Dying in silence: How abortion kills Filipino mothers

Re-posted from Newsbreak.

That it’s illegal exacerbates the situation, say experts

MANILA, Philippines –Amelia, 35, was sure she was dying. She was lying in bed in the emergency room of a busy hospital in Manila. Her dress was drenched in blood. Her stomach was in terrible pain.

Patients recuperate from post-abortion complications at the Fabella Memorial Hospital (Photo taken by Elena Masilungan for Newsbreak)

It happened almost a year ago. Her husband brought her to the hospital because she had been bleeding for three days. It got to a point when she had to change her sanitary pad every 30 minutes. Paracetamol only made the pain in her stomach worse. “I was so weak I could not even sit up. I got scared and went to the hospital.”

Amelia was suffering from complications due to induced abortion.

When she found out she was pregnant, she began seeing the hilot in their neighborhood thrice a week for three weeks for “massage” sessions. The hilotkneaded, poked and pressed her stomach for 10 to 15 minutes during these sessions. On the fourth week of her “massage” sessions, she started bleeding.

It was painful. It was also a crime.

The country’s penal code, enacted 8 decades ago, punishes with imprisonment women who undergo abortion.

Amelia’s case is by no means unique. A study done by the Guttmacher Institute said that in 2008 alone, 560,000 induced abortions were performed in the Philippines.

Amelia took the risk because she and her husband could no longer afford another—their 9th, supposedly—child to feed. A street vendor whose husband ekes out a living as a “pedicab” driver, Amelia considered her pregnancy as just another expense, “gastos lang.”

During an interview in their one-room shanty in Manila, Amelia was putting to sleep her one-year-old infant. Her two eldest children were not home, but neither were they in school. Her nine-year-old son was working as an errand boy in a nearby restaurant, while her 10-year-old was busy manning a car park by the streets.

Only her seven-year-old daughter was in school. The four other kids were with Amelia’s mother, since Amelia had to work.

Unsafe methods

Because abortion is illegal here, women like Amelia are forced to go to clandestine abortion service providers who use unsafe methods, at great risk to their health and their lives.

The consequences of such procedures can be fatal.

In 2008 alone, 1,000 women died from complications arising from unsafe abortion, according to according to a study made by the Guttmacher Institute. Almost every year, unsafe abortion takes more lives than the dreaded dengue fever, which caused a little over 700 deaths last year.

It is among the top five reasons why the number of mothers dying from pregnancy continues to be fairly high in the Philippines, according to data from the health department.

Making things worse is the attitude of many health professionals toward women who choose to abort their pregnancy. Apart from harboring their own moral judgments, these health practitioners hesitate to treat post-abortion patients for fear of criminal liability.

Amelia was lucky. Timely medical attention helped her survive.

In many cases, the women die because when they suffer from post-abortion complications they delay going to the hospital for treatment.

In an overwhelmingly Catholic country where the Church remains an influential voice, terminating a pregnancy is generally equated with murder. There is very little sympathy for women who opt for it.

Women suspected of having induced abortions often receive unsympathetic treatment if not outright threats from medical professionals. The moral judgment made by medical professionals can be so sweeping at times that even those who had spontaneous abortion are initially suspected of undergoing induced abortion.

As such, they are subjected to the same unsympathetic treatment, until such time that a final diagnosis is made that indicates they had, indeed, suffered from spontaneous abortion.

That’s what you get

Amelia felt the censure almost immediately upon entering the hospital’s emergency room.

It was her husband who explained Amelia’s condition to the nurse at the reception desk. The nurse glared at her for a few seconds, Amelia recalled.  She then left and came back minutes later with a doctor who asked Amelia where she was hurting and what she was feeling.

“After answering him, he next asked me in a loud voice if I had an abortion,” Amelia said. “There were people near us who heard him and they all looked at me.” She felt the judgment in their eyes. “They seemed to be saying, ‘that’s what you get for getting an abortion,’” Amelia related in almost a whisper.

Amelia did not answer the doctor directly.  She told him was that she had a miscarriage (“nakunan”), or a spontaneous abortion, which happens without medical or surgical interventions. The doctor looked at her and shook his head but said nothing more.

In countries where it is legal, abortion is done through surgery or medication. In the Philippines, women wanting to terminate their pregnancies do it through such means such as an abdominal massage, by inserting hazardous objects in the uterus, by ingesting abortifacient drugs or substances, or even simply by doing intense physical exertion.

