Side effects

Pinoy Kasi : Side effects

First posted 00:32am (Mla time) May 19, 2006
By Michael L. Tan
Inquirer

Editor's Note: Published on Page A15 of the May 19, 2006 issue of the Philippine Daily Inquirer

THE government’s annual family planning surveys are becoming almost too predictable.

The latest survey, conducted in 2005 among 50,000 households and released early this week, shows the CPR to be 49.3 percent. CPR here isn’t cardio-pulmonary resuscitation or the Gloria Macapagal-Arroyo administration’s “calibrated preemptive response” policy on protest rallies, but contraceptive prevalence rate, a fancy term for family planning usage. The National Statistics Office (NSO), which is responsible for conducting the survey, notes that this CPR has not increased in the last five years.

The release of the family planning survey (FPS) statistics came only a few days after Economic Planning Secretary Romulo Neri came out with the claim that the country’s annual population growth rate had dropped from 2.36 percent to 1.95 percent. Neri came under fire after the announcement as people wondered how he could make that claim when the government has not conducted a national census since 2000.

The release of the latest FPS shows that little is happening in the area of family planning, so it would be a major miracle indeed if the population growth rate has dropped. Yet, President Arroyo came out shortly after Neri’s announcement noting that drop in population growth rate and suggesting that family planning funds now be transferred to school-feeding programs.

The President was obviously responding to bad publicity from the latest survey by the Social Weather Stations research group on hunger in Filipino households. I wonder though if she has ever wondered if there’s a connection between hunger and rapid population growth, one which is likely to continue if family planning usage remains at its current low rates.

Let me put the CPR figures in context. First, the national average of 49 percent reflects wide discrepancies. Cagayan Valley has the highest CPR with 58 percent, while the Autonomous Region in Muslim Mindanao has a dismal 16 percent. The National Capital Region -- Metro Manila -- has a rate of 44 percent, lower than the national average.

One reason the national CPR of 49 percent is so infuriating is that we can’t seem to at least break the 50 percent mark, even as other countries all over the world are racing ahead. To give a few examples from among our neighbors, Vietnam has a CPR of 79 percent; Thailand, 72 percent; Singapore, 62 percent; and Indonesia, 60 percent.

In these countries, a large percentage of the family planning users employ modern methods, meaning those that are reliable. In the Philippines, the 49 percent figure includes some 13 percent who are using methods like withdrawal, a crude method with a very high rate of failure.

Fears

Why aren’t more Filipinos using family planning? The main reason, one which has persisted through the years, has not been religion. Muslim leaders in Mindanao, for example, issued a fatwa or religious edict a few years ago supporting family planning. And while Roman Catholic bishops oppose “artificial” family planning, most Catholics who are not using family planning have never heard of the papal encyclical Humanae Vitae, or the theological explanations of the “unitive” and “procreative” functions of marriage which are used to forbid “artificial” contraception.

What many Filipinos have heard are stories of “side effects” of family planning methods. In a research I conducted a few years back, these fears revolve mainly around the pill, with perceived dangers ranging from cancer to putting on weight. (I should say quickly that many low-income women actually saw the weight gain as a good thing, a sign that they had a good fit or hiyang with a particular brand.)

There are also “side effects” described for other modern methods. Tubal ligation, for example, is believed by many to lead to increased libido for the woman ... and a potential for extramarital affairs.

The fears are often unfounded, based on hearsay as well as popular misconceptions about how the body works. For example, pills are believed to cause cancer because they are taken daily, leaving residues (“latak”) in the uterus that accumulate.

The connection between tubal ligation and increased libido may have been based partly on husbands’ (and wives’) observations that women are more sexually responsive and relaxed after the ligation. That shouldn’t be surprising, considering that the fear of an unwanted pregnancy has been removed, but to equate that with nymphomania and extramarital pregnancies requires a fertile imagination.

The male imagination, that is. Many of the fears around contraception are really male-based. The irony is that as our family planning program weakens, men become even more powerful.

How so? The misconceptions going around in relation to family planning are often perpetuated by a mixed bunch of men. A vocal few are opposed to family planning for religious reasons, but others couldn’t care less about religion, their opposition based on machismo values that equate masculinity with having as many children as possible. Opposition from husbands was in fact mentioned together with a fear of side effects as the main reason for women wanting to drop out of family planning.

Losers

Perhaps what’s so painful about the FPS findings is that women generally seem to want family planning, and are even willing to pay for services and methods. Yet their access to family planning has been shrinking under the present government.

The President claims she is in favor of choices, and, claiming that too much had been poured into “artificial” family planning methods like the pill, she has called for more resources to be poured into natural family planning (NFP). The Catholic organization Couples for Christ received P50 million from the Department of Health two years ago to do this, but the impact doesn’t show in the FPS, which found NFP usage to be at a measly 0.4 percent. Reproductive health groups also observed that more time seemed to be spent spreading more misconceptions about “artificial” methods rather than promoting natural family planning itself.

Low family planning usage has many side effects for the nation. And who are the biggest losers in all this? It’s the women, who have to face up to one unwanted pregnancy after another, often finding themselves having to raise children alone as the men abscond. It’s the children who lose, with poorer health and nutrition, and higher dropout rates from schools.

There’s a story going around about one city mayor in Mindanao who asked his parish priest, “Father, we have so many street children now. Could you allow them to sleep in your church?” The priest hesitated, and then explained that it would be too difficult for him to handle so many children. The wise mayor smiled and said, “Then, Father, would you mind keeping quiet when I promote family planning?”