MULTIMEDIA

Unintended consequences of ECQ: Unplanned and unwanted pregnancies

Bernice Beltran

Posted at May 10 2020 02:10 AM

Likhaan Center’s clinics offer family planning, maternal services, and counselling on gender-based abuse for women, LGBTQ++, as well sexual and reproductive health. Likhaan Center remains open despite the lockdown. Bernice Beltran

After seeing her brother locked up in a city jail despite being a minor for charges that were withdrawn, Michelle (not her real name) discovered how poor families like hers are not treated fairly.

Since then, the 15-year-old girl from Tondo dreamed of becoming a lawyer but she was forced to set aside her ambition after learning that she was six months pregnant last January.

Her 19-year-old boyfriend wanted to keep the baby but Michelle insisted on getting an abortion. If they dropped out of school now, she was certain they would not be able to find decent-paying jobs.

Michelle’s story is not uncommon. A study by the Philippine Commission on Population (POPCOM) shows that about 500 teenagers give birth each day. On the other hand, the 2017 National Demographic and Health Survey reveals that the contraceptive prevalence rate (CPR) in the Philippines is 54.3%.

The CPR determines the proportion of married women in the reproductive ages of 15-49 reporting the use of contraceptives. Compared with other Southeast Asian countries such as Indonesia, Vietnam, and Thailand with a CPR of 61%, 76%, and 78% respectively as reflected on the World Bank’s website, the CPR in the Philippines is low.

Contraceptives and sexual and reproductive health services are harder to access during the pandemic. Recently, the United Nations Population Fund (UNFPA) predicted 7 million unplanned pregnancies and 31 million cases of gender-based abuse worldwide if the lockdown goes on for another 6 months.

Unintended Consequences of ECQ

By the time Michelle found an abortionist, she was told that it was a little too late for her to get an abortion leaving her with no other choice but to look for adoptive parents.

Little did she know that the government would be implementing an enhanced community quarantine (ECQ) by mid-March. The teenager quickly realized that there was no other way out of the situation. She had to keep the baby.

“My parents passed away. My sister is helping me but I don’t want to add to her burden,” Michelle said. “The pandemic has made job-hunting impossible.”

When the ECQ began on March 16, public transportation was suspended. Many workers either have started working from home or have lost their jobs. Only one person per household is allowed to go outside to buy food. While this scheme aims to flatten the COVID-19 curve, it also poses many problems for women.

Lilibeth Armayan and her fellow community workers from Likhaan Center for Women’s Health know this all too well.

With clinics across the Philippines, Likhaan Center offers services to women with a focus on family planning, maternal, adolescent reproductive health, and treatment and counseling for victim-survivors of gender-based violence, sexually-transmitted diseases, and HIV/AIDS.

Since Likhaan Center clinics have remained open throughout the ECQ, the community mobilizers often received text messages from their clients asking about their services.

“Can my husband pick up contraceptives and medicines for me?”

“How can I go to the clinic if I don’t have my quarantine pass?”

“I don’t want to give birth in a hospital because of the COVID-19 disease. Can I come to your clinic instead?”

Likhaan Center would also receive reports of women who are unable to escape their abusers during the ECQ.

When they joined groups of volunteers in relief operations, the community workers took the opportunity to distribute flyers about the COVID-19 disease and inform residents that Likhaan Center clinics are open for women who need their services.

“It’s important that women know where to go or who to contact,” Armayan said. “When women get sick or suffer abuse, their children also suffer.”

Clients wait for their turn at Likhaan Center for Women’s Health on Saturday, April 18, 2020. Likhaan Center’s clinics offer family planning, maternal services, and counselling on gender-based abuse for women, LGBTQ++, as well as sexual and reproductive health. Likhaan Center remains open despite the lockdown. Bernice Beltran

A client wearing a face mask waits outside the clinician’s office at Likhaan Center for Women’s Health in Navotas, Metro Manila. To protect its community organizers and clients against the coronavirus, Likhaan Center encourages everyone entering its vicinity to follow COVID-19 health guidelines, such as practicing physical distancing and wearing masks. Bernice Beltran

The staff of Likhaan Center are seen having lunch together during their downtime. Despite getting relatively fewer clients, the staff also make the most of their time outside, volunteering in relief operations in urban poor communities in Navotas and Malabon. Bernice Beltran

The staff of Likhaan Center are seen having lunch together during their downtime. Despite getting relatively fewer clients, the staff also make the most of their time outside volunteering in relief operations in urban poor communities in Navotas and Malabon. Bernice Beltran

Models showing the growth of a baby are displayed on the shelves of the Likhaan Center for Women’s Health. According to the Likhaan staff, many expectant mothers prefer going to their clinic as they are afraid to contract COVID-19 in hospitals. Apart from maternal services, Likhaan continues to provide family planning to couples throughout the lockdown. Bernice Beltran

To keep local communities informed about the COVID-19 disease, Likhaan Center distributes flyers to their clients and to residents of urban poor areas in Navotas and Malabon. These communities live in tight spaces which make it difficult for them to practice physical distancing. Bernice Beltran

Lilibeth Armayan, a community worker from Likhaan Center for Women’s Health, gives away flyers to inform residents of a community in Malabon of the symptoms of COVID-19 disease and the different ways to prevent catching and spreading the virus. Bernice Beltran