Asked why she lied, Amelia explained, “I did not want to admit to the doctor I had an abortion. I don’t think any woman can readily admit that. How can a mother admit to another person that she killed her child?”

After the doctor left her, a nurse sat Amelia in a wheelchair and led her to the obstetric ward. The nurse told her in a sharp tone, “Don’t lie when she asks you if you had an abortion. If you lie, we will report you to the police. Besides, it’s obvious you had one.”

Amelia was burdened with mixed feelings. “I was so scared I might die or if I live, they will get the police to arrest me.” She was also getting furious. “I was bleeding heavily. I could feel the blood trickling down my legs. My dress was also soaked in blood,” she narrated. “I knew they were deliberately delaying treating me because I had an abortion.”

Meantime, the pain kept getting worse. “I kept thinking of my children. The eldest was just 10 years old. What will happen to them if I die?,” she said.

Amelia had reason to be angry.

“I have witnessed many times how the health staff can be very judgmental in dealing with post-abortion patients,” observes an OB-Gyne doctor, who agreed to talk only on condition of anonymity.

Guilty feelings

The doctor, who is a consultant with the Dr. Jose Fabella Memorial Hospital, the largest maternity hospital in Metro Manila, admitted that it is very common to hear “self-righteous remarks” from health professionals when they talk to post-abortion patients. “They make the patients feel guilty for their ‘crime.’”

Anti-RH bill advocates sign up onlookers to pray the rosary “for the conversion of those involved in seeking or providing abortion" (Photo taken by Elena Masilungan for Newsbreak)

Dr. Alejandro San Pedro, chair of the Department of Obstetrics and Gynecology of the Bulacan Provincial Hospital, agreed that such situations do happen. “The influence of the Catholic Church is deeply ingrained in some doctors that it affects the way they behave toward their patients,” he said.

The code of ethics of the Philippine Medical Association (PMA) is clear on what it expects from doctors: to provide competent medical care with full professional skill in accordance with current standards of care, compassion, independence, and respect for human dignity.

But in reality, many doctors do not meet this expectation when it comes to dealing with post-abortion patients.

Flora, a 23-year old single mother of three, experienced this when she sought treatment in a private tertiary hospital for high fever, severe stomach cramps, and heavy bleeding after ingesting the drug misoprostol, a drug known for its abortifacient qualities.

“The scolding came first before the treatment,” relates Flora. “The doctor reprimanded me and told me I committed a grave sin. She told me, ‘You may still be alive but your soul is already burning in hell.’”

All Flora could do at the time was cry.

Some doctors we interviewed explained that they resent having to spend crucial time on a patient who is lying about her condition. “Admittedly, you can get impatient,” said Merlinda Montinola, chief resident of the OB-Gyne department of the Philippine General Hospital.

It is frustrating when a patient keeps on denying that she had an abortion when all her symptoms point to that, Montinola said. “You would want to know what she did because the treatment for induced abortion is different from spontaneous abortion.” When no amount of explanation would make the patient tell the truth, Montinola said, “you cannot help but sound irritable and unsympathetic.”

This mood can be aggravated when the doctor is overworked and very tired, she added.

Some doctors admitted threatening their patients that they will be reported to the police just to stop them from lying or from being evasive about their true situation. They clarified, however, that these are often empty threats— meant only to make the patient realize that what she did was illegal and risky.

Hopefully, these doctors said, the patient will be frightened enough and avoid a repeat in the future.

Legal and moral bind

There are doctors who feel they are in a bind when treating post-abortion patients because of the legal responsibility attached to induced abortion.

“Some doctors think that completing an induced abortion and providing post-abortion care mean they are continuing the crime,” according to Junice Melgar, executive director of the Likhaan Center for Women’s Health.  The center is a nongovernment organization that promotes the health and rights of disadvantaged women and their communities.

Melgar maintained that these fears are baseless. “The crime has been done already. And doctors are supposed to do their ethical role, which is to treat life-threatening complications.”

The specter of potential criminal liability, however, clearly affects the way health professionals and institutions deal with post-abortion cases.

In a forum on post-abortion care attended by health professionals, the assistant chair of the OB-Gyne department of a tertiary teaching hospital in Metro Manila revealed that they would direct their security guards to have the names of post-abortion patients listed in the police blotter.

The administration of the hospital, which is right across from a police station, was under the impression that they are required to do this. Curiously, no police ever came to the hospital to investigate.

