Responsible Parenthood and Reproductive Health Act of 2012

Sections The basic content of the Consolidated Reproductive Health Bill is divided into the following sections. SEC. 1. The Responsible Parenthood and Reproductive Health Act of 2012 SEC. 2. Declaration of Policy SEC. 3. Guiding Principles SEC. 4. Definition of Terms SEC. 5. Midwives for Skilled Attendance SEC. 6. Emergency Obstetric Care SEC. 7. Access to Family Planning SEC. 8. Maternal and Newborn Health Care in Crisis Situations SEC. 9. Maternal Death Review SEC. 10. Role of the Food and Drug Administration SEC. 11. Procurement and Distribution of Family Planning Supplies SEC. 12. Integration of Family Planning and Responsible Parenthood Component in Anti-Poverty Programs SEC. 13. Roles of Local Government in Family Planning Programs SEC. 14. Benefits for Serious and Life-Threatening Reproductive Health Conditions SEC. 15. Mobile Health Care Service SEC. 16. Mandatory Age-Appropriate Reproductive Health and Sexuality Education SEC. 17. Additional duty of the local population officer SEC. 18. Certificate of Compliance SEC. 19. Capability Building of Barangay Health Workers SEC. 20. Pro Bono Services for Indigent Women SEC. 21. Sexual and Reproductive health SEC. 22. Right to Reproductive Health Care Information SEC. 23. Implementing Mechanisms SEC. 24. Reporting Requirements SEC. 25. Congressional Committee SEC. 26. Prohibited Acts SEC. 27. Penalties SEC. 28. Appropriations SEC. 29. Implementing Rules and Regulations SEC. 30–32. Separability Clause, Repealing Clause, Effectivity Summary of major provisions The bill mandates the government to "promote, without biases, all effective natural and modern methods of family planning that are medically safe and legal." Although abortion is recognized as illegal and punishable by law, the bill states that "the government shall ensure that all women needing care for post-abortion complications shall be treated and counseled in a humane, non-judgmental and compassionate manner". The bill calls for a "multi-dimensional approach" integrates a component of family planning and responsible parenthood into all government anti-poverty programs. Age-appropriate reproductive health and sexuality education is required from grade five to fourth year high school using "life-skills and other approaches." The bill also mandates the Department of Labor and Employment to guarantee the reproductive health rights of its female employees. Companies with fewer than 200 workers are required to enter into partnership with health care providers in their area for the delivery of reproductive health services. Employers with more than 200 employees shall provide reproductive health services to all employees in their own respective health facilities. Those with fewer than 200 workers shall enter into partnerships with health professionals for the delivery of reproductive health services. Employers shall inform employees of the availability of family planning. They are also obliged to monitor pregnant working employees among their workforce and ensure they are provided paid half-day prenatal medical leaves for each month of the pregnancy period that they are employed. The national government and local governments will ensure the availability of reproductive health care services like family planning and prenatal care. Any person or public official who prohibits or restricts the delivery of legal and medically safe reproductive health care services will be meted penalty by imprisonment or a fine. == Support ==

Free choice regarding reproductive health enables people, especially the poor, to have the number of children they want and can feasibly care and provide for. There are several studies cited by those who support the bill: • Economic studies, especially the experience in Asia, the Freedom from Debt Coalition, Coalition Against Trafficking in Women Asia Pacific, Philippine Rural Reconstruction Movement - Gender Desk, Sanlakas Women, WomanHealth Philippines, Women's Crisis Center, Zone One Tondo Organization, and Health Alliance for Democracy. == Criticism ==

Opponents of the bill argue that: • People's freedom to access contraceptives is not restricted by any opposing law, being available in family planning NGOs, stores, etc. The country is not a welfare state: taxpayer's money should not be used for personal practices that are harmful and immoral; it can be used to inform people of the harm of BCPs. • The penal provisions constitute a violation of free choice and conscience, and establishes religious persecution President Aquino stated he was not an author of the bill. He also stated that he gives full support to a firm population policy, educating parents to be responsible, providing contraceptives to those who ask for them, but he refuses to promote contraceptive use. He said that his position "is more aptly called responsible parenthood rather than reproductive health". The Catholic Bishops' Conference of the Philippines and other church groups were among those that lobbied against the passage of the Reproductive Health Bill. == Economic and demographic premises ==

