Sunday Magazine: injectable contraceptives help Filipino families plan their lives

Today is Sunday

I remember my best Sundays. When I was married, they were the days you woke up to, unhurriedly. You cuddled in bed, enjoyed a leisurely breakfast, played with the kids, and then around noon, started catching up on your list. And before that, earlier in my life, as kids, Sunday was the last day of the weekend. Tomorrow, sigh, we’d have to go back to school. Well at least on Sunday, we would have something to do. We’d have breakfast then dress up for Mass. The Catholic mass was a satisfying ritual. It was a milestone during the week. Afterwards, the family might eat lunch outside. We’d get home and each of us kids would then do his own thing.

Do you have that Sunday feeling?

Well, with that Sunday feeling in mind, I’ve prepared a “deep” piece.

One of my Sunday morning things was the Sunday paper. The Sunday paper was the issue that contained the editorials, the weekly recap, and so forth.

Well this post turned out to be an editorial. The article started as a story about the state workers (meaning “of the national government“) doing their job in Cuyo. But I was aware of the swirling debate over the reproductive health (RH) bill. Initially I just wanted to report it. One paragraph. Bam, done. But the explanations went on. You’ll see what I mean.

Since it was going to be lengthy anyway, I decided to make it informational as well. That’s why I included two long quotes. If you’re thinking of contraceptives, consider injectable contraceptives. Here’s what it seems to be:

  • a contraceptive good for 90 days
  • a contraceptive that you can start and stop at will
  • inexpensive (100 pesos, about US$2.25)

If you’re anti-RH bill, I hope this sways your mind.

Giving families a choice

"Regional Health Unit" Cuyo retirednoway

Members of the Regional Health Unit of Cuyo, Palawan

Until I saw it with my own eyes, I didn’t know that the Department of Health helps needy Filipinos with family planning.

I spent the first four days of my Cuyo trip in Bisucay island. Anyone who knows me knows that I probably explored the island.

Aside from the schools, the only presence of the national government in the island was the barangay-level health office-slash-clinic.

Isn’t that revealing? You can tell the government’s priorities by the type of its buildings in remote corners of its responsibility.

Classrooms and a health office–education and health–two essentials of the Filipino population.

"health office" retirednoway Balading Cuyo

The staff of a barangay-level health office. This was located at Bgy. Balading on Bisucay island in the municipality of Cuyo, Palawan.

It’s sinking in!

I had observed twice before that the current child-bearing generation–Filipinos in their 20s to early-30s–limit their family size.

From my Brooke’s Point waterfall post:

"Palawan State University" retirednoway

Ronald Magno, 28, is a graduate of Palawan State University. He is one of 11 children! Fortunately, he has only one child, and takes his reproductive rights and responsibilities seriously.

Ronald is a tricycle driver. He rents his house. And he doesn’t even own his own tricycle.

From my post about a freshwater spring located in a most inconvenient spot:

"Retired No Way" "Oring-Oring" "Brooke's Point" Couple

Young family located at Bgy Oring-Oring in Brooke's Point, southern Palawan.

The couple above is likely in the bottom 25% of the population. Neither adult probably graduated from high school. Neither adult may even have graduated from elementary school.

The man works wherever and whenever he can. He probably works as a part-time fisherman and part-time farmer. And she’s probably a housewife. Limited education notwithstanding, this couple only has one kid with another coming soon.

It seems that Filipinos are now aware of the relationship between “their children, their livelihood, and their futures.” That’s a very good thing.

And I was impressed with the Department of Health for supporting that awareness by counseling the young couples who come to them for guidance. Good job DOH!

Bisucay Island Cuyo retirednoway "Regional Health Unit"

Bisucay Island & Cuyo Island: Division of responsbility for the Regional Health Unit

Bisucay is the smaller of the two islands in the map above.

While in Bisucay I witnessed a woman in her early-20s receive a contraceptive injection. She was injected with an oral form of contraception. Contraception’s objective is the prevention of fertilization. Contraception is a form of birth control.