Lawyer Claire Padilla, executive director of the NGO EngendeRights, who was in the same forum, asserted that the law is not categorical in requiring doctors and hospitals to report to authorities women who had induced abortion. This should explain the police’s lack of action against post-abortion patients in the said hospital.

There are doctors as well who refuse to treat post-abortion patients because to do so would be against the dictates of their conscience.

Doctors who admitted they turned away patients in the past told Newsbreak that they referred the cases to other doctors who were less conflicted. Likewise, in situations when they are the only ones available, these doctors said they eventually provide their patients with competent medical care.

In such situations when they are forced by circumstances to attend to post-abortion patients, however, the behavior and attitude of these doctors toward such patients sometimes go against the PMA code.

Training for doctors

Hospitals generally have an accountability mechanism that allows patients to complain if they experienced less than professional behaviors from their staff, including doctors and nurses. It is, in fact, a requirement for PhilHealth accreditation.

Most post-abortion patients, however, ignore these violations of their rights and prefer to suffer in silence.

Dr. San Pedro said training is crucial in changing the way medical professionals perceive women who undergo abortion. “Medical professionals must learn how to respect women and their reproductive rights. Our training when it comes to post-abortion care and treatment is heavy on the biomedical aspect. It’s time to devote as much emphasis on the ethical values of medical professionals in responding to the needs of post-abortion patients,” he explained.

One hospital, the Brokenshires Integrated Health Ministries in Davao City, has been doing this for some time now through its Woman Center. This health institution is managed by the United Church of Christ, a Protestant group.

Brokenshires’ Woman Center conducts regular training for residents, nurses and midwives on ethics and quality of care. The training has a specific section for post-abortion care that incorporates not just clinical discussions of cases but also the ethical practices involved.

“We recognize that even if our personal belief is against abortion, it is not right to reflect this in our attitude toward our patients,” said Dr. Darlene Estuart, project director of the center.

Estuart sees the value of exposing residents to nonclinical work and having them interact with poor women, abused women, and women in prostitution, who comprise a significant number of post-abortion patients.

“By experiencing this, they’ll know first hand these women’s daily struggle and the ordeals they have to go through in life. Hopefully, when someone like them becomes their patient, they’ll be less judgmental, more compassionate, and more respectful to them,” she explained.


Abortion in the Philippines: what the law says

Re-posted from Newsbreak.

Newsbreak’s Maggie De Pano Fellow

MANILA, Philippines – The Philippines is one of a few countries in the world where abortion is a criminal act, with no legal exception.

Since 1930, abortion has been a crime under Philippine law. The 1987 Philippine Constitution further underlines this when it stated that the State “shall equally protect the life of the mother and the life of the unborn from conception.”

The Penal Code punishes both intentional and unintentional abortion. Acts of violence committed against a pregnant woman that resulted in an abortion is a key element of the crime, even if there is no intention on the part of the offender to end the pregnancy.

Aside from the woman who commits abortion “to conceal her dishonor,” the law also holds either or both of her parents accountable when, with their daughter’s consent, they caused the abortion.

Doctors and midwives “who take advantage of their scientific knowledge or skill” to carry out an abortion, are also answerable to the law. So are pharmacists who give out “any abortive” with no “proper prescription from a physician.”

Penalties for those found guilty of committing abortion range from arresto mayor, or imprisonment of one month and one day to six months, in the case of pharmacists to reclusion temporal, or imprisonment of 12 years and one day to 20 years, to those who caused intentional abortion through violence.

Doctors and midwives are penalized with a six-year imprisonment. The woman and either or both her parents can also get prison sentences of up to six years.

No exception

Some legal experts contend that a provision in the Constitution— “equally protect the life of the mother”— allows therapeutic abortion or intentionally terminating a pregnancy for medical reasons, especially when the life or health of the mother is at stake.

In practice, however, many doctors are not willing to risk doing it since there is nothing definite in the existing law nor is there any policy or regulation that justifies such an exception.

For countries that allow therapeutic abortion, the following instances justify terminating a pregnancy:

  • Medical condition or illness of the mother where continuing the pregnancy may threaten her life or her health, such as hypertension, eclampsia, diabetes, and various forms of cancer, including those affecting the breast, the ovary and the cervix;
  • Fetal impairment where the pregnancy is likely to result in the birth of a baby with significant mental or physical defects, or where the baby will eventually die soon after birth; and
  • When the pregnancy is the result of rape or incest.