The Philippines is the 39th most densely populated country, with a density over 335 per square kilometer, and the population growth rate is 1.9% (2010 Census), 1.957% (2010 est. by CIA World Factbook), or 1.85% (2005–2010 high variant estimate by the UN Population Division, World Population Prospects: The 2008 Revision) coming from 3.1 in 1960. The 2013 total fertility rate (TFR) is 3.20 births per woman, from a TFR of 7 in 1960. In addition, the total fertility rate for the richest quintile of the population is 2.0, which is about one third the TFR of the poorest quintile (5.9 children per woman). The TFR for women with college education is 2.3, about half that of women with only an elementary education (4.5 children per woman). Congressman Lagman states that the bill "recognizes the verifiable link between a huge population and poverty. Unbridled population growth stunts socioeconomic development and aggravates poverty". Two authors of the Reproductive Health Bill appealed to their colleagues to remove provisions regarding population and development in the consolidated bill. Reps. Emerciana de Jesus and Luzviminda Ilagan wanted to delete three provisions that state that "gender equality and women empowerment are central elements of reproductive health and population and development", which integrate responsible parenthood and family planning programs into anti-poverty initiatives, and which name the Commission on Population and Development or POPCOM as a coordinating body. The two party-list representatives stated that poverty is not due to overpopulation but because of inequality and corruption. The Wall Street Journal in July 2012 said that Aquino's "promotion of a 'reproductive health' bill is jarring" since it could lead to "a demographic trap of too few workers. The Philippines doesn't have too many people, it has too few pro-growth policies". Opposing the bill, former Finance Secretary Roberto de Ocampo wrote that it is "truly disingenuous for anyone to proceed on the premise that the poor are to blame for the nation's poverty." He emphasized that the government should apply the principle of first things first and focus on the root causes of the poverty (e.g., poor governance, corruption) and apply many other alternatives to solve the problem (e.g., giving up pork barrel, raising tax collection efficiency). == Maternal health and deaths ==

Maternal deaths in the Philippines, according to the World Health Organization, is at 5.7 per day,. The proponents state that the passage of the RH Bill would mean: • Access to information on natural and modern family planning • Improvement of maternal, infant, and child health and nutrition • Promotion of breast feeding • Prevention of abortion and management of post-abortion complications • Improvement of adolescent and youth health • Prevention and management of reproductive tract infections, HIV/AIDS and other STDs • Elimination of violence against women • Counseling on sexuality and sexual and reproductive health • Treatment of breast and reproductive tract cancers • Male involvement and participation in reproductive health issues • Prevention and treatment of infertility • Reproductive health education for the youth The Department of Health states that family planning can reduce maternal mortality by about 32%. Access One of the main concerns of the proponents is the perceived lack of access to family planning devices such as contraceptives and sterilization. The bill intends to provide universal access through government funding, complementing thus private sector initiatives for family planning services, such as those offered by the International Planned Parenthood Federation (IPPF) which supports the Family Planning Organizations of the Philippines and the 97 organizations of the Philippine NGO Council. The UP School of Economics argues, in contrast, that there is lack of access especially for poor people, because contraceptive use is extremely low among them and "among the poorest families, 22% of married women of reproductive age express a desire to avoid pregnancies but are still not using any family planning method". == Abortion ==

Abortifacient issue According to the RH bill, one of its components is "prevention of abortion and management of post-abortion complications". It provides that "the government shall ensure that all women needing care for post-abortion complications shall be treated and counseled in a humane, non-judgmental and compassionate manner". It also states that "abortion remains a crime and is punishable", as the Constitution declares that "the State shall equally protect the life of the mother and the life of the unborn from conception". == Contraceptives ==

Morality and social effects Fourteen professors from Ateneo de Manila University, a prominent Catholic University, considering the empirical evidence of the dire socioeconomic conditions of the Filipino poor, urged that the bill be passed to help them. They argued: "As Catholics and Filipinos, we share the hope and mission of building a Church of the Poor. We are thus deeply disturbed and saddened by calls made by some members of the Catholic Church to reject a proposed legislation that promises to improve the wellbeing of Filipino families, especially the lives of women, children, adolescents, and the poor". They announced that "Catholic social teachings recognize the primacy of the well-formed conscience over wooden compliance to directives from political and religious authorities", urging Catholic authorities to withdraw their opposition the bill. Primary among the means is distribution of condoms. The proponents applauded government efforts last February 2010 when it distributed condoms in some areas of Manila. == Opinion polls and TV debates ==

