Philippine Fertility Rate Is One of the Highest in Asia: Santa Clara, Segundina and Other Stories

by Tess Raposas
– Philippines –

In this predominantly Catholic country, people often pray for divine intervention from Santa Clara (Saint Claire), the patron saint of the childless, for one very specific purpose: to aid fertility and bless them with children. The festival of Santa Clara brings couples to Obando Bulacan in the Philippines each May for a street dance in honor of the sanctified Santa Clara.

The town of Obando, just 16 kilometers northwest of the capital, Manila, sits on flat, low-lying coastal plains bordering Manila Bay to the west. Fishing is the major means of livelihood, along with raising ducks, other poultry and hogs. There is also garment and jewelry making and some food processing. 14% of the population live in rural barangays (Tagalog for barrios, otherwise known as districts or wards, the smallest local government unit). The rest of the households make up the urban population. The average monthly income is slightly below what the Department of Social Welfare and Development has established as the minimum for a family of six.

My maternal grandmother, Segundina, had no need to dance to the beat of Santa Clara’s drums and guitars in Obando; after all she was blessed, if it can be considered that, with 13 children – all without divine or biotechnological intervention. Back then, it was just a natural phenomenon that women in her generation gave birth prodigiously. Segundina passed away just shy of her 60th birthday, succumbing to diabetes, one of the country’s principal killer diseases. Undoubtedly, being pregnant year in and year out for at least 13 years and having to care for so many children for so long took an enormous toll; then there was her already strenuous and hard-scrabble life. As for me, I only wish I had been born in time to meet her. I’ll never have the experience of hearing firsthand stories about the women of her time, over a cup of ginger ale in the pale moonlight. But realistically, she might not have had the luxury of extra quality time to spend alone with me. However, in extended families in the Philippines; grandmothers usually do double as nannies to their grandchildren, in the name of love and tradition.

My own mother pales in comparison: she only had eight live births and twelve pregnancies under her belt. But that’s another story.

The Philippines is currently the 11th most populous country in the world; its population is 91 million and growing. Official sources report that our fertility rate, at 3.05 children, is one of the highest in Asia, versus what is considered by demographers an optimal rate of 2.7. Adolescent and youth health is currently not adequately addressed, while sex education and access to contraceptives in general are quite limited. Maternal deaths of women between ages 15-49 who die due to lack of prenatal care and limited access to professional health care is currently at 14 percent.

2007 UN data claim that abortion is on the decline worldwide with 19 million abortions reported, however reports show it is the other way around in the Philippines. The latest data from the University of the Philippines Population Institute shows that there are an estimated 750,000 cases of induced abortion every year, and one out of every six of those end up in complications from hemorrhaging or death. These are usually due to unsafe and unhygienic procedures performed at clandestine backstreet clinics. To say that the country is going backward in the area of reproductive health and population control programs is an understatement. The current government has almost no policies that address either preventive programs or the dissemination of reproductive health management information. Health advocates note an overall lack of health programs for displaced and marginalized women (that is, lesbians, women in prostitution, indigenous peoples) and government health personnel who have discriminatory practices against poor and unmarried women. Government health personnel are notorious for their rudeness and indifference, as well as their irrational use of drugs and medical procedures. The majority of women seeking medical attention in the country routinely suffer insulting and unnecessary indignities from the only people available to treat them.

But this is, after all, the Philippines – a bastion of the Catholic faith. In our country, the powerful Catholic Church often influences and sometimes even dictates the culture, beliefs and consciousness of the people. And the manifestation of the Church’s power shows up in the laws we have and do not have. The Philippines is one of only two countries in the world where divorce is illegal (the other being Malta). Even now the Church remains fully committed to its prohibition of artificial contraception such as condoms, pills and IUDs, all of which are deemed instruments of the devil designed solely to promote sex. Guilt trips abound; sexuality is to be suppressed and never discussed openly. Human rights and social development organizations view the Church’s policy as impinging on basic human rights; they have been vocal about their opposition to this systematic intrusion into reproductive health rights.

The conflict between the Church and human rights groups on issues of population and reproductive health continues, but it’s hardly a contest among equals. The latest effort to legislate a comprehensive reproductive health law has been no match for the loud, accusatory barrages of the Catholic Church, which condemns reproductive health advocates as “abortionists.” Even the momentum of several decades of work to update and define reproductive health rights has so far been easily thwarted by the Church. The movement to guarantee reproductive health rights has yet to gain enough ground to effect much-needed changes.

