Saturday, October 11, 2008
I am a Christian. I have been raised and educated as a devout Catholic and am fairly active in my church. But I am also a doctor, and this is one issue where my personal beliefs and dogma and I do not see eye to eye.
And I agree that it's past time that a Reproductive Health Bill in the Philippines was passed - and executed.
It's a delayed reaction to a fairly dated issue, but I felt so strongly about the topic that I couldn't resist.
I am pro-choice but I do not believe in induced abortions. This is something that I, as a doctor, would never do for any patient. But what I don't understand is the mass hysteria being drummed up by about the issue of artificial means of contraception.
Just reading the statistics alone is already quite convincing. The Philippines is among #15 in Asia with the highest maternal mortality rates - the top causes of which are hemorrhage and abortion, of which a significant number are induced. Many of these deaths are preventable - by adequate nutrition, proper spacing between pregnancies, and, yes, even limiting family size.
How is teaching the largely ignorant populace about responsible parenthood and providing them with means to practice it an affront to the dignity of life? How does seeing the logic behind a smaller family size and wanting to prevent unplanned pregnancies make those of us who are for this bill akin to murderers?
There are those who feel that sex education, education about artificial contraceptive methods, and providing free access to artificial contraceptives somehow encourages a culture of promiscuity. Frankly, I think this argument is flawed on several levels, not the least of which is that it seriously undermines the people that they are seeking to protect. Besides this, the reality is that, despite our largely conservative-leaning society, increasing sexual activity among the young and unmarried is actually quite prevalent and has been for some time. Turning a blind eye to this reality and sticking our head in the sand will not make it go away.
I think, that for me as a doctor, the most convincing argument for family planning, responsible parenthood, and sex education was working in the OB Admitting Section every three days for several weeks as a medical student, then as an intern.
The concept of a woman having more than 3 kids for me simply boggles the mind, but there I saw countless grand multiparas (women who have given birth more than 5 times) reaching their status before the age of 30, already on baby number 6 or 7. I'd had to assist at emergency hysterectomies for these women with overused uteruses that refused to contract after delivery, causing them to bleed and bleed and threatening to leave their many children motherless.
On the other end of the spectrum were the young primis - the youngest in my experience was 14, just in her first year of high school, who never had a single pre-natal consult prior to delivery. I can't imagine what kind of parenting these young girls can offer their babies, not when they were hardly out of childhood themselves and were now forced to grow up much too soon.
And then there were the women who came in for induced abortions that were not completed, septic, bleeding, and often on the brink of death. It was both fascinating and appalling how creative and innovative some of these very desperate women would be in trying to terminate their unwanted pregnancies, turning to methods ranging from the sedate to the bizarre. Some are lucky enough to make it through. Some are not.
Do I believe passing the Reproductive Health Act will change the stories of the women who I've talked about above? Maybe, maybe not. But let's not lose sight of the fact that in the end, no one but the couples themselves can dictate what they do in their bedroom, in their sex life, and in their family lives. No one can argue with that. Isn't it then only right that they are given the chance to make informed choices?