The ban even on therapeutic abortion in the Philippines is one of the reasons why women undergo unsafe abortion, according to the World Health Organization, which said that the legality of abortion is a key determinant of maternal mortality and morbidity.

Desperate women seek desperate measures

Re-posted from Newsbreak.

Newsbreak’s Maggie de Pano Fellow

Poor pregnant women are faced with very few choices

MANILA, Philippines – Many mothers go through abortion for economic reasons.

According to a 2006 study made by the Guttmacher Institute, the average Filipino woman wants 2.5 children, a goal that can be achieved if she uses effective family planning methods. But to almost half of the female population, this need remains unmet.

The study also notes that nearly half of the 1.43 million pregnancies each year in the country were unintended and six out of 10 Filipino women had experienced an unintended pregnancy.

Amelia is weighed down–figuratively and literally–by the bags she’s selling and the burden of earning a living for her 8 children

“I never wanted a large family,” said Amelia, the street vendor we interviewed for this series. After the birth of her second child, she asked the midwife in the health center about family planning.

When she asked about free condoms and contraceptive pills, the midwife informed her that they were not giving them out anymore ever since the city mayor issued an order allowing only natural family methods for residents.

By coincidence, a nongovernment organization visited the community to research on the reproductive health practices of the women living there. It also held training on family planning and maternal and child health for the mothers.

“I attended the training. They also gave free condoms to us. One day, they came with doctors who did tubal ligation to mothers who wanted to have them. At another time, the doctors did vasectomy,” she said.

Amelia availed of the free condoms and gave them to her husband. “At first, he did not want to use it. He said there was no need for us yet to plan our family because we had just two children at that time. But I was stubborn. I told him that ‘no condom, no loving-loving.’ Eventually, he gave in,” Amelia said, laughing.

The NGO stayed in the community for a little over a year. When it left, Amelia’s supply of free condoms went with it.

“When the NGO left, we bought our own condoms but only if we had extra money. Later on, what extra money we had we spent on food and other expenses for the children. We used ‘withdrawal’ but it is not as effective as the condom. So I started getting pregnant again,” she said.

When Amelia learned that she was pregnant with her ninth child, she became desperate.

“I thought at once of abortion.” Many of her neighbors who had unwanted pregnancy had been through it already anyway. A  hilot living in their neighborhood helped perform the abortion. Amelia told her husband what she  wanted to do. “He agreed because he knew that with the kind of life that we have right now, there is no way that we can afford another child.”

Posters around the Fabella Memorial Hospital speak about saving mothers’ lives. The Philippines has one of the highest maternal mortality rates in Southeast Asia

The decision almost cost Amelia her life. (See first part:Dying in silence, how abortion kills)

Gambling with life

“Once a woman has decided to have an abortion because of an unwanted pregnancy, there is nothing much that anybody can do to change her mind. Not even a doctor’s cautionary advice will do,” noted Dr. Alejandro San Pedro, an OB-Gyne.

As chair of the Department of Obstetrics and Gynecology of the Bulacan Provincial Hospital, San Pedro has counseled a number of women who have dealt with unwanted pregnancy and has experienced treating patients with post-abortion complications as a result of unsafe abortion.

A woman with an unwanted pregnancy is ready to risk all to end it, doctors say.  Many go to the extent of having an unsafe abortion where the possibility of suffering from further disabilities, and even dying, is a real gamble.

While Filipinos generally believe that pregnancy is a blessing from the heavens, not all pregnant women feel the same way.

This is true among many poor mothers particularly when the prospect of having one more child could spell economic doom for the family. This is also true for those who want to protect their health from medical complications arising from pregnancy.

There are also women who opt to have unsafe abortion rather than give birth to a child who was the result of rape or incest. Or those who do not want to get pregnant but are unable to control their fertility because of lack of access to information and affordable contraceptive methods.

Therapeutic abortion

Most doctors interviewed for this story think that abortion is justified in certain cases, particularly if based on ethical grounds.

One is when the pregnancy is the result of rape or incest. The other is when it threatens the health, or even the life, of the mother, such as when she has eclampsia, malignant hypertension, or a heart condition.

They would also consider therapeutic abortion in cases of ectopic pregnancy or fetus malformation or deformity such as anencephaly, a condition present at birth where the brain of the baby does not develop fully and for which there is no treatment.

