IN SOUTHERN Mindanao, thousands of women continue to die of complications related to childbirth. Causes of maternal deaths are hemorrhage, sepsis, obstructed labour, hypertensive disorders in pregnancy, and complications of unsafe abortion -- most of which are preventable with proper diagnosis and intervention.

Many women are also having more children than they want. Most of them are in impoverished situation and the frequency of their pregnancy and childbirth takes toll on their health. It also prevents them from taking on a more active role in the community as most of their time is spent in responding to the needs of their families.

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Currently, the total number of children a Filipino woman has during her reproductive years is one child higher than the desired number. For the poorest women, the number of children a woman has is about two children higher than desired. (NDHS, 2008)

The country has an adjusted maternal mortality ratio of 160 per 100,000 live births against a goal of 55-60 deaths per 100,000 live births, according to UNICEF. A closer look would show that the country is still statistically off-track from the Millennium Development Goal of 55 deaths per 100,000.

Things are not going well. According to the 2006 Family Planning Survey, only 50.6 per cent of women used family planning methods. Condoms, pills and other forms of modern contraception are equated with abortion. As a result, contraceptives are not available in most government and rural health clinics.

House Bill 5043, known as the Reproductive Health Bill, advocates a comprehensive range of programmes and services addressing sexual and reproductive health, including education and universal access to both traditional and modern family planning services.

The bill has been languishing in legislative debates for two decades, preventing women, especially in lower income groups, from obtaining reproductive health information and services.

Data from the 2003 National Demographic and Health Survey and 2006 Family Planning Survey shows that in the National Capital Region (including Manila), a reported 90 per cent of births are supervised by a skilled birth attendant. In Mindanao, the comparable figure is 24 per cent.

Due to some cultural beliefs, geographical location and the lack of access to facilities and skilled birth attendants, many women still opt to go to a community based traditional birth attendant. Inaccessibility and lack of personnel are the main factors that contribute to Mindanao having one of the highest MMRs in the country.

While concerted effort has been undertaken to accelerate and promote cost effective interventions and access to emergency obstetric care; increasing the number of births in health facilities and universal access to reproductive health services, including family planning, old habits and misconceptions persist.

Many women die from pregnancy because they are too young (under 18 years old), too old (older than 35 years), have had too many pregnancies or have pregnancies that are too close to each other (less than 3 years apart). The maternal deaths could have been prevented with family planning. It could also prevent deaths related to ill-health resulting from unintended pregnancy. About 2,000 women die in the region each year because of pregnancy related causes.

In an environment where reproductive health of women are decided by men and religious beliefs have a stronger influence on family planning, a multi sectoral level campaign on family planning needs to be undertaken. Email comments to roledan@gmail.com