Birth control provides a choice.

What does birth control give families? A choice.

I don’t know about you but I want the controversial reproductive bill to become law in the Philippines.

To my mind, the Catholic church in this country is opposing a bill that, if made into law, would  give families a choice.

It’s not a stretch for the church to claim that contraception, because it prevents new life from being created, goes against their teachings.

But doesn’t the church’s position ignore the self-interest of the Filipino?

Would you all agree that the right to reproduce is God-given?

If so then you would probably agree that the right to reproduce–to bear new life–is inalienable. If it can’t be divorced from our human-ness (or what makes us human), then you would agree that the right to reproduce is a basic human right.

Well, the Catholic church is interfering with that right. The church that claims to represent the God that gave us the right to reproduce is interfering with that God-given right.

How?

The Catholic church of the Philippines wants the Filipino to assume the risk of an unwanted pregnancy without–and this is the irony–without even offering to share in the multi-year effort needed to raise that baby into a healthy young man or woman with a promising future.

Mr. Hypothetical

A responsible Filipino will weigh other factors. And these factors, to many Filipinos, matter more than the church’s displeasure.

I’m 23. I earn 12,000 a month working at the front desk of one of Puerto’s pension houses. My wife’s also 23. We rent a house. We turned half of the house into a sari-sari store which my wife runs. It brings in 5 to 7 thousand a month.

We’ve got two kids, 3 and 1.

I graduated from Palawan State University with a degree in Accountancy. My wife did not finish. She had to drop out after she became pregnant with our first child.

Since after our firstborn, she’s been getting free regular 90-day injections. Two years ago, we decided we were going to try for a boy. She discontinued injections and became pregnant.

The man is hypothetical but the background is based on real people I’ve met here. That background fits the profile of a young urban professional in Puerto Princesa City.

Notice that when the couple decided they were ready, they willingly let nature take its course. But the church, in its current struggle against the reproductive health bill, thinks that it owns a higher reason that allows it to usurp a basic human right–the right to reproduce.

That’s arrogant don’t you think?

Are the church’s interests aligned with the Filipino family’s?

Should the Filipino be more concerned with satisfying church leaders or raising, in a responsible manner, his family?

And finally, does this demonstration by the Catholic church indicate that, once again, it’s part of the problem and not of the solution?

An injectable contraceptive

Contraceptive "Medroxyprogesterone Acetate" retirednoway

An Injectable Contraceptive. (Medroxyprogesterone Acetate). Inexpensive. Effective. Simple to Use. Safe.

The woman in Bisucay was injected with a 90-day contraceptive. The government-issued vial was a generic brand called Lyndavel.

retirednoway Lyndavel medroxyprogesterone

Lyndavel (a generic brand of medroxyprogesterone)

The contraceptive’s generic name is medroxyprogesterone acetate. Several brands of generics compete. The largest brand is Depo-Provera. It’s manufactured by the drug giant, Merck.

Depo-Provera, the generic contraceptive

From a consumer’s medical website.

Depo-Provera is a form of progesterone, a female hormone that prevents ovulation (the release of an egg from an ovary). This medication also causes changes in your cervical mucus and uterine lining, making it harder for sperm to reach the uterus and harder for a fertilized egg to attach to the uterus.

Depo-Provera is used as contraception to prevent pregnancy. It is also used to reduce pain caused by endometriosis.

From a website for medical professionals:

Article Abstract — Depot MedroxyProgesterone Acetate (DMPA; Depo-Provera®, Merck) is a very safe and effective method of birth control that can be used by virtually every woman.

Depo-Provera has not achieved its full potential for pregnancy protection. With correct and consistent use, the first-year pregnancy rate should be 0.3%, but in typical use, the first-year pregnancy rate is 7.4%. This gap is due to interrupted use and high discontinuation rates.

Product description — The 3-month injectable Depo-Provera was registered for use as a contraceptive in 1979. It is the fifth most commonly used contraceptive method worldwide.