But doctors in the country are in a legal bind even on this matter. (See: what the law says about abortion)

“In other countries, doctors will end the pregnancy as soon as they detect anencephaly,” said an OB-Gyne doctor, who prefers to remain anonymous.

In the Philippines, doctors are compelled to let the pregnancy continue and wait for the baby to die, which may take a few hours, days, or weeks after delivery, she added. “In some ways, it would be kinder to just end the pregnancy rather than have the mother carry it to term when there is no chance at all that her baby will live longer.”

While it appears more humane and compassionate, especially for the mother, to terminate an anencephalic pregnancy, doctors do not do this in deference to the guidelines of the Philippine Obstetrics and Gynecological Society that regard the fetus “as a patient from the time of conception.”

This blanket ban further fuels the demand for underground and unsafe abortion services in the country.

Dangerous procedures

The common ways of unsafe abortion include painful massages by hilots, taking abortion-inducing drugs such as misoprostol, inserting catheters or other pointed objects into the uteri, undergoing dilation and curettage (raspa), drinking herbal concoctions that induce muscle contractions in the uterus, and even doing heavy physical labor and jumping from great heights.

Many women combine two or three of these methods together when trying to get rid of unwanted pregnancies.

But these methods of getting rid of a fetus could be dangerous. A whole range of medical complications can develop from unsafe abortion, including hemorrhage, sepsis, perforation of the uterus, damage to other internal organs, and toxic reactions to the chemicals or the drugs taken to induce abortion.

Patients may also have to undergo hysterectomy and be unable to bear children anymore in the future. Worse, complications from unsafe abortion can be fatal and can result in the patients’ death.

These risks, however, are not enough to deter women from having an abortion.

Pregnant women wait to consult a doctor at the Fabella Memorial Hospital

2008 Guttmacher Institute study bears this out: out of 560,000 women who had induced abortions, 90,000 of them were treated for complications, and 1,000 of them died because of these post-abortion complications.


“If I have other choices, I would not have an abortion,” Amelia said.  “I wanted to try and use contraceptives but I don’t have any money to buy them. I tried withdrawal, even abstinence, but they didn’t work.”

After her abortion, while recovering in the hospital for complications she sustained after the procedure, Amelia asked the doctor to do a tubal ligation on her. “I should have done it years ago when doctors brought by the NGO offered to do it for us for free. But I did not know any better then.”

Having an abortion is one experience that she said she does not want to ever live through again. “I do not want to experience that terrible pain again. I do not want to experience being scolded and shamed by people who do not know me. I do not want to experience the panic and fear of being arrested or losing my life,” she said.

The way things are, Amelia said, she will never live down the guilt. “The guilt because I killed my own child never leaves me. They said I will never be forgiven by God for this one sin.”

The only remedy to salve a guilty conscience is to pray. “I keep praying to Him everyday. I believe that He understands my reason for doing what I did. If He cannot forgive me, I pray that He can at least have mercy on me,” she sighed.


Let’s talk about abortion

The word in most newspapers and everyone’s mouth this week was abortion.

In a nation among the only remaining 6% of the world where abortion is illegal and where even “condom” is an emotionally-laced word, it wasn’t surprising that the topic of abortion drew first blood among many.

There was the usual name-calling of “baby killers” and “murderers with no moral conscience”, which was expected. Check the comments of a news article about abortion.

At a recent round-table discussion hosted by Likhaan Women’s Health Center, RH advocates discussed the issue.  Sharon Camp, President of Guttmacher Institute, presented the current global statistics on abortion, after which, we watched a video called “Agaw Buhay”  (“Fighting for Life”), a documentary about three women – one of whom was a doctor – who got an unsafe abortion and later died from it.

Even among this group of university professors, NGO leaders, and civil society groups, we needed to clarify certain ambiguities.

This article aims to share the highlights of that afternoon’s discussion with you so that you may have a better understanding of abortion. More importantly, it hopes to shed some light on the anguish and torment that comes with contemplating abortion – which is often overlooked in the discussion of this controversial issue.

There is a difference between abortion on demand and abortion for medically acceptable reasons or in the case of rape or incest or mental illness.

This abortion map shows the countries where abortion is legal on demand (like in the United States and Europe) and other countries where it is legal only for certain reasons.