A mannequin’s head with a hand-written poster attached to it reminds residents of the Malabon City to wear masks and bring their quarantine passes when going outside during the lockdown. President Rodrigo Duterte placed the entire Luzon under an enhanced community quarantine since last March 16, 2020. Bernice Beltran

Likhaan community worker Lilibeth Armayan distributes packs of relief goods in Malabon, Metro Manila. The enhanced community quarantine (ECQ) restricted movement of people in communities in Metro Manila. Bernice Beltran

Benigno Vere, a community worker from Likhaan Center, checks text messages from the mothers in the community who want to reach out. When they are not working in the clinic, the community organizers of Likhaan spend time in different neighborhoods in Malabon, Metro Manila. Bernice Beltran

A woman walks back to her house in Malabon, Metro Manila. Only one person per household is allowed to leave the house during the enhanced community quarantine (ECQ). Bernice Beltran

An empty procedure room inside Likhaan Center for Women’s Health in Navotas, Metro Manila. Likhaan Center began arranging rides for the clients upon request since many women are unable to leave the house. Local government units (LGUs) issue 1 quarantine pass per household to allow the individual to go out and buy food. Often, this is given to the man in the family. Bernice Beltran

Inside the Likhaan Center clinic in Tondo. With many clinics across the Philippines, Likhaan Center offers services to women focusing on family planning; maternal health; adolescent reproductive health; and, treatment and counseling for victim-survivors of gender-based violence, sexually-transmitted diseases, and HIV/AIDS. Bernice Beltran

Fifteen-year-old Michelle (not her real name) gave birth to her daughter during the ECQ. A study by the Philippine Commission on Population (POPCOM) shows that about 500 teenagers give birth each day. Bernice Beltran

Teen mom Michelle learned she was pregnant last January. Unable to find a job because of her age, she decided to quit school to look after her daughter and relied on the financial support of her relatives. Bernice Beltran

When she found out that she was pregnant, Michelle wanted to get an abortion so she could continue her studies. High incidence of unintended pregnancies and unwanted pregnancies could lead to high incidence of unsafe abortion. Bernice Beltran

Inside Likhaan Center’s delivery room. Many expectant mothers prefer going to small clinics for check-ups. The community mobilizers say that some of their clients are afraid of going to hospitals where many COVID-19 patients are being treated. Bernice Beltran

Right to Life and Right to Health

“To ensure access to sexual health and reproductive rights or realization of sexual health and reproductive rights, you need access to the full range of contraceptives methods. This includes information, services, and supplies,” the founder and executive director of EnGendeRights Atty. Clara Rita Padilla says.

“The presumption is that when women and the adolescent girls have access to contraceptives and the information on contraceptives, this could effectively avert unintended and unwanted pregnancies,” Padilla explains.

Even before the ECQ, the feminist lawyer points out that, apart from the lack of access to sexuality education, there has also been inadequate access to contraceptives supply, information, services in the Philippines. This problem has been prevalent especially among poor women, adolescents, and those who live in rural areas, which often result in unintended or unwanted pregnancies.

“This also impacts not just the socio-economic aspect but women’s basic right to life and right to health, which intersect in various aspects of her life,” the lawyer adds.

“High incidences of unintended pregnancies and unwanted pregnancies could lead to high incidences of unsafe abortion,” the feminist lawyer says. “Because the Philippines has had a long-standing restrictive law ever since 1930, women and adolescent girls do not have access to safe abortion.”

Although therapeutic abortion for rape victims and 'medical necessity' is recognized, the availability of the procedure is not widely publicized, according to Atty. Padilla.

Abortion is a subject that stirs up a lot of heated debate for many experts, politicians, and church groups in the Philippines. But those who need safe abortion often talk about it in hushed tones.

“Some OB-GYNEs refer women to providers. It’s a matter of finding ‘kindred spirits’ who will refer to them,” Atty. Padilla explains.

Women who suffer spontaneous abortion, commonly known as ‘miscarriages,’ are treated differently by medical workers. Women who can afford the services of private hospitals are able to get treatment. Poor women are not always lucky.

Atty. Padilla says that there has been many cases wherein poor women were asked by medical workers ‘what drug did you take?’ even if it was a clear case of miscarriage.

“What advocates of decriminalization of abortion are saying is: The restrictive law is discriminatory against women. It could lead to deaths and morbidity, not just women suffering from induced abortion, but also those who suffer miscarriages, incomplete abortion, and even fetal death,” the lawyer asserts.

Michelle was supposed to give birth in April but her water broke only days after the ECQ was implemented. The young mother bled excessively as she pushed her daughter out, prompting the midwife to rush her to the hospital.

Sheltering in her older sister’s house in Tondo, Michelle is now looking after her newborn. The more she spends time with her daughter, the more she realizes that she wants to keep her baby.

“I’ve changed my mind about the adoption,” Michelle confessed. “I love her.”

The pandemic has brought the world into a standstill, but Michelle is determined to continue her studies even if it would take her years before she could get back to school and become a lawyer.

“I don’t want teenagers to end up like my brother who is still in jail,” the teenager said. “Or get pregnant early like me. We all deserve to enjoy our youth.”

This work was supported by the National Geographic Society's Emergency Fund for Journalists.