to achieve a responsible, open and reasonable parenthood in todays circumstances. The editorial of the Philippine Daily Inquirer, moreover, stated that Catholic teaching is "only" a religious teaching and should not be imposed with intolerance on a secular state. Responding to the Inquirer, opponents of the bill said that science and secular moral reasoning show the objective truth that contraception is evil and disastrous for society, and therefore a secular state should stand by this evidence. Thus they cite the 15 non-religious reasons against contraception provided by the Ethics Guide of the secular BBC which includes the loss of potential beneficent human life, causing widespread moral promiscuity, weakening family life, being unnatural and anti-life.[57] They stress that it is the errors of conscience pushed by the "dictatorship of relativism" --rather than the objective truth and the good--- that is imposing itself on people. They say that Catholic Church doctrine on contraception has been the same since its beginning,[57] taught by bishops around the world, thus part of infallible ordinary magisterium.[58] Prestigious secular and anti-Catholic social scientists are also reported to have found empirical evidence linking contraception and a variety of social ills: more premarital sex, fatherless children, and abortion; decline of marriage, crimes by unmarried men, poverty, social pathology (George Akerlof, Nobel prize winner);[25] heightened spread of AIDS (Edward C. Green, Harvard Director for AIDS);[27] breakdown of families, female impoverishment, trouble in the relationship

between the sexes, and single motherhood (Lionel Tiger).[26][59] Opponents argue that misery is not the result of the church which they say is the largest charitable organization in the world, but of a breakdown in moral sense that gives order to society, nor does misery come from parents who bring up children in faithfulness, discipline, love and respect for life, but from those who strip human beings of moral dignity and responsibility, by treating them as mere machines, which they believe contraception does.[60]

[edit] Health reasons

In Medical Issues in the Reproductive Health Bill, Dr. Angelita Miguel-Aguirre refers to metaanalyses at scientific journals that show oral contraceptives (OCs) are unsafe.[19] A meta-analysis of the Stroke Journal concluded that OCs confer "risk of first ischemic stroke."[31] The World Health Organization (WHO) announced the findings of The International Agency for Research on Cancer (IARC) in 2007 that "there is sufficient evidence in humans for the carcinogecity of combined estrogen-progestogen contraceptives."[28][29] The Journal of Clinical Endocrinology & Metabolism also concluded in 2005 that "a rigorous meta-analysis of the literature suggests that current use of low-dose OCs significantly increases the risk of both cardiac and vascular arterial events."[30] In its list of essential medicines, WHO stated that these drugs "have been questioned" and "will be reviewed" by its Expert Committee.[14]

The World Health Organization announced scientific findings that the pill causes cancer and kept it in its list of essential medicines Opponents also say that being pregnant with a child is not a disease but a blessing, and that there are real diseases among the leading causes of mortality that should take on a higher priority, given the limited budget. They refer to data from the Department of Health as to the leading causes of death in the Philippines, and the daily death toll per 100,000 women are: (1) Heart diseases - 80; (2) Vascular diseases - 63; (3) Cancer - 51; (4) Pneumonia - 45; (5) Tuberculosis 23; (6) Diabetes - 22; (7) Lower chronic respiratory diseases 16.[24][61] Dr. Aguirre of the Makati Medical Society also said that "The health risks of the pill actually outweighs by far the risks of pregnancy and childbirth to a woman's health."[19] Proponents such as E. Ansioco of Democratic Socialist Women of the Philippines argued that "The World Health Organization (WHO) includes contraceptives in its Model Lists of Essential Drugs" and thus are safe medicines.[13][14] "Medical and scientific evidence," says the main proponent, "shows that all the possible medical risks connected with contraceptives are infinitely lower than the risks of an actual pregnancy and everyday activities...The risk of dying within a year of using pills is 1 in 200,000. The risk of dying from a vasectomy is 1 in 1 million and the risk of dying from using an IUD is 1 in 10 million. ... But the risk of dying from a pregnancy is 1 in 10,000."[15]

In Facts on Barriers to Contraceptive Use in the Philippines, Likhaan made the following projection: "If all women who wanted to avoid pregnancy used modern methods, there would be 1.6 million fewer pregnancies each year in the Philippines. Unintended births would drop by 800,000, abortions would decline by 500,000 and miscarriages would decline by 200,000. Expanding modern contraceptive use to all women at risk for unintended pregnancy would prevent 2,100 maternal deaths each year. It would also reap savings on medical care for pregnant women and newborns that would more than offset the additional spending on modern contraception."

[edit] HIV/AIDS
The RH bill provides for "prevention and treatment of HIV/AIDS and other, STIs/STDs," especially since the number of HIV cases among the young nearly tripled from 41 in 2007 to 110 in 2008.[50] Primary among the means is distribution of condoms. The proponents applauded government efforts last February 2010 when it distributed condoms in some areas of Manila. On the other side of the debate, Dr. Rene Josef Bullecer, Director of AIDS-Free Philippines, said that in 1987, Thailand had 112 AIDS cases, more or less the same number as the Philippines (135). By the year 2003, there were around 750,000 cases in Thailand, where there was an intense campaign for the "100% Condom Use Program", while there were only 1,935 cases in the Philippines, whose population is around 30% greater than Thailand's.[62][63] Pro-life groups refer to the Director of Harvard's Aid Prevention Center, Edward C. Green, who said that the "best evidence" agrees with Benedict XVI's statement that condom distribution risked exacerbating the spread of the virus, because availability of condoms leads to riskier sexual behavior.[27]

[edit] Sexuality Education

To achieve its goals, the bill provides for mandatory reproductive health education and that it be taught in "an age-appropriate manner... by adequately trained teachers starting from Grade 5 up to Fourth Year High School." Opposition to the bill is concerned about early sexualization of the youth and say that sexuality education promoters themselves state that it has led to more teenage pregnancies and illegitimacy. They stressed that what is needed is chastity education, especially taught by their parents, rather than sex education in school. Proponents refer to the latest UNESCO study dated December 2009 which concluded that sexuality education did not encourage early initiation into sex, but actually increased the age at which people first engage in sexual activity.[64]

[edit] Opinion polls

Proponents refer to many surveys conducted by two prominent locally based organizations (SWS and Pulse Asia) which show majority support for the bill. A survey conducted in 2008 by the Social Weather Stations, commissioned by the Forum for Family Planning and Development (FFPD), a non-government advocacy group, showed that 68 percent of Filipinos agree that there should be a law requiring government to distribute legal contraceptives.[65] SWS President and

RH Bill proponent, Mahar Mangahas reported that the "survey found 71 percent in favor [of the RH Bill], 21 percent undecided, and a mere 8 percent opposed. Among those who originally knew of the bill, the score is 84 percent in favor, and 6 percent opposed. Among those who learned of the bill for the first time because of the survey, the score is 59 percent in favor, versus 11 percent opposed.[16][65] Pulse Asia reported that in an October 2008 survey "most Filipinos are aware of the reproductive health bill pending at the House of Representatives (68%) and are in favor of the bill (63%)."[66] In December 2010, Pulse Asia announced based on the results of an October 2010 survey, 69% of the Filipinos are in favor of the bill. Saying that nation-wide surveys are financed by wealthy, foreign-funded political lobby groups to create a bandwagon effect, Senator Tatad remarked that an objective measure of Filipino preference is the consistent top electoral success of the pro-life party-list, Buhay Hayaan Yumabong (Let Life Flourish).[24] President of Prolife Philippines, Lito Atienza, said that the surveys conducted by SWS and Pulse Asia were misleading, because the participants were not fully informed of the bill, were merely aware of it, and informed that it was about health and "modern methods". Instead he referred to the Filipino Family survey of December 2009 conducted by the HB&A International (an affiliate of Louis Harris & Associates) together with the personnel of Asia Research Organization (the Philippine affiliate of Gallup International). The survey concluded that 92% of people in Metro Manila rejected the bill, "85 percent are not aware that once passed the RH bill would allow teenagers to secure 'abortifacient devices and substances' without their parents knowledge and consent....90 percent do not agree that Congress should appropriate P2 billion to the detriment of other essential medicines for free childrens vaccinations, treatment of dreaded diseases and other more important health and medical concerns."[32] Mangahas acknowledged that the SWS surveys did not include the penalties.[67]