Proponents refer to many surveys conducted by two prominent locally based organizations (SWS and Pulse Asia) which show majority support for the bill. A survey conducted in 2008 by the Social Weather Stations, commissioned by the Forum for Family Planning and Development (FFPD), a non-government advocacy group, showed that 68 percent of Filipinos agree that there should be a law requiring government to distribute legal contraceptives. The President of Prolife Philippines, Lito Atienza, said that the surveys conducted by SWS and Pulse Asia were misleading, because the participants were not fully informed of the bill, were merely aware of it, and informed that it was about health and "modern methods". Instead he referred to the Filipino Family survey of December 2009 conducted by the HB&A International (an affiliate of Louis Harris & Associates) together with the personnel of Asia Research Organization (the Philippine affiliate of Gallup International). The survey concluded that 92% of people in metropolitan Manila rejected the bill, "85 percent are not aware that once passed the RH bill would allow teenagers to secure 'abortifacient devices and substances' without their parents' knowledge and consent...90 percent do not agree that Congress should appropriate P2 billion to the detriment of other essential medicines for free children's vaccinations, treatment of dreaded diseases and other more important health and medical concerns." In the separate online poll held on the Harapan microsite that livestreamed the debate, majority voted against the bill at the very end of the debate. On TV5's Debate Hamon sa Pagbabago on August 21, 2011, the studio audience voted 100% against the bill, while 58.7% of the viewers voted against the RH Bill via text messaging, versus 41.3% in favor. The online poll conducted by the Philippine Star published on May 18, 2011, showed that 56% were against the RH Bill, while 44% were in favor. == Rallies ==

on August 4, 2012 Beginning in late 2010, there were rallies for and against the bill. In the legislative arena, women's rights NGOs like Likhaan organized mobilizations to amplify the voices of impoverished women within broader discussions. They strategically organized urban poor women to participate in rallies, applying pressure on legislators. Consequently, these women were invited to share their experiences during plenary sessions and committee hearings in Congress, specifically addressing the deliberations on the Reproductive Health Bill at that time. == Penalties ==

There is mandatory sexuality education starting grade 5, and "malicious disinformation" is penalized. All health care service providers which provide reproductive health services, including faith-based hospital administrators, may be imprisoned or fined if they refuse to provide family planning services such as tubal ligation and vasectomy. The same may happen to employers who do not provide free services to employees. Imprisonment ranges from one to six months or a fine ranging from ten thousand pesos (P10,000.00) to fifty thousand pesos (P50,000.00). Former Finance Secretary Roberto de Ocampo stated that these punitive provisions "are tantamount to an affront to civil liberties and smack of religious persecution". Defending the bill, Felipe Medalla, former dean of the University of the Philippines School of Economics, said that "although the poor's access to family planning services can be improved even without the law, the absence of the law makes it easier to block the program". == Separation of church and state ==

One of the prelates in the Roman Catholic Church in the Philippines, then Archbishop Luis Antonio Tagle opposed the Reproductive Health Bill, along with abortion and contraception. Because more than 80% of Filipinos are Catholics at least on paper, the Catholic Church exerts a strong influence in certain aspects of public and moral life. Its staunch opposition to the bill has drawn the controversy among non-Catholics and Catholics alike who support the bill whereby many invoke the principle of separation of church and state. == Culture war and its implications ==

The national debate is seen as part of a wider culture war. Passing it or not passing it of the bill has negative implications depending on the views. Proponents state that the not passing the bill will make the Philippines no longer be a backward state and unable to achieve the Millennium Development Goals, especially the points on poverty alleviation and maternal health. It will mean reneging on international commitments and will slow down modernization. Also, the poor will not have free access to family planning support that many have want, and thus will have more children than they can care for and will not have the money to invest in education to break the intergenerational poverty they are trapped in. Proponents also accuse the Catholic Church of holding the Philippines "hostage" and violating the separation of church and state. They argue that a decreased population growth will lead to improved quality of life and economic development. == Financials ==

The Department of Health proposed 13.7 billion to fund the RH Bill if passed in 2012, according to Senator Pia Cayetano. Filipinos for Life, an anti-abortion organization, claimed that the bill was funded by foreign population control groups, a claim that Rep. Edcel Lagman denied as "an old yarn which is destitute of factual basis", saying that the lobby opposing the bill was the one which was backed by the "wealthy Catholic hierarchy with the aid of dozens of lay organizations". Young Nine Legislators (Y9L)—including Aliah Dimaporo, Lucy Torres-Gomez, Karlo Alexei Nograles—said that "The proposed P3 billion appropriation for the RH bill, if put towards education, can help secure the future of young Filipinos. That amount can build 4,644 new classrooms…or it can subsidize the college education of 300,000 scholars—a chance for underprivileged student achievers to earn their diploma". Lagman on the other hand said that both these priorities are important but with a burgeoning population the budget will become even tighter, thus population growth is a major issue. == International reactions ==

