Sen. Pia Cayetano's sponsorship speech on the RH Bill
SB No. 2865, Committee Report No. 49 "The Reproductive Health Act"

A. INTRODUCTION

Mr. President, distinguished colleagues, Wednesday last week, I sponsored Senate Bill No. 2849 which seeks to amend the Philhealth law with the end in view of making quality and essential health care services affordable and accessible to all Filipinos, especially the underprivileged. As I said in my sponsorship speech, this bill is part of a whole package of reforms from your Health Committee.

It is again my honor to stand before you today to present on the floor an important addition to such package of health reforms.

Mr. President, as a woman, a mother, sister, daughter, and a lady legislator who looks out most especially for the welfare of the women and their children, it is with great pleasure that I stand to sponsor and seek your support for Senate Bill No. 2865 entitled, "AN ACT PROVIDING FOR A NATIONAL POLICY ON REPRODUCTIVE HEALTH AND POPULATION AND DEVELOPMENT".

B. WHAT THE BILL IS NOT

Mr. President, because of all the misinformation regarding the contents and objectives of the bill, let me start by what this bill is NOT.

1. This is NOT a bill that promotes or legalizes abortion. On the contrary, it is for the protection of the unborn along with its mother.

2. This is NOT a bill that imposes one mode of family planning method on all. Every person will be allowed to choose the method suitable to his needs and his religious beliefs.

3. This is NOT a bill that imposes a certain family size.

4. This bill will NOT solve all the problems of our country. Like most of the bills filed in the Senate, it is just one measure that will address a particular problem. In this case, it is the reproductive health of all Filipinos, particularly the women and her child.

5. This is NOT a bill that will teach 9 year olds how to use a condom. Neither does it promote sexual activity among the youth.

C. WHAT THIS BILL IS ABOUT

This bill aims to:

1. Save the lives of the mother and the unborn.

2. Provide Filipinos with information on their reproductive health so they can make informed and intelligent decisions.

3. Provide Filipinos with access to health care facilities and skilled health professionals.

Mr. President, this bill seeks to acknowledge that women have reproductive health care needs that are distinct to women and to provide measures to address such needs. In the same way that the Philhealth bill seeks to provide affordable and accessible quality and essential health care services to all, this bill seeks to provide affordable and accessible quality and essential reproductive health care services to Filipinos, particularly the underprivileged women.

D. FEATURES OF THE BILL

1. Access to skilled health professionals before, during, and after delivery

Mr. President, the bill aspires to address the number of mothers who die while giving birth and the high incident of infant mortality which are also connected with maternal health. It is our goal to enable all pregnant women to have access to pre-natal care, to be attended to by a skilled health professional while giving birth, and to be given post-natal care for her and her newborn.

Mr. President, no mother should die while bringing forth new life into this world. However, the depressing reality is that for every 100,000 live births, 162 mothers die. These are the number of newborns robbed of a mother's love and care just when they need it the most. And because of that special bond between mother and child which begins from pregnancy, a child who loses a mother at childbirth is ten times more likely to perish. Without a mother, who will now care for the child? Who then will instill into the child morals and values at home while the father is away? Who will ensure that the child will grow up to be a good and productive citizen of our country? No other human being can take the place of the mother ... and I dare say neither can the State.

Mr. President, the death of a child is no less devastating than losing one's mother. However, another sad reality is that for every minute, three babies are born, and for every 1000 babies born, thirty-three (33) die before reaching age five (5). I have personally experienced the loss of a baby boy and can empathize with the feeling of pain and great loss.

2. Establishment and upgrading of facilities and training of skilled health professionals

Because the common causes of maternal mortality are highly preventable, Section 6 calls for the establishment and upgrading of facilities with adequate and qualified personnel, equipment and supplies in every province or city to be able to provide emergency obstetric and newborn care. Section 12 further necessitates each congressional district to acquire a mobile health care service in the form of a van or other means of transportation to ensure the provision of health care goods and services even to people living in remote areas.

To further address the dearth in medical personnel in certain localities, Sections 5 and 14 directs the hiring of an adequate number of skilled health professionals such as doctors, nurses and midwives and the training of barangay health workers (BHWs) in each respective local government unit (LGU).

3. Addressing HIV and other Sexually Transmitted Diseases

Mr. President, there is the ever looming threat of an HIV epidemic in the country demonstrated by the sharp increase in reported HIV cases. While other countries have shown a declining number of new HIV infections, our country seems to be going the opposite direction. Among the 63 countries with HIV infections, the Philippines is one of the ONLY seven(7) countries with increasing prevalence, together with countries such as Bangladesh and Kazakhstan. This year, the number of cases from January to March alone is already at 483. By doing nothing, the Department of Health predicts that the number of HIV cases in the country will have more than quadrupled from 11,000 in 2008 to 45,000 in 2015.