[edit] Rallies and TV Debate

From late 2010 to the present, there have been rallies for and against the bill. The pro-life rallies against the bill where in: Manila (March 25) - 40,000[68] - 200,000,[69][70] Mindanao - 50,000,[71] Manila (Feb 13) - 10,000[72] - 50,000,[73] Bacolod - 20,000,[74] Cebu 10,000 to 12,000,[75] Balanga - 10,000,[76] Lucena - 8,000,[77] Dipolog - 10,000 and Pagadian 8,000,[78] Maasin, Leyte - 6000 to 7000,[79][80] Manila Knights of Columbus March (March 2011) 7000,[81] Legazpi - 4000,[82] Iloilo - 4000,[83] San Pablo, Quezon - 2000,[84] Quiapo (Oct) 1500.[85] The pro-RH rallies were: Batasan - 1500,[86] CBCP complex - 1000[87] A TV Debate was also hosted by ABS-CBN last May 2011. Leaders of both sides, including Rep. Lagman and Rep. Golez were present. According to the ABS-CBN news which reported on the results: "In the SMS poll, 69.58% of votes cast reject the RH bill while 30.42% support it. In the separate online poll held on the Harapan microsite that livestreamed the debate, 63.91% support the RH bill while 36.09% oppose it.[88]

[edit] Penalties

There is mandatory sexuality education starting grade 5, and "malicious disinformation" is penalized.[7] All health care service providers which provide reproductive health services, including faith-based hospital administrators, may be imprisoned or fined if they refuse to provide family planning services such as tubal ligation and vasectomy. The same may happen to employers who do not provide free services to employees.[7] Imprisonment ranges from (1) month to six (6) months or a fine ranging from Ten Thousand Pesos (P10,000.00) to Fifty Thousand Pesos (P50,000.00).[7] Former Finance Secretary, Roberto de Ocampo, stated that these punitive provisions "are tantamount to an affront to civil liberties and smack of religious persecution."[33] Defending the bill, Dr. Felipe Medalla, former dean of the School of Economics of UP, said that "Although the poors access to family planning services can be improved even without the law, the absence of the law makes it easier to block the program."

[edit] Separation of church and state

Because 81% of Filipinos are Catholics, the Catholic Church exerts a strong influence in public life. Its staunch opposition to the bill has drawn the ire of non-Catholics and Catholics alike who support the bill, and they invoke the principle of separation of church and state to stop the church. Fr. Joaquin Bernas, S.J, one of the drafters of the Philippine Constitution and a prominent lawyer and writer, explained that the concept of separation of church and state is directed towards the state, rather than the church, as it is a political concept. Technically it means non-establishment of religion, as the Constitution stated that No law shall be passed respecting an establishment of religion ... It means that the state should be guided by the principle that it should support no specific religion. This means that government funding should not be allocated for building churches or mosques, and not favor any particular religion. It does not prevent the church, parents, supervisors, teachers and other moral educators from expressing their views and educating their wards on the morality of their personal and social actions. Proponents, on the other hand, state that the church should not meddle in matters of the state, and should focus on religious matters, not political matters.

[edit] Culture war and its implications

Millenium Development Goals at the UN

The national debate is seen as part of a wider culture war.[89][90] Passage or non-passage of the bill have negative implications depending on the views. Proponents state that the non-passage of the bill will mean keeping the Philippines in a backward state and unable to achieve the Millennium Development Goals, especially the points on poverty alleviation and maternal health. It will mean reneging on international commitments and will slow down modernization. Also the poor will not have free access to family planning support that many have expressed desires to have, and thus will have more children than they can care for, and will not have the money to invest in education to break the intergenerational poverty they are trapped in. Proponents also accuse the Catholic Church of holding the Philippines "hostage" and violating the separation of church and state.[91] They argue that a decreased population growth will lead to improved quality of life and economic development. Opponents of the bill see the bill as allowing the Filipinos to be fooled by the deceptive manipulations of American imperialism and eugenicist control, using United Nations Agencies for its own national interests, and to use Philippines' own national funds to kill the youngest Filipinos, harm its own mothers, and encourage immorality. They see the bill as an act of disrespect and ingratitude to the Catholic Church that works for the poor and the sick, and for the education and development of Filipinos.[24][90] They accuse the Philippine Legislator's Committee on Population and Development as "essentially a foreign body" that has drafted the bills, and that its "2008 lobbying fund of two billion pesos comes from the David and Lucile Packard Foundation, IPPF and UNFPA the latter two both well known for their global agenda to legalize abortion."[90] They say that a two-child policy will make the country fail to cash in on a possible demographic dividend of rapid economic growth, and great reduction of poverty, a chance for complete modernization without destruction of human life and promotion of immorality.[39]

[edit] Status
[edit] Legislature
On January 31, 2011, six different bills were consolidated into a single RH Bill which was then unanimously approved for plenary debate by the House Committee on Population and Family Relations. On February 7, 2011, the bill was scheduled to go before the House Appropriations Committee. February 16, 2011 the bill was endorsed by the House Appropriations Committee with amendment and referred back to the Population Committee for finalizing the language.

[edit] President and Cabinet

President Noynoy Aquino will provide contraceptives to parents who ask, but will not promote its use. President Noynoy Aquino during the presidential campaign said that it confounds him why he is always associated with the RH Bill and reiterated that he is neither an author nor a co-author, much less did he sign the committee report regarding the bill. He said that "he will fully support the crafting of a firm policy that will address the serious problem on population."[34] At the same time, Aquino said that "artificial contraception was a matter of choice and conscience and that health professionals who fool people into using artificial contraceptives should be penalized. As a Catholic, Aquino said he himself was not promoting artificial contraception but believes that the government should be able to provide it to Filipinos who ask for it." Aquino stressed: "Im a Catholic, Im not promoting it. My position is more aptly called responsible parenthood rather than reproductive health."[35] According to Rina Jimenez David who is pro-RH, during the Women Deliver Philippines Conference held September 2010, Dinky Soliman, Aquino's Secretary of Social Welfare and Development, said that "choice and access constituted the keystone of the Aquino governments policy, reiterating the administrations support for the pending reproductive health bills.[92] The Cabinet and the CBCP have agreed to have a joint campaign providing full information on the advantages and risks of contraceptives, natural and artificial family planning and responsible parenthood. They have established a technical working group for this purpose. They also agreed that government will not be an "instrument to enforce or violate the conscience of the people about these issues."

[edit] Compromise and alternatives

Senate PresidentJuan Ponce Enrile, Congressman Roilo Golez and Buhay party-list separately filed bills that seek to restrict abortion and birth control use. These bills have been seen either as a nullification of the RH Bill, its alternative, or as a way of achieving unity among the populace, since the RH Bill proponents have stated their concern in preventing abortion.