European Union European Union Ambassador to the Philippines Alistair MacDonald said "We have all seen the figures on illegal abortion a year in the Philippines and I very much hope that both Houses of Congress will take these issues into account in producing a reproductive health legislation which will really help people make their own choices and to provide for their families." MacDonald said that lack of effective access to reproductive health services in the Philippines was "antithetical" to the country's struggle against poverty and "It seems to me extremely unlikely that the Philippines will be able to meet its commitment under the MDGs under the present policy." MacDonald noted that the total fertility rate for the richest quintile of the population is 2.0, while the total fertility rate of the poorest quintile is 5.9. The total fertility rate for women with a college education is 2.3, about half that of women with only elementary education (4.5). He mentioned that the lack of access to RH services is anti-women, citing the slow decline in the maternal mortality ratio in the Philippines. He also said surveys suggest that the total wanted fertility rate for the Philippines is 2.4 children, or below the actual TFR of 3.3 children. == Status ==

Legislature On January 31, 2011, six different bills were consolidated into a single RH Bill which was then unanimously approved for plenary debate by the House Committee on Population and Family Relations. On February 7, 2011, the bill was scheduled to go before the House Appropriations Committee. On February 16, 2011, the bill was endorsed by the House Appropriations Committee with amendment and referred back to the Population Committee for finalizing the language. President and Cabinet President Noynoy Aquino during the presidential campaign said that it confounds him why he is always associated with the RH Bill and reiterated that he is neither an author nor a co-author and did not sign the committee report regarding the bill. He said that "he will fully support the crafting of a firm policy that will address the serious problem on population" However, by April 2011 Aquino has given his full support to the entire RH Bill in a speech at the University of the Philippines Diliman and promised to push for its passage even at the "risk of excommunication." Compromise and alternatives Senate President Juan Ponce Enrile, Congressman Roilo Golez and Buhay party-list separately filed bills that seek to restrict abortion and birth control use. These bills have been seen either as a nullification of the RH Bill, its alternative, or as a way of achieving unity among the populace, since the RH Bill proponents have stated their concern in preventing abortion. Presidential candidate Gilbert Teodoro or Gibo suggested a cash transfer from the government to individuals wanting access to family planning methods, whether natural or artificial. The individuals can then make use of the cash they receive to purchase birth control devices they may choose, thus guaranteeing freedom of choice. Congressional approval and presidential assent At 3 in the morning on December 13, 2012, the House of Representatives voted on second reading in favor of the bill with 113–109 while five representatives abstained. In the upper house, the Senate voted, on December 18, 2012, to pass the bill on second reading with 13–8, while Senators Sergio Osmeña III and Lito Lapid were absent. On the same day, both houses passed the bill on the third and final reading. Members of the House of Representatives voted 133–79, while seven representatives abstained. The Senate registered 13–8, the same result as the second reading. On December 19, 2012, both versions of the bill were passed to the Bicameral Committee to produce a final version to be signed by the President Aquino. The committee quickly passed the bill in just one session. It was transmitted back to the House of Representatives and the Senate, which both ratified the bill, with the Senate voting 11–5 in favor of ratification, and the House of Representatives voting via voice vote. On December 21, 2012, President Aquino signed the bill into law, codifying the bill as Republic Act No. 10354, otherwise known as the "Responsible Parenthood and Reproductive Health Act of 2012". News of the signing was announced by House Majority Leader Neptali Gonzales II on December 28, 2012. Supreme Court challenge and delay of implementation In response to petitions challenging the law's constitutionality, the Supreme Court voted 10–5 on March 19, 2013, to issue a status quo ante order halting the implementation of the law for four months. Oral arguments concluded on August 27, with the petitioners against and for the law being instructed to submit memorandums within 60 days. Notwithstanding the restraining order on certain methods of contraception, in September 2018, President Duterte decided to ensure, within 2018, free contraception for 6 million women with unmet needs for modern family planning – in 2018, for 2 million women identified as poor, and later for further 4 million women. ==Notes==

Full text of the bills • House Bill No. 4244 • Senate Bill No. 2865 Supporting the RH Bill • • • • • • • • {{cite web • • • • Opposing the RH Bill • Other readings • Full text of NSSM 200 (US government source) • Philippine Family Planning Statistics (National Statistics Office)