Efficacy — Scientists report that women who are given 150 mg of Depo-Provera every three months reported a pregnancy rate of 0.3%. I interpret that to mean that for every thousand women who take regular 90-day injections, three will become pregnant over a period of time.

In contrast to the significant evolution that has taken place with other hormonal contraceptives, injectable contraception has undergone little modification over the decades.

Learn from mistakes! About the Failure Rate — The failure rate refers to the 3 unexpected pregnancies per thousand.

Failure rates do not vary by patient weight. Therefore, adjustments in dose are not needed for heavier women.

However, failure rates are higher if the drug is inadvertently injected in or near a vessel, because the drug will be more rapidly absorbed. Failure rates are also increased if the injection is not made deep in the deltoids (shoulders) or glutes (buttocks), or if the area is massaged soon after the injection. Massage tends to convert the drug deposit from a sphere into a flattened disc with a greater surface area, so again, absorption will be more rapid and the drug effects will be shorter lived.

"Muscular System" retirednoway

Best spots to inject: shoulders and buttocks

Despite these promisingly low failure rates with correct and consistent use, the first-year failure rate of Depo-Provera in typical use is estimated to be 7.4%. This large discrepancy from its potential for near-perfect pregnancy prevention reflects the fact that women often return late for their reinjections.

Measurements of timely refills of Depo-Provera from private pharmacies throughout the U.S.A. provided disturbing insights into the real-world patterns of over 161,000 women followed. Even in a publicly-funded family-planning clinic where all methods of birth control are provided free of charge and same-day appointments are available for reinjection, over one-sixth of all women continuing their Depo-Provera returned late for reinjections.

Considerations for Use of Depo-Provera® — In addition to offering convenient and potentially excellent intermediate-term pregnancy protection, one of the most attractive features of Depo-Provera is that, as a progestin-only method, it is a go-to method for virtually all women with significant medical problems.

Noncontraceptive Health Benefits — By suppressing ovulation, Depo-Provera reduces the risk of ectopic pregnancy and postovulatory ovarian cyst formulation. Depo-Provera also meets many other reproductive health needs of a variety of women.

Two final points about the controversy over the reproductive health bill

The reproductive health bill notes that the Philippines is the 12th most populous nation in the world today and the Filipino women’s fertility rate is at the upper bracket of 206 countries.

It also states that studies and surveys show that Filipinos are responsive to having smaller-sized families through free choice of family planning methods. It also refers to studies which show that rapid population growth exacerbates poverty while poverty spawns rapid population growth. And so it aims for improved quality of life through a consistent and coherent national population policy.

That’s the background of the problem.

We’ve got a lot of people. As it is the country is barely able to support everyone. That’s why so many Filipinos work overseas. Filipinos, like everyone else, would like to live a more comfortable life. Fortunately, Filipinos today are aware of the link between family size, poverty, and a bright future. Filipinos are probably willing to limit their family size and the proposed law will help them decide how to do it.

What the proposed law does and doesn’t do

"Org Chart" "Regional Health Unit" Cuyo retirednoway Midwife

Note the number of midwives in the Org Chart of the Regional Health Unit of Cuyo, Palawan.

Note that the law will not try to force people to plan their families, much less to use contraceptives. It just wants to give people who want more choices, more choices.

  • This article written by the bill’s principal author presents the main points of and misconceptions about the bill.
  • This blog post analyzes the bill’s proposed legal framework.

These are the services that the proposed law proposes:

  1. Information and access to natural and modern family planning
  2. Maternal, infant and child health and nutrition
  3. Promotion of breast feeding
  4. Prevention of abortion and management of post-abortion complications
  5. Adolescent and youth health
  6. Prevention and management of reproductive tract infections, HIV/AIDS and STDs
  7. Elimination of violence against women
  8. Counseling on sexuality and sexual and reproductive health
  9. Treatment of breast and reproductive tract cancers
  10. Male involvement and participation in reproductive health issues
  11. Prevention and treatment of infertility and
  12. RH education for the youth.