Presidential candidate Gilbert Teodoro or Gibo suggested a cash transfer from the government to individuals wanting access to family planning methods, whether natural or artificial. The individuals can then make use of the cash they receive to purchase birth control devices they may choose, thus guaranteeing freedom of choice.[93] The Loyola School of Theology and the John J. Carroll Institute on State and Church Issues issued 9 "Talking Points" on the RH Bill. Among other points, they proposed a study on the meaning of conception in the Constitution, and if it means fertilization, abortifacients "are to be banned even now and regardless of whether the RH Bill is passed". They also proposed "parallel programs for providing information and training, one for Natural Family Planning (NFP) and another for artificial methods of family planning".[94]

[edit] Recent Events

In September 2010, Aquino during this visit to the US reiterated his stand that he is in favor of responsible parenthood and respects the decision of each couple as to the number of children they want, and if they need the government support for contraception, then the government will provide it. This statement has created a furor as Catholic church leaders say that Aquino has sold out the Filipino soul in exchange for some "measly" aid from the United States. The President of the Catholic Bishops Conference said that there can possibly be an excommunication of the President if he continues on with his stance. Pro RH Bill Senators encouraged the President to be steadfast to do his duties towards the state. The President's spokesperson Edwin Lacierda explained that the President "has not changed his stand" and is reaching out to the prelates and said that the President himself has not made any decision in support of the Reproductive Health Bill as he is still studying the document. Lacierda said that the Executive Branch "is not involved in the passage of the RH bill, saying the measure's fate rests solely on the legislative branch." Filipino Freethinkers, an association of agnostics, atheists, progressives, etc., who have been very active in the fight in favor of the RH bill, stepped up the pressure, creating more controversy that fired up renewed interest in the bill on both sides. On 30 September 2010, one of the freethinkers, Carlos Celdran staged a protest action against the Catholic Church, holding a sign which read "DAMASO" -- a reference to the villainous, corrupt clergyman Father Dmaso of the novel Noli Me Tangere by Filipino revolutionary writer Jose Rizal -- and shouting "stop getting involved in politics!" A fan page, Free Carlos Celdran was created in Facebook, which generated 23,808 fans in 24 hours. Francisco Montalvan of the Inquirer said that in the end the Damasos are the scheming, corrupt and deceptive people, implying that the "pro-death advocates" are these, while the Cardinal Rosales who started a nationwide fund for the poor is very far from Damaso. Meanwhile, the Imam Council of the Philippines, the top leaders of the Moslem population which at 4.5 M constitutes 5% of the Philippine population, declared that they are against contraceptives since using them "underestimates God," and "makes one lose morality in the process." During the first public hearing on Nov 24, the chair of the Committee on Population handling the bill said that there is no instruction from the Speaker of the House to expedite the bill. Upon the call of anti-RH congressmen, the Committee Chair decided to refer the bill also to the Committee on Health, since the bill is about Reproductive Health. Leader of the pro-RH group, Elizabeth

Ansioco, said that the bill is doomed if it is referred to the Committee on Health. Anti-RH Deputy Speaker Congressman Pablo Garcia said the members of the Committee on Health know of the WHO announcement on the carcinogenicity of combined estrogen-progestogen oral contraceptives. House Speaker Belmonte said that Congress is not likely to rush the legislation of the bill and will tackle it in plenary early next year. Belmonte said it is better that highly contentious bills be given more attention. On 3 December, the Senate cut the proposed budget of P 880M for contraceptives down to P 8M for condoms since other contraceptives violated the Constitution's ban on abortifacients, and Senator Tito Sotto III said that his constituents never asked for contraceptives. Iglesia ni Cristo (INC) has expressed support for the Reproductive Health (RH) Bill. In a letter to House population and family relations committee chairman Rep. Rogelio Espina on October 2010, INC Executive Minister Eduardo Manalo said the bill needs to be passed.

[edit] International reactions

[edit] European Union
European Union Ambassador to the Philippines Alistair MacDonald said "We have all seen the figures on illegal abortion a year in the Philippines and I very much hope that both Houses of Congress will take these issues into account in producing a reproductive health legislation which will really help people make their own choices and to provide for their families."[95] MacDonald said that lack of effective access to reproductive health services in the Philippines was 'antithetical' to the countrys struggle against poverty and "It seems to me extremely unlikely that the Philippines will be able to meet its commitment under the MDGs under the present policy."[95] MacDonald noted that the total fertility rate for the richest quintile of the population is 2.0, while the total fertility rate of the poorest quintile is 5.9. The total fertility rate for women with a college education is 2.3, about half that of women with only elementary education (4.5). He mentioned that the lack of access to RH services is anti-women, citing the slow decline in the maternal mortality ratio in the Philippines. He also said surveys suggest that the total wanted fertility rate for the Philippines is 2.4 children, or below the actual TFR of 3.3 children.[95]

[edit] International scholars

An international group of conservative catholic scholars, including George Weigel, Mary Ann Glendon, Thomas Lickona have expressed opposition to the bill in a one-page ad in the major newspapers of the Philippines, entitled Population Control Does Not Reduce Poverty. They refer to the RAND Corporation study of 2003, which states that "Most economic analysis has examined the statistical correlation between population and economic growth and found little significant connection... there is little cross-country evidence that population growth impedes or promotes economic growth... The neutralist theory has been the dominant view since the mid-

1980s... population neutralism has in fact been the predominant school in thinking among academics about population growth for the last half-century."[17] The international scholars stressed that "Corruption, lack of education, and lack of opportunity cause poverty. The poor are victims of poverty, not the cause of poverty... HB 96 seeks to establish a government-managed program of population management and demographic targets in the Philippines. This policy is based on incorrect economics assumptions."

Youth
A number of resources targeted at the empowerment of girls and related issues have been produced. Protecting and Empowering Adolescent Girls: Evidence for the Global Health Initiative provides key resources on the topic of the empowerment of adolescent girls, advocacy, targeting vulnerable girls, regional resources, and other tools. Empowering Young Women to Lead Change a training manual has been produced as a training resource for and by young girls, with support of UNFPA and YMCA. Sakhi Saheli Promoting Gender Equity and Empowering Young Women to Lead Change, a training manual published by CORO for Literacy (Mumbai); Horizons/Population Council (New Delhi); Instituto Promondo (Rio de Janeiro)

Y-PEER (Youth Peer Education Network Program) has a produced a series of resources targeted at youth peer education to prevent HIV/AIDS and improve reproductive health. Available as part of its youth peer education toolkit, these resources include a Training of the Trainers Manual, Theatre Techniques Manual, Standards for Peer Education Programmes, Performance Improvement: a Standard for Youth Peer Education Managers, and Assessing Peer Education Quality. It's All One Curriculum. Volume I: Guidelines for a Unified Approach to Sexuality, Gender, HIV, and Human Rights Education and Volume 2: Activities for a Unified Approach to Sexuality, Gender, HIV, and Human Rights Education. Developed by an international working group comprised of representatives from the following organizations: CREA (India), Girls Power Initiative (Nigeria); International Planned Parenthood Federation; IPPF/Western Hemisphere Region; International Womens Health Coalition; Mexfam (Mexico); Population Council.

International Technical Guidance on Sexuality Education Volume 1 The rationale for sexuality

education and Volume II topics and learning Objectives by UNESCO.

