Imposing Misery

Josie Dequito looks decades older than her actual age. With no teeth, sunken eyes and hollowed cheeks, the 40-year-old mother could easily be mistaken for a 60-year-old.

"Life is really difficult," she said as she prepared assorted goods to sell door-to-door all day around San Andres Bukid, a slum village in Manila City. "I have to earn extra because of my big family."

"Sometimes, I get home really, really tired but I still have to take care of my children," she said.

Dequito has 11 children – the eldest, a 19-year-old daughter, the youngest a two-year-old son.

She said she only wanted to have four children and that most of her pregnancies were "accidents" because she could not afford to pay for contraception.

Like Dequito, many women in Manila City are in a similar situation – with bigger families than they can afford to have – due to a lack of free family planning services at government health centres.

The problem began in 2000 when former Manila City mayor Lito Atienza, a staunch pro-life advocate, issued an executive order "discouraging" the promotion and distribution of artificial contraception in the city.

With the order, essential family planning services, including free supplies of condoms and birth control pills, disappeared from city health centres, according to a study entitled "Imposing Misery."

Providers also refused to provide women basic information about family planning, added the study, which was conducted by three reproductive health rights groups including the New York-based Center for Reproductive Rights in 2007.

With about 70 per cent of Filipinos relying on the public sector for family planning services, including female sterilization, oral or injectable contraception and intrauterine devices, the "contraceptive ban" has produced devastating effects on women’s health and quality of life, the study said.

Of the dozens of women interviewed for the study in San Andres Bukid, all have at least four children more than they planned and now face financial difficulties raising a larger family.

Mayor Fred Lim, who was elected in 2007, has not revoked Atienza’s order, but has allowed non-government organizations and private groups to hold family planning seminars as well as distribute free contraceptives.