Wednesday , June 20, 2018

Editorial: Informing choices for RH

THE lifting of the temporary restraining order (TRO) against the Responsible Parenthood and Reproductive Health (RPRH) Law puts pressure on the implementors to catch up, particularly since approximately 200,000 sub-dermal implants being stocked by the Department of Health (DOH) are expiring in September 2018.

According to reports, Commission on Population (PopCom) Executive Director Juan Antonio Perez III said that in order to consume the stocks before expiry, the target is to inject 1,000 women every working day.

This consideration should not be prioritized, though, over informing women and their partners about the injectable contraceptives and other options so they can make informed choices about their health and that of their families. 

The information women and their partners need to know will enable them to assess if the benefit desired from using a particular birth control method is worth the side effects that they may experience.

For instance, while injectables have been tested as being highly effective in preventing pregnancy, there also bodily changes arising from its use, such as prolonged bleeding, dizziness, headaches, bloating, weight gain, reduced sex drive, and mood changes.

Women need to know about these side effects and decide if they are willing to risk these, given their other duties, such as taking care of children, working outside the home, commuting to work, and caring for other family members who are elderly or disabled.

The social dimensions of advising couples about choosing an appropriate birth control method and the planned family size should be considered by the PopCom, DOH, and extension workers. 

Education on reproductive health should be conducted house-to-house, ideally in the evenings when both partners are around to meet with the health worker. 

In consultations conducted at the health center, women usually are unaccompanied because either the men are at work or unwilling to be subjected to “women’s talk” while being the only man present.

The lack of privacy at communal centers may not only work against drawing out the partner to participate. During home visits, the extension worker can observe and respond to the family’s dynamics, such as the influence of parents or reservations regarding reproductive health arising from religious or superstitious beliefs and practices.

Among the important matters that need clarification with the public concerns the perception that contraceptives are abortifacients.

In June 2015, the Supreme Court issued the TRO because of a petition by the Alliance for Family Foundation Philippines Inc. that the implants cause abortion.
The TRO was lifted after the Food and Drug Administration evaluated after four months that the implants are not abortifacients.

However, stakeholders implementing the RPRH Law should continue educating the public about the issue concerning abortifacients.

Injectables prevent ovulation, or the release of eggs from the ovaries. Some pills delay ovulation while others “thicken cervical mucus so sperm have trouble swimming,” according to a Dec. 31, 2012 article posted on

Contraceptives block the creation of fertilized eggs; these do not induce abortion, which is the deliberate termination of a fetus.

Couples also need to know that the efficacy of the implant contraceptive is for three years after implantation. After injectable contraceptives are stopped, there is a delay of three to four months before a woman can be fertile again. 

These distinctions are crucial for shaping the decision-making of couples, specially those who are Catholic.

The government and other civil society stakeholders should focus on educating first the public and engaging couples in dialogues that will steer them towards making prudent decisions that promote the best interests of their families and the country in the long run.