Comprehensive Sexuality Education: Advancing Human Rights, Gender Equality and Improved Sexual and Reproductive Health. Report from the December 2010 Global Consultation on
Sexuality Education, organized by the United Nations Population Fund (UNFPA) in Bogota, Colombia, to discuss the most effective approaches to sexuality education that promote human rights, advance gender equality and improve sexual and reproductive health. The consultation brought together some 80 practitioners and programmers from more than 36 countries.

The law on sex factsheet (January 2011)

This factsheet summarises some of the key points of UK law relating to sexual behaviour. It does not constitute legal advice. The law on sex factsheet (PDF) Purchase a Factfile containing a full set of UK factsheets.

Contents

The age of consent for heterosexual sex Contraception and under 16s Sex between men Sex between women Rape Sexual assault by penetration Sexual/Indecent assault Exposure Definitions of some common terms Legislation References Further reading

The age of consent for heterosexual sex

England and Wales
The age of consent to any form of sexual activity is 16 for both men and women. The Sexual Offences Act 2003 introduced a new series of laws to protect children under 16 from sexual abuse. However, the law is not intended to prosecute mutually agreed teenage sexual activity between two young people of a similar age, unless it involves abuse or exploitation. Specific laws protect children under 13, who cannot legally give their consent to any form of sexual activity. There is a maximum sentence of life imprisonment for rape, assault by penetration, and causing or inciting a child to engage in sexual activity. There is no defence of mistaken belief about the age of the child, as there is in cases involving 1315 year olds.

Scotland
The age of consent to any form of sexual activity is 16 for both men and women, so that any sexual activity between an adult and someone under 16 is a criminal offence.

There are possible defences if the sexual activity does not involve penetrative or oral sex. These are if the older person believed the young person to be aged 16 or over and they have not previously been charged with a similar offence, or the age difference is less than two years. Sexual intercourse (vaginal, anal) and oral sex between young people aged 13-15 are also offences, even if both partners consent. A possible defence could be that one of the partners believed the other to be aged 16 or over. Guidance from the Scottish Government acknowledges that not every case of sexual activity in under-16s will have child protection concerns, but young people may still be in need of support in relation to their sexual development and relationships(1). A range of specific offences protect children under 13, who cannot legally give their consent to any form of sexual activity. The maximum penalty could be life imprisonment for rape, sexual assault, sexual assault by penetration, or causing a young child to participate in sexual activity. There is no defence that the accused believed that the child was older.

Northern Ireland
The age of consent to any form of sexual activity is 16 for both men and women. The Sexual Offences (Northern Ireland) Order 2008 introduced a new series of laws to protect children under 16 from abuse. However, the law is not intended to prosecute mutually agreed teenage sexual activity between two young people of a similar age, unless it involves abuse or exploitation. Specific laws protect children under 13, who cannot legally give their consent to any form of sexual activity. There is a maximum sentence of life imprisonment for rape and assault by penetration. There is no defence of mistaken belief about the age of the child, as there is in cases involving 13-15 year olds. Article 79 of the Sexual Offences (Northern Ireland) Order 2008 amends relevant offence for section 5(1) of the Criminal Law Act (Northern Ireland) 1967 to exclude the duty to report information about the commission of an offence under Article 20. This therefore means that there is no statutory duty under criminal law to report to the police cases of sexual activity involving children under the age of 16 under articles 16 to 19 of the Order, where the other party is aged under 18. This exclusion does not apply to information about offences against children under 13, as set out in Articles 12 to 15 of the Order. Separate guidance has been issued by the Department of Health, Social Services and Public Safety to inform practitioners and professionals about the implications of the law on child protection procedures(2). Attention is also drawn to the Regional Area Child Protection Policy and Procedures.

Contraception and under 16s

Health professionals in the UK may provide contraceptive advice and treatment to young people under 16 if, in their clinical judgement, they believe it is in the young persons best medical interests and they are able to give what is considered to be informed consent(1,3,4,5). The various sexual offences laws in force in the UK do not affect the ability of professionals to provide confidential sexual health advice, information or treatment. Each specifically states that this is not an offence if it is in order to protect the young persons sexual health, physical safety or emotional wellbeing.

Sex between men

The age of consent for sex between men is 16 throughout the UK. In England and Wales, the Sexual Offences Act 2003, the Sexual Offences (Northern Ireland) Order 2008 and the Sexual Offences (Scotland) Act 2009 introduced a series of child sex offences which equally protect young men from sexual abuse and exploitation. As current sexual offences throughout the UK are gender neutral, the information in the section on heterosexual sex will also apply to sexual activity between men. Laws requiring privacy for sex between men in the UK have largely been repealed. Sex between men is no longer an offence when more than two people are present (Sexual Offences Act 2003, Convention Rights (Compliance) Act ( Scotland) 2001).

Sex between women

The age of consent is 16 throughout the UK. As current sexual offences are gender neutral, the information in the section on heterosexual sex will also apply to sexual activity between women.

Rape
In each UK country, a man would commit rape if he intentionally penetrates with his penis the vagina, mouth or anus of another person, male or female, without that persons consent or if they are under 13. This is the only sexual offence which can only be committed by a man. Women cannot be charged with the offence of rape as this is defined as penile penetration, but she could be charged with another offence such as causing a person to engage in sexual activity without consent, sexual coercion or assault, or assault by penetration. These may not all apply in each country.

Sexual assault by penetration

This new offence was introduced in England and Wales by the Sexual Offences Act 2003, the Sexual Offences (Northern Ireland) Order 2008, and the Sexual Offences (Scotland) Act 2009. It is an offence for someone, male or female, intentionally to penetrate the vagina or anus of another person with a part of their body or anything else, without their consent. The purpose also has to be sexual. Practitioners who legitimately conduct intimate searches or medical examinations are excluded from this offence.

Sexual/Indecent assault
In England, Wales and Northern Ireland it is an offence (sexual assault) for a person intentionally to touch sexually another person without reasonable belief that they consented. Touching covers all physical contact, whether with a part of the body or anything else, or through clothing In Scotland the range of sexual assault offences relating to sexual touching is similar, with the addition of sexual penetration of the vagina, anus or mouth; ejaculating semen onto someone; spitting or urinating onto them. There is some overlap with the offences of rape and sexual assault by penetration. There also remains a common law offence of assault in Scotland, which has a wider application. In Northern Ireland, indecent assault on a woman is also a common law offence, while indecent assault on a man is provided for in the Criminal Justice (Northern Ireland) Order 2003. The definition of indecent is: ... conduct that right-thinking people will consider an affront to the sexual modesty of a woman ...[would] right-minded persons ...consider the conduct indecent or not ...[was] what occurred ... so offensive to contemporary standards of modesty and privacy as to be indecent. The person must also have intended to indecently assault.

Exposure
In England, Wales and Northern Ireland, it is an offence for someone, male or female, to expose their genitals if they intended another person to see them and to be caused alarm or distress. There is a similar offence of sexual exposure in Scotland. Offences of public indecency or breaching the peace could also apply in the UK, in circumstances such as nude sunbathing or streaking.

Definitions of some common terms

Consent
England, Wales and Northern Ireland: if a person agrees by choice and has the freedom and capacity to make that choice. Scotland: free agreement. An offence will have taken place if the victim did not consent, or the accused had no reasonable belief that they consented. The laws of each UK country also allow for a range of circumstances which may affect a persons capacity to freely consent, such as when they are asleep or have been subject to threats or violence.

Sexual
England, Wales, and Northern Ireland: if a reasonable person would always consider it to be so; or a reasonable person may consider it to be sexual, depending on the circumstances and intention. Scotland: if a reasonable person would, in all the circumstances of the case, consider it to be sexual.