To address this problem, Section 11 provides that all serious and life threatening reproductive health conditions such as HIV and AIDS shall be given the maximum benefits under PhilHealth, such as the provision of Anti-Retroviral Medicines (ARVs).

4. Access to different family planning methods

The poor Filipino couples are the real beneficiaries of this bill, Mr. President. The privileged can either afford to have larger families or afford reproductive health services by specialized doctors. It is a sad fact that this is not the same for the poor. Many of them would prefer smaller families than what they have. In fact, every year, there are over half a million clandestine abortions happening in our country primarily brought about by unplanned or unwanted pregnancies. Most of these women are the poorest of the poor who have no access to reproductive health care services, including family planning. Stories range from women jumping off coconut trees to dislodge babies from their bellies to teenagers inserting hook shaped wires inside their vaginas to scrape off fetuses to even married women bleeding on makeshift beds of "abortionists" --- all forced to undergo the pain and perils of abortion because they do not want, and cannot afford to have, a baby. But surveys and my personal visits to the grassroots all over the country have shown that more women want the information and services available for them to plan their pregnancies. Indeed, this is the better way out than enduring the immense pain and possible bleeding to death from an abortion.

Mr. President, I just want to make this clear. Senate Bill No. 2865 does not, in any way, compel any individual to choose one form of family planning method over the other, or even to use any family planning method at all. The guiding principles under Section 3 merely seeks to equip all Filipinos with accurate and sufficient information on family planning methods necessary for them to make an informed choice as to how many children they want, when they want it and what family planning method to use, if any. The end goal, Mr. President, is to provide all Filipinos with information and access, without bias, to quality reproductive health care services and supplies essential to the promotion of every person's right to health.

5. Age- and Development- Appropriate Reproductive Health Education

All that I have discussed merely scratch the surface of the problem. To eradicate maternal and infant deaths, lessen unwanted pregnancies and prevent the infection and transmission of HIV and AIDS, we should address the root cause of the problem --- lack of education and awareness.

Mr. President, knowledge is the best tool in our deadly battle against these evils. It is for this reason that Section 13 provides for reproductive health education to be taught by adequately trained teachers in formal and non-formal educational systems and integrated in age and development appropriate subjects. It is also important to note that the bill mandates that minors are taught the value of healthy relationships including how abstinence is still the best form of protection from pregnancy and diseases. Mr. President, it is not true that 9 year old children will be taught how to use contraceptives. This is not age appropriate...

E. CONSTITUTIONAL BASIS

Mr. President, this bill is grounded on the following Constitutional provisions:

1. Article II Section 15. The State shall protect and promote the right to health of the people and instill health consciousness among them.

2. Article II Section 12. The State ... shall equally protect the life of the mother and the life of the unborn from conception...

3. Article II Section 6. The separation of Church and State shall be inviolable. Article III, Section 5. No law shall be made respecting an establishment of religion, or prohibiting the free exercise thereof. The free exercise and enjoyment of religious profession and worship, without discrimination or preference, shall forever be allowed...

4. Articles VI, VII and VIII all establish the three independent branches of government with their specific mandates.

E.1. On the right to health

Mr. President, I believe the Constitutional right to health needs no more further explanation.

E.2. On the protection of the life of the mother and her child

Mr. President, the health of the mother is intrinsically related to that of her child. Her health before and during pregnancy directly affects her child's health. Numerous studies have shown that malnourished mothers and those who do not undergo pre-natal care give birth to malnourished and underweight children many of whom die before reaching five.

E.3&4. On the separation of Church and State and the freedom of religion.

Mr. President, we, as Senators have our own personal views and relationship with God. This is a part of who we are. Thus, I do not ask that we separate our moral values from our scrutiny of the bill. I simply ask that we remember that our religious views may be different from our neighbors and we cannot use our legislative seat to deprive a fellow Filipino of his legal and constitutional rights to exercise his religion, to make choices within the legal boundaries but based on his own religion and NOT ours.

Time and again, the position of the Church has been discussed as a basis for not supporting this bill, but as Senators, we are tasked to separate our religious beliefs when they interfere with matters that belong to the State. I simply ask that we recognize the right of every citizen to make choices regarding ones reproductive health based on one's own conscience, moral and religious views.

Just because we are a predominantly Catholic country doesn't mean we can impose Catholic dogma on every Filipino. That is the job of the clergy and they can do as they please in the Church and its activities with their flock. But, in the halls of Congress, the Constitution is clear, - - there must be a separation of Church and State. If for the sake of argument, 99.9% of Filipinos were Catholic and every single one expressed a certain view, I would still be standing here today to fight for the rights of that 1 Filipino who is entitled to choices based on his religion and not the religion of the majority ... because that is the mandate of our Constitution -- that we make laws respecting the freedom of religion of all without the Church interfering with matters that should be left with the State.