The proposed law revolves around contraception which is the prevention of fertilization. If contraception succeeds, no new life is created.

The proposed law is not about contragestion which is the prevention of the implantation of the fertilized egg in the uterus. If contragestion succeeds, new life is prevented from developing.

And neither is the proposed law about abortion which is the removal of the fetus or embryo from the uterus. If abortion succeeds, unborn life is terminated.

That’s the final argument: the proposed law will not change the current rule. If contraception fails and the woman becomes pregnant, she carries it to full-term. The proposed law isn’t changing that.

Be clear!

Birth control is an umbrella term for several techniques and methods used to prevent fertilization or to interrupt pregnancy at various stages. Birth control techniques and methods include:

  • contraception (the prevention of fertilization),
  • contragestion (preventing the implantation of the blastocyst) and
  • abortion (the removal or expulsion of a fetus or embryo from the uterus).

Contraception includes barrier methods, such as condoms or diaphragms, hormonal contraception, also known as oral contraception, and injectable contraceptives.

Contragestives, also known as post-coital birth control, include intrauterine devices and what is known as the morning-after pill.

Wikipedia

How to enlarge these images

Click on an image and then click on the image’s final resolution (encircled).

"How to enlarge an image" retirednoway

How to enlarge an image

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8 responses to “Sunday Magazine: injectable contraceptives help Filipino families plan their lives

  1. Pingback: Prevention Male Reproductive

  2. The Catholic Church opposes contraception because the Catholic religion teaches us about God — and because of God, thus the purpose of life, and the ultimate end, heaven or hell.

    If you don’t accept the teachings of the Catholic Church about God, then the rest of this is pointless. If it’s not about heaven and hell — then you will do whatever you want. There are many, like myself, however who follow Catholic teaching because we believe that Christ established this Church alone – to teach his doctrine. Those who live by the teachings of Christ, though his Church, will inherit eternal life.

    So, as I see it, your argument is not about contraception at all. No, it’s an argument against the authority of the Catholic Church. You don’t believe that the Catholic religion is true. You’re teaching that one does not have to obey Christ’s Church to attain eternal life.

    But you’ve given no evidence at all that you’re correct about this. How do you know that God will not judge your views worthy of eternal damnation?

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    • Thanks for your comment.

      You’re correct. My argument about the Catholic church’s opposition to the reproductive health bill goes against the will of the church.

      That doesn’t remove my argument’s validity, or do you think so? If you do, then to paraphrase your message, the rest is pointless.

      If you are willing to take me to task for believing that I don’t need the wisdom of the Catholic church then let’s argue.

      We can start with my belief that I don’t need the wisdom of the Catholic church to secure my soul’s salvation. Or, how about my contention that the Catholic church is a human institution with mortal wisdom? Or, that the Catholic church believes and would like everyone to believe that it is interpreting God’s word correctly?

      Friend, you will find that many of my points will constantly return to the Achilles Heel of the Catholic church: the fact that it was built by men.

      For best results, ignore the indignity of having to deal with an ex-Catholic. That means not resorting to scaremongering (“eternal damnation”) and non-sequiturs (because my argument is against the authority of the Catholic church, I don’t believe that the Catholic religion is true, and I’m teaching that one does not have to obey Christ’s church to attain eternal life).

      Your turn.

      Like

  3. Faith saves! Not dogma, not even good works. Mark 16:16 http://nasb.scripturetext.com/mark/16.htm.

    Like

  4. Pingback: [From the web] Why I support the Reproductive Health Bill? – www.magph.org | Human Rights Online Philippines

  5. If you are supposed to learn from your mistakes, why do some people have more than one child.

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  6. Dogma and Faith are almost synonyms :http://www.answers.com/topic/dogma Just had to leave this comment after listening to a lecture on Faith matters on EWTN Blessed Sunday 🙂

    Like

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