Legislation
Convention Rights (Compliance) Act (Scotland) 2001 Criminal Justice (Northern Ireland) Order 2003 Criminal Law Act (Northern Ireland) 1967 Sexual Offences Act 2003 Sexual Offences (Northern Ireland) Order 2008 Sexual Offences (Scotland) Act 2009

References
1. Scottish Government, National Guidance - Under-age Sexual Activity: Meeting the Needs of Children and Young People and Identifying Child Protection Concerns, 2010 2. Department of Health, Social Services and Public Safety, Child protection, accessed 19 February 2009. 3. Department of Health, Best Practice Guidance for Doctors and Other Health Professionals on the Provision of Advice and Treatment to Young People Under 16 on Contraception, Sexual and Reproductive Health, 29 July 2004.

4. National Assembly for Wales, Best practice advice on the provision of effective contraception and sexual health advice services for young people. Welsh Health Circular (2001) 041. 5. Northern Ireland. Department of Health, Social Services and Public Safety, Reference guide to consent for examination, treatment or care. (Belfast: DHSSSNI, 2003).

Further reading
Stevenson, Kim et al. Blackstone's guide to the Sexual Offences Act 2003. Oxford University Press, 2004. The Scottish Government, Guidance on the Sexual Offences (Scotland) Act 2009. sexual health direct is supported by the Department of Health

http://www.fpa.org.uk/professionals/factsheets/lawonsex

Family Planning/Abortion/Birth Control

Print PDF Cite Share Background History Birth Control Abortion Roe v. Wade After Roe v. Wade Additional Resources Organizations

Background
Family planning involves decisions made by women and men concerning their reproductive lives and whether, when, and under what circumstances they have children. Family planning most often involves the decisions of whether to engage in sexual activity that could lead to pregnancy, whether to use BIRTH CONTROL, and whether to terminate a pregnancy. Individuals faced

with these decisions often rely on moral or religious beliefs. Because moral and religious beliefs vary widely in the United States, family planning laws are frequently controversial.

History
During the nineteenth century in the United States, birth rates began to decline, in part due to an increase in scientific information about conception and contraception, or birth control. The average white woman in 1800 gave birth seven times; by 1900, that number dropped to an average of three- and-a-half. At the beginning of the nineteenth century, early stage abortions generally were legal. The use of birth control and ABORTION, however, declined as growing public opinion considered information about birth control methods to be obscene and abortion to be unsafe.

Birth Control
Birth control is any method used to protect a woman from getting pregnant. Beginning in the 1800s, laws in the United States prohibited birth control, when temperance and anti-vice groups advocated outlawing birth control devices and information about birth control devices. These groups considered birth control information to be obscene, a belief that was popular enough that in 1873, Congress passed the Comstock Act outlawing the dissemination of birth control devices or information through the mail. Most states followed suit by passing their own laws outlawing the advertising, sale, and distribution, of contraception. The turn of the century brought increasing attention to issues involving women's rights. Margaret Sanger, a strong advocate of birth control, opened the country's first birth control clinic in New York City in 1916 and was prosecuted for violating New York's version of the Comstock Act. She served a 30-day sentence in a workhouse but later established the National Committee for Federal Legislation for Birth Control. Sanger proposed a federal bill that outlined the health and death risks to women who underwent illegal abortions or who completed unwanted pregnancies. The bill sought to reverse the federal position prohibiting birth control, but under pressure from religious groups such as the Catholic Church, Congress did not pass Sanger's bill. Sanger then sought to challenge the Comstock Act by sending contraception through the mail to a doctor. Her actions were prosecuted, but she achieved her goal when a federal district court deemed that the Comstock Act did not prohibit the mailing of contraceptives when such an act could save a life or promote the health of a doctor's patients. Sanger continued to lead a growing national movement advocating more information and access to birth control, and in 1921 she founded the American Birth Control League. In 1942, the American Birth Control League became the Planned Parenthood Federation of America, still in existence today. Planned Parenthood advocates for a range of safe, legal, and accessible birth control options. In the 1950s, Sanger and Planned Parenthood supported the research efforts of Dr. Gregory Pincus that led to the development of the birth control pill. The birth control pill revolutionized family planning, and by the 1960s popular opinion was shifting in favor of making contraception and information about contraception readily available.

By the 1950s and 1960s, most states had legalized birth control, but many state laws still prohibited the dissemination of information about contraception, and some states still prohibited the possession of contraception. A 1965 landmark Supreme Court decision further eroded these laws sanctioning birth control. In Griswold v. Connecticut, the Court addressed the prosecution of a Planned Parenthood executive director charged with violating a Connecticut state law that prohibited the distribution of contraceptives, information about contraceptives, and prohibited the possession of contraceptives. The Court found that although the U. S. Constitution does not explicitly offer a right to privacy, that right can be inferred from the language in various sections of the BILL OF RIGHTS. The Constitution therefore does contain what the Court called a "zone of privacy." Connecticut's STATUTE violated that zone of privacy in the realm of marriage because it permitted police officers to search the bedroom of a married couple for EVIDENCE of contraception. The Court deemed this action to be overly intrusive and an unconstitutional violation of the right to marital privacy, and it threw out the Connecticut law insofar as it applied to married couples. In 1966, the federal government, with an endorsement by U. S. President Lyndon B. Johnson, began public funding of contraception services for low-income families. President Richard M. Nixon in 1970 signed into law an act promoting research of population and family planning issues. Finally, in 1971, Congress repealed the key elements of the Comstock Act. Some states, however, kept birth control laws despite the REPEAL of the federal Comstock Act. In 1972, the Supreme Court found unconstitutional a Massachusetts law that only permitted married couples to receive contraception. The Court found this law to violate the EQUAL PROTECTION rights of single persons. In 1977, the Court addressed a New York state law that permitted only physicians to distribute contraceptives to minors under the age of sixteen, and only physicians or pharmacists to distribute contraceptives to adults. The Court struck down this law as well. It became clear that the Supreme Court viewed as constitutionally protected the right of an individual, married or unmarried, to make personal decisions regarding whether to have children.

Abortion
Abortion occurs when an embryo or fetus is expelled from a woman's body. Abortions can be spontaneous or induced. In the legal context, discussions about abortions usually involve induced, or intentional, abortions. Before the United States became a country, the COMMON LAW of England permitted abortions before the fetus "quickened." Quickening was the term used to describe the mother's first feeling of the fetus moving in her uterus. Typically, quickening occurs between the sixteenth and eighteenth weeks of pregnancy. After the founding of the United States, laws regarding abortions did not exist until the 1800s. Women at that time were not allowed to vote and were not allowed to be doctors or members of the American Medical Association, which, along with religious leaders, advocated the passage of laws outlawing abortion. Abortions in the nineteenth century were generally unsafe, and women

who survived abortions frequently were left sterile. By the 1880s, all states had laws criminalizing abortions. These laws stayed on the books until the 1960s and 1970s. Beginning in the mid-twentieth century, women's groups, along with doctors and lawyers, organized a movement to reform abortion laws. Reformers cited inequalities between men and women that were exacerbated by women's inability to adequately control their reproductive lives. The post World War II population explosion also increased awareness about the environment and the need to limit family size. In other countries, abortions were legal and generally safe, but in the United States, women continued to undergo illegal abortions and risk permanent injury or death. In the 1960s, the anti-nausea drug thalidomide and an outbreak of German measles caused a rash of birth defects in babies born during that decade. The increase in birth defects brought further attention to the issue since women wishing to avoid the birth of a seriously deformed child could not seek legal abortions. Women's rights organizations, including the National Organization for Women (NOW), lobbied for abortion law reform and filed lawsuits when LOBBYING efforts failed. States responded, reforming their laws about abortion, but women's rights groups continued to fight for unfettered access to abortion services for women. Anti-abortion groups fought back, arguing that a woman's right to reproductive freedom is no greater than the right of an unborn child to be born. The battle ultimately went before the U. S. Supreme Court, which in 1973 decided the landmark abortion case of ROE v. Wade.

