On New Year's eve, Lala (name changed) lay curled up in a dark room, weak and bleeding, frightened and anxious - oblivious to the feasts and colorful fireworks outside. Close to two years later, she still recalls December 31, 2004 with bitterness. Alone, she induced the abortion of a barely three-month-old fetus. At the age of 24, with a promising, bright future ahead of her, Lala could not deal with an unwanted pregnancy.
A 2006 study by the Alan Guttmacher Institute (AGI) and the University of the Philippines Population Institute found that approximately 46 per cent of women aged 24 and below have attempted abortion - about 473,000 abortion yearly or 27 per 100,000 women. The study says that because abortion is illegal in the Philippines, there remains a high level of underestimation and underreporting. In the Philippines, abortion is only legal to save the life of a women. It is not available on request, and nor for a host of other reasons - like, to preserve physical or mental health, to end a pregnancy that is result of rape or incest, or because of fetal impairment. The actual figures, therefore, could actually be higher.
The US-based Population Reference Bureau confirms these findings. It says that the Philippines has one of the highest abortion rates in the world - third only to Brazil and Nigeria.
Lala moved from provincial to city life when she took a Mass Communications broadcasting course with one of Philippines' prestigious universities. A promising future awaited her after graduation when she was offered a job in a radio station. It was here that she had an intense and intimate relationship with a married man. Lala admits she never used contraceptives. "I expected him to responsible," she says. But her lover did not use condoms.
As with Lala, most women go through an abortion because the pregnancy is unplanned or unwanted - or both. However, the 2006 study also finds that most Filipino women who seek an abortion are married or living with a partner, reside in urban areas, have at least three children and are Catholic.
In November 2004, Lala remembers experiencing morning sickness and dizziness. Initially, her lover was happy about the pregnancy. It brought them closer and Lala, at first, wanted to keep the baby. However, as the pregnancy progressed, the relationship began to sour - mostly stemming from the fact that her lover would not leave his family and take responsibility for their unborn child. "We were always fighting," she recalls.
This was, perhaps, the reality check Lala needed. She realized that she would have to be practical and abort the pregnancy. Only her boyfriend knew about it and she needed to keep the pregnancy a secret. If her colleagues found out, she could lose her job. If her family and friends found out, she would be disgraced. And if her lover's family found out, there would be hell to pay.
Desperate and alone, she turned to her landlady for help, who - used to her female student boarders' troubles - sold Lala eight Cytotec pills "My lover did not know of my plan to abort the baby," Lala says. At around 10 pm on December 29, Lala took three tablets orally and inserted the other three in her vagina, as her landlady instructed. By midnight, her stomach was throbbing with pain. She had to go to the bathroom frequently because of profuse blood flow and diarrhea. By December 31, she was weak from blood loss and dehydration. Lala bled for a month.
Cytotec used to be an over-the-counter drug, originally intended to cure ulcers. However, after its abortion-inducing properties were discovered, the drug was abused, leading to its classification as a strictly prescriptive medication. This in turn led to it becoming a contraband drug that fetched a steep price in the black market. The US Food and Drug Administration has marked Cytotec as an abortifacient. The drug is so strong that it can cause complete or partial miscarriages, infertility and bleeding in pregnancy women. It is one of the most commonly used abortion methods in the Philippines.
Lala was not really sure the abortion was complete because a few months later, she started bleeding profusely again. She was, however, afraid to see a doctor.
In the Philippines, a lot of Filipino women - especially the poor - adopt extremely unsafe methods. They go to backstreet practitioners or attempt to induce the abortion themselves. The AGI and other health agencies believe that illegal abortion is a major cause of maternal deaths every year. According to a 1999 Country Population Assessment, UNFPA found that some 46 unsafe induced abortions are performed every hour in the country.
Since the Philippines is largely Catholic, contraception is still a thorny issue. The debate among the government, NGOs and the Church on this issue is stuck in a stalemate.
Although illegal abortion remains a neglected issue, there have been attempts to address it. Since 1994, the International Conference on Population and Development (ICPD) has defined reproductive health as the state of complete physical, mental and social well-being and not merely the absence of disease or infirmity in the reproductive system. The proposed Responsible Parenthood and Population Management Act in the Philippines seeks to provide adequate and relevant reproductive health services and information to the people as a basis for informed choice and responsible parenthood. However, this Bill still has a long way to go, given the prevailing political atmosphere in the country. The Philippines is also a signatory to the Convention on Elimination of All Forms of Discrimination Against Women, which upholds women's right to health services, including access to all family planning methods.
Women like Lala, meanwhile, wait for these promises to move from paper to actions. Lala herself admits that she cannot move on. She feels alone because she broke up with her boyfriend after the abortion. She longs for the day when she really feels at peace with herself. Until then, she tries to put the closing nights of the year 2004 behind her - one day at a time