Government policy mirrors the Church’s position of refusing to endorse artificial contraception; therefore, progress on this subject has been glacial. Fearing the ire of the Church, officials are reluctant to step out of line lest it mean fewer votes come election time. When all else fails, the government always uses the reasoning which silences opposition: “there’s just no money for it”.

In a situation such as this, what are we to do? What is a nation to do? There are all sorts of ironies in the current situation: the government desperately tries to keep married couples together yet makes no legal provisions for those families which do separate, including providing no legal recourse to guarantee support for women and children who commonly struggle to survive. Moreover, although the incidence of domestic abuse is sky high, both the Church and consequently the government prescribe couples’ staying together until death. This policy is dictated by a Catholic Church that demands strict adherence to its doctrines yet harbors within its hierarchy many priests embroiled in sexual abuse scandals, including reports of sexual harassment, rape and other heinous crimes.

Philippine law criminalizes abortion, even meting out capital punishment for women who undergo the process, ignoring the fact that hundreds of thousands of abortions happen every year anyway. And in many instances, women die because they are forced to seek unprofessional, shoddy medical services for the illegal procedure. At the behest of Manila’s Mayor, Lito Atienza, the capital city banned the sales of condoms and other artificial contraceptives. Atienza makes no apologies for his zealous devotion to the stance of Couples for Christ, a Catholic organization whose operatives even carry out raids on convenience stores and drugstores which make the evening news.

Solving social problems in any country is a subjective process. The history of Catholicism in the Philippines spans 377 years and is strongly embedded in the consciousness and culture of the Filipino people. To be critical of this doctrine means to deny one’s “Filipino-ness,” so to speak. The people’s attachment to their beliefs makes it all the more difficult for them to challenge the status quo. Filipino culture dictates that children are a parent’s investment for the future. They are regarded as caregivers who will later care for their parents in their old age. In rural areas where agriculture is the main source of livelihood, children offer extra hands in production work, and in other enterprises, much valued added labor.

Encouraged to “go forth and multiply”, parents do so, even under the worst of circumstances for the child. And because the Church teaches them to patiently bear the sacrifice of poverty, they do, believing they will be rewarded in heaven.

But no country is destined to be poor. And no country ever wants to be mired in hopelessness. Unfortunately, there are no easy solutions to these big problems.

How do you re-educate a hierarchy as big and powerful as the Catholic Church? The answer is: you can’t. A better solution can be found by bringing information to the people – information that can help them address the issues that affect them most.

Community-based health workers are on the front lines of the country’s health services, be they non-governmental or otherwise. They must bring their perspectives and those of the women they treat to bear on the creation of a comprehensive national health law so as to inspire and pressure the upper echelon of the national legislation to do the same. The voices of the country’s women must truly be heard and considered when it comes to matters that concern their own bodies, their lives and their children’s lives. If they make clear the difficulty and ineffectiveness of “natural” family planning methods and demand alternatives, the country should respond by presenting alternatives instead of trying to convince them otherwise. And paradigms are already shifting as seen by emerging concern over male reproductive health as an integral part of advocacy.

What better scenario could be imagined for the executive, legislative and the judiciary branches of government – having only to consult with reproductive health advocates to formulate and implement a law that works for everyone?
And though we have a few international instruments at our disposal, (the Cairo Convention, the Beijing Platform for Action, and the Convention on the Elimination of All Forms of Discrimination) they only work if effectively implemented. Thankfully, the international solidarity among reproductive health advocates throughout the world has harnessed a public consciousness that we can build on.

It may be a long shot, but there’s no harm in dreaming. We will keep taking small strides and we will get there someday.

There is however one word of caution in this development debacle where vested interests are at stake. Living in the midst of poverty predisposes people to tolerate human suffering and increases their susceptibility to marginalization. These issues must be addressed with urgency and critical concern. But “being poor” is sometimes a misused and abused descriptor – one sometimes used by the lazy to avoid being more critical and more aware of social conditions. After all, knowing a problem exists usually means that you have to do something about it.

So the next time couples pray to Santa Clara for fertility, I hope they will consider asking her for earnest guidance on how to raise their child – not only financially but in every aspect of the child’s development. Maybe they’ll even re-think the whole notion of having a child.

That is if Santa Clara will ever grant their wish in the first place.

I have but one wish – that our leaders have the political will to do the right things and do right by their people. But which Saint will grant me this?

About the Author

For the past 15 years, Tess Raposas has been a freelance journalist and media and development consultant, having worked on various writing and research projects on gender and environmental concerns. She believes that every journalist must grow from being an “objective”, somewhat robotic truthsayer to a socially aware and accountable truthseeker. She is based in Quezon City, Philippines.