Roe v. Wade
Jane Roe was a pseudonym for Norma McCorvey, an unmarried pregnant Texas woman who sought an abortion but was denied under Texas law. Roe, with the help of attorneys, filed a federal lawsuit seeking to have the Texas law thrown out as unconstitutional. She argued that a law prohibiting her from obtaining an abortion violated her constitutional right to privacy. The Supreme Court, voting 7-2, agreed with Roe that the law criminalizing abortion violated her right to privacy. But the Court held that states do have an interest in ensuring the safety and well-being of pregnant women as well as the potential of human life. Acknowledging that the rights of pregnant women may conflict with the rights of the state to protect potential human life, the Court defined the rights of each party by dividing the pregnancy into three 12-week trimesters. During a pregnant woman's first trimester, the Court held, a state cannot regulate abortion beyond requiring that the procedure be performed by a licensed doctor in medically safe conditions. During the second trimester, the Court held, a state may regulate abortion if the regulations are reasonably related to the health of the pregnant woman. During the third trimester of pregnancy, the state's interest in protecting the potential human life outweighs the woman's right to privacy, and the state may prohibit abortions unless abortion is necessary to save the life or health of the mother. The Court further held that a fetus is not a person protected by the constitution.

After Roe v. Wade

Roe v. Wade established the limited right of a woman to have an abortion. Recognizing that fact, states liberalized their abortion laws following the Supreme Court's decision, but abortion soon

became an even more divisive issue in the United States. Groups opposed to abortion, including the Catholic Church, became organized and politically powerful. The issue of abortion became a platform issue for all candidates for federal office, including the office of the U. S. president. During the 1980s, President Ronald Reagan, an opponent of abortion, used his presidency to argue for a reversal of Roe v. Wade. He appointed C. Everett Koop, another abortion opponent, to the position of surgeon general and referred to abortion as a "silent holocaust." Reagan believed that abortion caused pain to the fetus and that the rights of the fetus were not outweighed by the rights of the pregnant woman. Groups opposed to abortion, known as pro-life groups, have worked in various ways to reduce or eliminate entirely abortions in the United States. These groups have sponsored legislation limiting access to abortion and have attempted unsuccessfully to reverse Roe v. Wade by way of a CONSTITUTIONAL AMENDMENT. Some groups opposed to abortion attempt to persuade patients not to undergo abortions by demonstrating outside of abortion clinics. In some extreme cases, individuals and groups opposed to abortion have bombed abortion clinics, injuring and killing patients and staff members, or have murdered doctors who provide abortions. Because of these extreme actions, many doctors are unwilling to perform abortions and many abortion clinics have shut down, making access to abortion difficult in some regions. Other attempts to reduce the number of abortions have involved eliminating public funding of abortions and even prohibiting health care clinics that receive public funding from counseling women about the option of abortion. Soon after taking office in 1993, President Bill Clinton effectively reversed federal regulations that prohibited staff members at health care clinics that receive public funding from dispersing information about abortions or referring women to abortion providers. Once this so-called "gag rule" was lifted, these clinics once again were able to give women information about abortion. Also complicating the issue of abortion rights are rules requiring a woman to get INFORMED CONSENT or parental consent. Informed consent involves a requirement that before undergoing an abortion, the abortion provider must give the woman information about the risks of abortion, alternatives to abortion, the age of the fetus, and the availability of government assistance for carrying the pregnancy to term. Parental consent involves a requirement that a minor wishing to undergo an abortion first obtain consent from her parent or GUARDIAN. The Supreme Court generally has upheld parental consent laws provided the laws allow a minor the ability to obtain permission to have an abortion from a judge rather than a parent and provided that the judge's decision take into account the minor's best interests, maturity, and ability to make decisions. The Supreme Court generally has upheld laws requiring the notification, as opposed to consent, of parents of minors seeking to undergo an abortion. The Supreme Court generally has upheld informed consent laws so long as the laws do not create an undue burden on the woman seeking an abortion. The Supreme Court has not upheld laws requiring a woman to obtain her spouse's permission before undergoing an abortion. Laws regarding the right to undergo an abortion continue to evolve. The pro-choice movement and the anti-abortion movement battle aggressively to protect their causes, and the issue remains deeply mired in differing opinions about ethics, religion, and medical science. There is little question that abortion will remain a divisive and powerful political issue in decades to come.

Additional Resources
Reproductive Health Online. Johns Hopkins University, 2001. Available at: www.reproline.jhu.edu. http://www.enotes.com/everyday-law-encyclopedia/family-planning-abortion-birth-control

Introduction
Christian ideas about contraception come from church teachings rather than scripture, as the Bible has little to say about the subject. As a result, their teachings on birth control are often based on different Christian interpretations of the meaning of marriage, sex and the family. Christian acceptance of contraception is relatively new; all churches disapproved of artificial contraception until the start of the 20th century. In modern times different Christian churches hold different views about the rightness and wrongness of using birth control. Liberal Protestant churches often teach that it is acceptable to use birth control, as long as it is not used to encourage or permit promiscuous behaviour.

Less liberal churches only approve the use of contraception for people who are married to each other. Since these churches regard sex outside marriage as morally wrong (or if not wrong, as less than good), they believe that abstaining from sex would be morally better than having sex and using birth control. More conservative churches suggest that contraception should be limited to married couples who are using it to regulate the size and spacing of their family. They often teach that using contraception to prevent children altogether is not desirable. The Roman Catholic Church only allows 'natural' birth control, by which it means only having sex during the infertile period of a woman's monthly cycle. Artificial methods of contraception are banned. Thus the only way for a Catholic couple to be faithful to the Church's teachings on human sexuality and to avoid having children is to use 'natural' family planning. Many Catholics have decided to disobey church teaching in this part of their lives, causing a substantial breach between laity and the Church establishment. Top

History of Christian attitudes

For most of the last 2000 years all Christian churches have been against artificial birth control. In the first centuries of Christianity, contraception (and abortion) were regarded as wrong because they were associated with paganism or with heretics such as the Gnostics, the Manichees and, in the middle ages, the Cathars. Protestant attitudes to birth control began to change in the 19th century as theologians became more willing to accept that morality should come from the conscience of each individual rather than from outside teachings. Another influence was the churches' changing attitude to sex. Instead of seeing sex as something rather dangerous, many Christians began to regard sex as one of God's great gifts. Sex was a force that could preserve the institution of marriage if couples didn't feel threatened by the possibility of having children they could not support. Influenced by this, the Protestant churches concluded that as the use of birth control often led to stronger families and better marriages, churches should let believers use birth control as their own consciences dictated.