In the Philippines, abortion is illegal and punishable by law. A woman who has an abortion is liable to be punished with imprisonment of up to 6 years and what’s more medical officials who assist her are liable to have their license revoked. It is a direct adaptation from the Spanish Penal Code.

So all abortions in the Philippines are, for the most part, done unsafely.  Those who-have-not resort to all sorts of herbal concoctions and clandestine backroom procedures. Those who-have fly off to any of the other countries where abortion is legal on demand to have the medical procedure done in a safe and hygienic environment.

RH Bill supporters who advocate for abortion on health grounds have drawn a fine line in the RH Bill: i.e. that while the bill did not try to legalize abortion for any ground, at least the law would help prevent abortion and treat post-abortion women without judgement.

There are valid medical reasons why a woman would need an abortion.

During the round–table discussion, one woman shared her own experience where she needed to have a pregnancy terminated. She was not a skimpily dressed teenager who had let a hot date turn into a due date.

She was a woman was in her late 30s to early 40s, married, and a professor at a leading Catholic university.

Several years ago, she was diagnosed as having an ectopic pregnancy. Her doctor told her that there was no way the ovum was going to survive, but because abortion is illegal, the pregnancy could not be terminated. The only option presented to her was to wait for her condition to get worse.

She suffered through excruciating pain over the next couple of days until finally, the pregnancy was terminated. She asked the doctors present in the room if there was really no other choice for her.

The doctors in the room, who included former Department of Health Secretary Alberto Romualdez and POGS President, Dr.  Reggie Pitchay were all mortified.

Dr. Pitchay categorically said, “That is a life-threatening condition and pregnancy should have been terminated immediately upon diagnosis.” Dr. Pitchay added, “Even if it is Black Saturday!” just to emphasize her point.

Another doctor explained that the international medical definition of when life starts is upon the implantation of the blastocyst in the uterus and not at conception. In this case, the ovum had implanted itself in the fallopian tube and not in the proper place of the uterus.

According to Atty. Beth Pangalangan of the UP College of Law, the legal definition of life according to the Constitution is only at birth or when life actually exists.

This is one example of a life-threatening condition that would classify as a valid medical reason to terminate a pregnancy. Waiting for the condition to worsen endangered that woman’s life.

Rape and incest are considered valid reasons for terminating a pregnancy.

A while back, one man, a former colleague, begged me to ask him about his opinion on allowing abortion in the case of rape or incest. He wanted to tell me that he was not in favor of it because  women might pretend they were raped just to get an abortion.

Saying that we shouldn’t let rape victims get an abortion because others might pretend to have been raped is like saying that we should outlaw alcohol because people are, for sure, going to get piss drunk and do some really crazy things, like drive under the influence and put their life and the lives of others at risk.

As Dr. Junice Melgar, Executive Director of Likhaan said, “Judgment and condemnation like this trivializes the decision and the anguish that comes with deciding to have an abortion. There is no woman out there who dreams of having one.”

And finally, the current classification of abortion as illegal has unimaginable ramifications on women who suffer from abortion-related complications.

They are publicly humiliated in hospitals, brutally reprimanded (some report being slapped by health care officials) and sometimes even refused treatment despite their critical condition.

One story in “Agaw Buhay” was about a doctor who had undergone an illegal abortion. She suffered from complications and was hospitalized. She stayed in the charity ward and actually refused to be transferred to the private room which was being offered to her by colleagues who learned she was a doctor. She preferred to stay anonymous in the charity ward where she literally just withered away until she became very pale, and later, her extremities turned a deep shade of purple.

After a few days, she died.

That woman was a doctor. She was educated and presumably someone with adequate means. Poorer women report of similar and at times, much worse treatment.

Gunshot patients are treated without the need to know if the patient is the perpetrator or the law enforcer. The goal is simply to save a human life.

Why should a woman’s life – endangered because of abortion complications – come to mean any less?

Highlights of the Guttmacher Institute Presentation
As presented by Sharon Camp, President of the Guttmacher Institute

60% of women live in regions where the abortion laws are liberal
6% of countries where there is no access to safe and legal abortions (the Philippines is included here)
42 million abortions worldwide – about half of  which are unsafe
20 million unsafe abortions occur in the developing countries
4 in 10 women who undergo unsafe abortions experience complications
Poor women are disadvantaged and are most likely to experience serious abortion complications.

In the Philippines, there are:

560,000 induced abortions every year
90,000 treatments at facilities for abortion complications
1,000 deaths