Following the same argument, if 99.9 % of the population belonged to a different religion, I would still stand up for that 1 Catholic to ensure that his rights were protected and that services and facilities were available to allow him to make choices based on his beliefs. Those are the principles of separation of Church and State and the freedom of religion.

Does this now mean that we have no boundaries? That because we all have different views, the free flow of drugs and devices that may in fact be harmful to both mother and her unborn, are now to be allowed?

Of course not, Mr. President. We are still guided by the Constitution. And clearly we are to protect the life of the mother and the unborn from conception. Thus, knowingly taking a drug or performing an act after conception with the intention of aborting the fetus would be a violation of the Constitution and existing laws. And that brings me to my next point.

E.5. On the role of the executive, specifically the Department of Health through the Food and Drug Adminstration (FDA)

Mr. President, some groups would have the Senate arrogate upon itself the power to define, classify, allow or ban contraceptives. But this is clearly the jurisdiction of the FDA, a government agency that falls under the DOH which is part of the Executive branch. It is the FDA that has been tasked by law, among others to determine the efficacy of all drugs and medical devices, define what are abortifacients and how their use is to be regulated. It is the entity with the scientific and technical ability to do that job.

So why not simply put a statement in the bill banning all abortifacients? Would that not simplify this debate? It sounds tempting, Mr. President. But I humbly submit it will not simplify this debate. Why? Because medicine is a technical field. And without the appropriate scientific background, we, as legislators who are not medical experts, could easily make mistakes and kill mothers and their babies instead of saving their lives.

Allow me to explain. A careless phrase like "no drug known to be an abortifacient will be made available in the Philippines" sounds like a statement we could all support. But what most of us do not understand is the fact that many life-saving drugs are made available to an ailing mother to address her medical condition although there is a possibility that they may be harmful to a pregnant mother and her fetus. Thus, we have for instance, drugs for diseases of the heart, hypertension, seizures, ulcers and even acne, all of which are to be taken only under doctors' prescription and supervision.

Making a blanket statement banning all medicines classified as abortifacients would put these mothers and their child's life in greater danger. I would like to give another example. A known abortifacient, misoprostol commonly known as cytotec, is one of the drugs that can save a mother's life. I am talking about a mother who just gave birth but has internal hemorrhage and is in danger of bleeding to death. Her child has been born. He will live. But she will die without this drug to stop her bleeding. Are we now to ban the use of this drug? Clearly, we need to distinguish. These life saving drugs SHOULD NOT BE USED for purpose of carrying out an abortion, but under strict guidelines by the FDA can be used by a health practitioner to save a mother's life.

F. CONCLUSION

Mr. President, I appeal to our male colleagues for patience and understanding and above all, an open mind. Because although reproductive health affects both men and women, it is primarily a women's issue.

1. Men do not die from childbirth, but women and their newborn do.

2. Men are not affected by the deadly hpv virus which leads to cervical cancer, women do. Men merely pass along this virus to women thru unsafe and unprotected sex.

3. Men infected with HIV likewise pass it on to women (although this virus can be passed both ways), but when a man transmits it to a woman, it can then be passed on to the unborn child as well.

4. No man can claim that he has experienced the pain of choosing to end the life of the unborn baby in his womb. But half a million mothers in this country do that every year.

Mr. President, I believe the options are simple. Do we provide the facilities and the professional services women need? Do we want to equip our women with the means to plan their family using natural or modern family planning methods, as they so choose within the boundaries provided by our Constitution, all of which, and I repeat, are subject to the scrutiny by our FDA? Or do we want our women to live in the dark ages, unable to make informed and intelligent choices about planning their family. And worse, resorting to abortion, when they find themselves carrying an unplanned child.

Mr. President, if one woman is given the ability to make informed choices and access to services and facilities, that changes her life and that of her family. Why is this privilege limited to the rich? Every woman deserves this as a matter of right...

The statistics I mentioned earlier are not just mere numbers, these are real people with families orphaned by the loss of a loved one. The ball is now in our hands, Mr. President, and we cannot stand idly by as these deaths continue in our country. We have the power to end this. We have the power to provide poor Filipinos sufficient information for the exercise of their reproductive rights. We have the power to put an end to these problems. Let us show the Filipino people that we have not only the compassion but also the moral commitment and the political will to do something to prevent these tragedies from befalling upon families.

Mr. President, the bill is a work in progress. It is not carved in stone. I look forward to a healthy debate. I will keep an open mind and consider the inputs from our colleagues to be able to further strengthen the bill.

With this, I simply ask for your indulgence and compassion when you study Senate Bill No.2865 under Committee Report No. 49.

Thank you Mr. President.