This change came slowly - as late as 1908 the Lambeth Conference of the Anglican Church stated that birth control "cannot be spoken of without repugnance," and denounced it as "demoralising to character and hostile to national welfare." But the Anglicans were the first church to issue a statement in favour of contraception, which they did at the Lambeth Conference in 1930 by a majority of 193 to 67. A group of American Protestants followed in 1931. Nowadays most Protestant denominations permit artificial birth control to some extent. The history of modern Roman Catholic thinking on the subject is dealt with in the Roman Catholic pages. Top

The Bible and contraception

Two parts of the Bible are often quoted to show God's disapproval of birth control:

First, God commanded his people to "Be fruitful and multiply," and contraception is seen as specifically flouting this instruction. Second, Onan was killed by God for "spilling his seed," which is often taken as divine condemnation of coitus interruptus.

The first of these examples is normally rebutted by demonstrating that contraception has not prevented human beings from being fruitful and multiplying. There are at least two interpretations of the second example:

God may have been angry with Onan for having sex for a purpose other than having children o this interpretation supports the idea that contraception is morally wrong o it also supports the idea that there is only one kind of morally good sexual act: sex between a man and a woman who are married and who are having sex to produce children God may not have been angry with Onan for preventing conception but for failing to honour a commandment to produce a child with his dead brother's wife o but this interpretation has no application to modern cultures or morality o the act that Jewish law required Onan to perform would nowadays be regarded as rape, since the widow's consent was not required - and this makes the story a very dubious foundation for moral argument

Scripture in favour of contraception

The Bible never explicitly approves of contraception.

However, there are a number of passages where the Bible appears to accept that sex should be enjoyed for other reasons than the production of children, and some people argue that this implies that no wrong is done if a couple have sex with the intention of not having children. Top

Church of England
The Church of England approves the use of contraception. It wasn't always so - as late as 1908 the Lambeth Conference stated: the Conference records with alarm the growing practice of the artificial restriction of the family and earnestly calls upon all Christian people to discountenance the use of all artificial means of restriction as demoralising to character and hostile to national welfare. Lambeth Conference, 1908 By 1930 the Lambeth Conference had changed its mind and declared that if there was an ethically acceptable reason not to have children and to continue to have sex then: the Conference agrees that other methods may be used, provided that this is done in the light of Christian principles. Lambeth Conference, 1930 By 1958 the Anglicans had concluded that God wanted the responsibility for deciding upon the number and frequency of children to be something for the consciences of the potential parents, and that they could manage their family and fertility "in such ways as are acceptable to husband and wife". Top

Catholic - introduction
The Church forbids sex outside marriage, so its teachings about birth control should be understood in the context of husband and wife. The Roman Catholic Church believes that using contraception is "intrinsically evil" in itself, regardless of the consequences. Catholics are only permitted to use natural methods of birth control. But the Church does not condemn things like the pill or condoms in themselves. What is morally wrong is using such things with the intention of preventing conception. Using them for other

purposes is fine - for example, using the pill to regulate the periods of a woman who is not in a sexual relationship is not wrong. The Church teaches that using artificial contraception is wrong because:

it is against 'natural law' it breaks the natural connection between the procreative and the unitive purposes of sex it turns sex into a non-marital act it gives human beings the power to decide when a new life should begin - that power belongs to God it leads to widespread immorality it damages the institution of marriage it reduces male respect for women it gives human beings the idea that they can have complete power over the body it allows the implementation of eugenic programmes

Commentary
This is one of the most controversial areas of the Church's moral teachings; partly because birth control is now accepted in most of the West, but also because the philosophical and theological ideas behind the ban are hard to understand. As a result, many Roman Catholics see the ban as arbitrary and unreasonable, but in fact the ban is based on a thorough analysis of the issues involved. Catholic objections to artificial contraception are partly based on 'natural law' and partly on the bad consequences that will result if contraception is widely used. But Catholic policy on birth control is also derived from the way the Church views the nature of marital sexuality and responsible parenthood. The Church teaches that the physical expression of love between husband and wife in sexual intercourse can't be separated from the reproductive implications of both the act and marriage. Sex is seen as intimately involved in God's design for the universe, and as something profoundly important that involves a person's mind and spirit as well as their body. The Catholic Church does not see any point in putting forward the various arguments that show the benefits of contraception to individuals or to the world. Pope Paul VI put it like this: "It is never lawful, even for the gravest reasons, to do evil that good may come of it."

The Tablet survey

A 2008 study suggests that most practising Catholics are ignoring the Church's teachings on contraception and sex.

The Tablet magazine surveyed 1,500 Mass-goers in England and Wales; 40 years after Pope Paul VI forbade birth control use in his encyclical Humanae Vitae (Of Human Life). 82% of people are familiar with the Church's moral teachings but more than half of 18-45 year olds still cohabited before marriage. The contraceptive pill is used by 54.5% and nearly 69% had used or would consider using condoms. The survey also found that more than half think that the teaching should be revised. Top

Catholic - modern teachings

1930
The modern attitude of the Catholic Church to contraception was laid down in the 1930s when Pope Pius XI issued Casti Connubii (which translates as 'Of Chaste Marriage'). This document said that artificial birth control was a violation of the "law of God and nature" and that those who used it committed "a deed which is shameful and intrinsically vicious."

1951
In 1951 Pope Pius XII said that it was acceptable to use the rhythm method if a couple had a good reason to limit the size of their family.

1958
In 1958 Pius XII stated that it was legitimate for women to take the birth control pill for medical reasons other than contraception. He said that the contraceptive side effect would not be wrong because of the doctrine of double effect.

1968
In 1968 Pope Paul VI issued Humanae Vitae, which banned all artificial methods of birth control. His uncompromising position on birth control led to protests around the Catholic world and Roman Catholic hierarchies in some countries openly modified the policy. The document surprised many Catholics, who had hoped for a relaxation of the traditional attitude after Vatican II, and it rejected the views of the commission appointed to consider birth control, which had recommended that the ban on contraception be ended.

Pope John Paul II

Pope John Paul II thought birth control was profoundly important; while still Cardinal Wojtyla he wrote that the issue of contraception was a "struggle for the value and meaning of humanity itself" (1978). When he became Pope he confirmed the Church's position, "the natural regulation of fertility is morally correct; contraception is not morally correct." Top

Catholic - natural family planning

'Natural family planning' involves using self-control to regulate sexual activities in harmony with nature. The natural methods of family planning are:

Abstention: not having sex o this method is 100% reliable Rhythm method: having sex at times of the woman's menstrual cycle when she is unable to conceive o this method is calendar based o its reliability is around 85% Body function methods: these use other functions of the woman's body, such as mucous patterns and temperature patterns, to determine when the chance of conception is low. The couple only have sexual intercourse during the period of low fertility. o these methods are up to 98% reliable

Natural family planning methods are quite hard work. The couple must measure and chart certain physical symptoms with accuracy, and then interpret the charts properly, keeping in mind other events that may interfere with the woman's normal bodily rhythm. They also need the selfdiscipline to regulate their sex life accordingly.

Why is natural family planning OK?

