sexandsensibilities.com

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?

In the Philippines, there are:

        

This article also appeared in Female Network, May 2010

If educational background and length of experience in the medical field are important to you, then take advantage of verifying the doctor’s credentials on websites like RXPinoy.com.

Where is his or her clinic, and what are its facilities?

Most doctors hold clinics in more than one hospital and have different timeslots for each. Check if the locations are easily accessible to public transportation or if parking is readily available. It’s also a plus if your doctor holds a clinic near your home or workplace or on your route home.

You may also want to check out the facilities available. Doctors with clinics in a hospital will frequently have access to the hospital’s women’s health center and its complement of facilities. However, if your doctor’s clinic is not in a hospital, you may want to find out if it has the necessary equipment for a full checkup in-house or at a nearby location so you don’t have waste time traveling between your doctor’s clinic and the facility where you can have tests done. For example, you should check if the clinic has an ultrasound—contrary to popular opinion, these are commonly used to examine non-pregnant women as well as pregnant ones!

Do the clinic hours fit in with your schedule?

This is really important because, while it may be tempting to wait till the weekend before going to the doctor, this may also be the time when most patients come in for a consultation. You might end up spending most of your weekend queuing for your turn. So you should try to get a doctor whose clinic hours often coincide with your free time.

If the doctor’s clinic is near your place of work and is open during the lunch hour, it’ll make it easier to slip out for a consultation during your midday break.

Can the doctor explain things to you in a way that is easy to understand?

The medical field is filled with big long words that to a non-doctor are not only alienating but sometimes also intimidating. Make sure your doctor is someone who is patient enough to break down medical jargon so as not to cause premature alarm.

“My pap smear showed abnormal cells which I was told might be indicative of pre-cancerous cells. I was referred to another procedure called a colposcopy for a biopsy. These words freaked me out, and I was really, really scared,” says Isabelle, 32.

“Thank god, my OB explained to me the other possible results of a pap smear. She  mollified me by saying that the ‘abnormal cells’ found in my pap smear were known to be one of the more benevolent findings when compared to others and the additional examination was just to be very, very prudent,” concludes Isabelle who says that this explanation, though lengthy, went a long way in putting her premature fears to rest.

You’ll want an OB-GYN who cares about your feelings, like Isabelle’s does, so she or he will lay any unqualified fears to rest. This is a very important quality to have because, should you have any conditions or diseases that need treatment, this type of doctor would be able to explain what’s going on, your options for treatment, and any repercussions in a way you can understand as well.

Is the OB-GYN reachable even after clinic hours?

If you’ve forgotten to take your pill and want to be doubly sure about not getting pregnant, or if you’ve engaged in unprotected sex and are worried it could have unwanted consequences, can your OB be reached by phone? More importantly, will he or she allow consultations during non-clinic hours?

Be careful about going overboard with the questions though, because you just might be surprised when you get the bill for your next consultation. Gigi, a birth plan consultant says, “Some doctors will charge you for consultations made through SMS or phone call. They’re less than actual face-to-face clinic consultations, but these can add up.”

For non-urgent questions, it may be better to wait for your next appointment. You should also use your appointment time to clear up any “what ifs” and “just in cases.”

Is the OB-GYN non-judgmental?

Theresa, an OB-GYN who asked that she not be named, admitted that because of her religious beliefs, she doesn’t do tubal ligations and simply refers her patients who request for this procedure to another doctor.

If it is important to you that your doctor not let moral beliefs influence her practice, then this is something that you might want to consider.  Ann, a 28-year-old bank employee, steered clear of such doctors when she was looking for a prescription for birth control pills because she was not married.

“I did ask one doctor point blank if she had a problem with prescribing pills to me seeing that I wasn’t married [in my chart], and she said that she had no problem at all with that. It was a great relief to me,” shares Ann.

Can you see yourself consulting this OB-GYN for a long time?

You’re going to need the services and expertise of an OB-GYN for a long time—ideally, from the time that you start becoming sexually active, all the way to your menopausal years. In case we weren’t clear at the start, you’ll need to see an OB-GYN regularly, and not just when you are pregnant! Look at your OB-GYN as your partner in sexual and reproductive health. So when you think of choosing an OB-GYN, as you would with a partner, pick one you can see yourself with for a long time.