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Twenty two year old, Marissa is pregnant with her 5th child. She was married at the age of 12 -- she had not even begun to menstruate.

Porac, Pampanga — The village is 7 kilometers away from the city center, but the dusty, bumpy ride on the unpaved road to the mountain highlands feels like it’s much farther.

Our destination is Barangay Porac, a small Ayta village filled with nipa huts. Dark-skinned and curly haired children are scattered all around playing.  The women are busy preparing food or doing other chores. The men are carrying canisters of water from a pump that is at least a two hour walk away.

This is home to Marissa de la Cruz. At 22, Marissa is now pregnant with her 5^th child.

She was married at the age of 12, and her husband was 14. It was an arranged marriage where her family received three water buffalo and one cow.

At the time of their marriage, which she says was formalized through a mountain ritual, she had not even begun to menstruate.

She recalled her first delivery at 14 years old, as difficult. “It was incredibly painful and there was a lot of blood.” Marissa gave birth at home through the help of a quack doctor or what is known locally as an “arbulario”.

“He used leaves and other herbal mixes as medicine to assist my delivery.”, said Marissa.  Her subsequent deliveries were done in the community hospital.

She says she would like to stop having children after her fifth child and is open to the idea of tubal ligation as taught to her and the other community women by the mid-wife who visits Brgy Porac twice a month.

But Marissa says she is also open to just drinking the mixture of leaves prepared by the “arbulario”. She drinks this in between her periods to prevent pregnancy. “I like it because it does not have side effects. And I know it is effective because it comes from our sacred mountain.”

The other women in Marissa’s village have 10 children; some as many as 12 children.

Gemma Buanan, the barangay health official has a similar story. The 36 year old has three children, but lost the same number to various complications. She admits that lack of pre-natal care played a role in the poor health of her children.

“I would forget [to go for check-ups]. I was busy working in the field,” said Gemma.

The nearest health center being a 7 kilometer walk away compounded the problem.

Now, Gemma uses her story as a testimonial about the importance of family planning, birth spacing and pre-natal care.

It certainly is a challenge.  There are only six barangay health workers to service the needs of the estimated 1,000 families [about 5,000 individuals] in the community.  A mid-wife comes to the village only twice a month; and there is no doctor.

While Marissa and the other Ayta women say that their beliefs do not run counter to modern forms of contraception, they remain rooted in their old world beliefs.

Finding a way for Ayta ancient cultures and beliefs and modern medicine to come together may not be impossible, it still remains a challenge.

This article was written by Ana Santos during a workshop  conducted as part of a journalism grant to research on maternal health in the Ifugao region. The journalism grant was awarded by the Probe Media Foundation, the Philippine Press Institute and the US Embassy.