Natural family planning is not unethical or disobedient to God because:

it uses a mechanism God designed it is natural because it is based on the natural human property of self-control o self-mastery is a power which God gave only to human beings o they should use self-mastery rather than methods which work against nature it does not completely prevent conception - the sexual act remains 'open' to the creation of a new life it does not add anything artificial to the sexual act to change it

Natural family planning is not always good

Natural family planning alone does not satisfy Catholic teaching about birth control; motivation and purpose are also important. Family planning must be used responsibly and not for trivial reasons. So while it would be good to use family planning to space out a family's children, it would be wrong to use family planning because a couple would rather spend their money on a new car than caring for a child. Top

Catholic arguments against

Catholic arguments against contraception in detail
A lot of Roman Catholic moral reasoning is based on the idea of natural law - not just sexual ethics. Natural law is a way of describing the basic moral code that comes to mind when human beings think seriously about ethical issues. To Catholics, natural law amounts to the way God wants the universe to work. Don't get confused and think there is a direct connection between 'natural law' and 'natural family planning' or between 'natural law' and 'unnatural sexual practices'. Natural law is a technical theological and philosophical doctrine. Pope Pius XI objected to contraception as breaking natural law: No reason, however grave, may be put forward by which anything which is intrinsically against nature may become comformable with nature and morally good. Since, therefore, the conjugal act is designed primarily by nature for the begetting of children, those who in exercising it deliberately frustrate its natural power and purposely sin against nature and commit a deed which is shameful and intrinsically vicious. Pope Pius XI, Casti Connubii Paul VI also used the natural law argument, emphasising the: inseparable connection, established by God, which man on his own initiative may not break, between the unitive significance and the procreative significance which are both inherent to the marriage act. Pope Paul VI Closely related to the Natural Law argument, but not quite the same, is the argument that procreation is "a fundamental human good," and any voluntary action that frustrates its intent is intrinsically evil.

Sex should not be separated from reproduction

The Catholic Church teaches that there is an inseparable connection between sexual intercourse and conceiving children, and that it is wrong for human beings to use artificial methods to break this connection. Church documents speak of the connection between the "unitive significance" and the "procreative significance" of sexual intercourse.

Are sex and procreation inseparable?

There has been much argument about this in the Church. Here are some of the points that have been made:

The two elements are not always linked, since for much of the monthly cycle it is not possible for a woman to conceive o But they are always linked in possibility, since one can never be certain that a particular period of time is definitely infertile. If sex must always be open to conception it should be unethical for people to "take advantage of the infertile period" since this would break the connection between sex and conception o But artificial contraception changes the nature of the sexual act, taking advantage of the infertile period does not If the connection is inseparable it would be unethical for couples to have sex hoping that they will not conceive o Many theologians say that this is true: if a couple has sex with the intention of not having a child, that sexual act is morally flawed The possibility of conception may seriously damage the unitive significance of the sexual act by causing the couple to be distracted from full union by the worry of having a child o But many theologians argue that such a couple need to think more deeply about themselves and their family, so that they do not see the possibility of a child as something distressing

Does every sexual act have to be open to reproduction?

This question was asked by members of the commission which investigated birth control at the request of Popes John XXIII and Paul VI. The majority of that commission thought that though marriage as a whole should be open to new life, every single sexual act did not need to be. They thought that it would be better for sexual acts using contraception to be ethically assessed in the light of the state of the marriage as a whole, and the motivation and approach of the couple concerned.

Looking at it that way, the union in one flesh of husband and wife is formed over the whole period of the marriage, and so only if the partners of a marriage intended never to have children would they be failing to connect the procreative and unitive significance of sex.

Natural law and artificial contraception

The meaning of "artificial contraception" in Papal condemnations is not quite what it seems, and does not just refer to the method of birth control. The basic idea is that everything in the universe has been created by God with a particular end in mind. Human beings follow natural law when their actions are in line with this 'natural' end. God is said to have created sexual intercourse for two purposes; both of which must be fulfilled if the act is to achieve God's intention:

Procreation: When a man and a woman have sexual intercourse the natural end - the end God had in mind - is that a child is conceived if the timing is right. Uniting: When a man and a woman have sexual intercourse they unify themselves as one flesh (Despite the use of the word 'flesh' this means a mental and spiritual union as well as a physical union.)

If a couple have sex with artificial birth control they do two wrong things:

they artificially prevent the sexual act achieving one of its natural ends they deliberately choose to prevent the sexual act achieving its natural end (In the Church's view, this deliberate choice is morally worse than the use of artificial contraception.)

Their action is therefore unethical and against God's plan. In contrast, natural family planning is not unethical or disobedient to God.

How contraception changes the sexual act

Catholic teaching says that using artificial contraception changes the nature of the sexual act. At first sight this seems odd, but to Catholic theologians the effect is quite clear. Compare a couple who have sex when the wife is on the pill, and a couple who have sex during the infertile period. There seems to be no difference whatsoever between the acts performed by each couple. And there doesn't seem to be any difference in the mental background either - both couples are having sex with the intention of not getting pregnant. But theologians say that there really is a difference:

When a couple have sex during the infertile period, their intention not to have a child doesn't actually change the act itself at all - it's still the same act that can transmit life, but because of timing, it doesn't When a couple have sex using the birth control pill, their intention is the same as above, but in this case they have taken action to convert a potentially fertile act into an infertile act - it's now a different kind of act altogether

And according to Church teaching that different kind of act is a wrong act - it's often described as a non-marital act, and as such it undermines the whole idea of Christian marriage.

Birth control and the unity of the couple

Sexual intercourse using contraception is said not to satisfy the uniting purpose of sex. The physical or chemical barrier of contraception is said to create a spiritual barrier between the partners. This sounds odd and needs a step-by-step explanation:

The unifying function of sexual intercourse depends on each partner giving themselves completely to the other Two people who intend to prevent the conception of a child are holding back part of the gift contained in the sexual act o either they give everything except their fertility, or they only accept the other if their fertility has been prevented Therefore they cannot be said to be giving themselves completely to each other Therefore they cannot be said to have fully become 'one flesh'

Why is this so bad?

Because the Church believes that a human being can "only find himself by making a sincere gift of himself" (from Gaudium et Spes), and a couple using artificial contraception are not giving each other the sincere gift of themselves. To Catholic theologians there is a clear analogy with Christ's giving his life on the Cross to save humanity, which is regarded as the ultimate and full gift. As Christ held nothing back, nor should a married couple hold anything back.

Bad consequences of contraception

Pope Paul VI pointed out four bad consequences for humanity that would result if artificial contraception were permitted.

Immorality: Artificial contraception would encourage "conjugal infidelity and the general lowering of morality."

Many people, Catholic and non-Catholic alike, now accept that the Pope was right and that the wide use of artificial contraception has weakened sexual morality in Western society o But this could be seen as the result of the abuse rather than the use of artificial contraception, and that if human beings had limited contraception to the context of loving relationships no harm would have been done Disrespect for women: It would lead a man to lose respect for his partner: "a man who grows accustomed to the use of contraceptive methods may forget the reverence due to a woman, and, disregarding her physical and emotional equilibrium, reduce her to being a mere instrument for the satisfaction of his own desires." o Some people have criticised this argument and pointed out that if a couple can only have sex during the infertile period, this too may disregard the sexual needs of a woman and so actually be bad for her physical and emotional equilibrium Eugenics: Artificial contraception could be used by governments to implement eugenic policies - i.e. as a weapon of social engineering to remove elements of society o This is true o But once again could be regarded as a misuse of contraception, and not an inevitable consequence o One example is the way developed countries have sent contraceptives to the third world to limit their population Disrespect for the body: Using artificial contraception could mislead human beings into thinking they were entitled to unlimited power over their own bodies o But most people do now believe that they have the right to do what they want with their bodies, and that they are not wrong to believe they have this right. o But although contraception may have contributed to this view, so have many other medical developments that the Church does not object to. o The commission that reported to Pope Paul VI on contraception remarked that "it is natural to man to use his skill in order to put under human control what is given by physical nature."
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http://www.bbc.co.uk/religion/religions/christianity/christianethics/contraception_1.s html