Contraception, the Philippines, and Pope Francis' passion for the poor

After 18 months of contentious debate, the controversy over access to contraception in the United States seems to be arriving at a peaceful resolution. On Tuesday, the Catholic Health Association (CHA) announced its approval of an accommodation in the Obama administration's mandate that all health care plans cover contraception services.

Under the accommodation, nonprofit organizations that are not explicitly religious (like Catholic hospitals, charities and universities) will not have to contract, provide or pay for contraceptive coverage. Employees of these organizations will still be guaranteed their right to have contraceptive services covered, but insurers will pay the cost using funds from sources other than the premiums paid by these nonprofits.

Unlike the CHA, the U.S. Conference of Catholic Bishops was dissatisfied with the latest version of the accommodation, even though many of those who supported the bishops a year and a half ago have agreed that this new accommodation is a workable compromise. (Back in February 2012, I laid out some of the reasons I believe the bishops never will be satisfied.)

The bishops' reprisal of their Fortnight for Freedom and their cries that religious liberty is under siege are increasingly looking less like an authentic fight for constitutional protections and more like the worsening symptoms of Chicken Little syndrome.

There are places in our world, however, where the Roman Catholic church still has powerful influence over the workings of the state, particularly in regard to access to contraception. This week, the bishops of the Philippines have been sitting in their country's Supreme Court, waiting for the fate of a reproductive health law to be decided.

The law passed in December after being stalled for 10 years by the resistance efforts of the Roman Catholic Church, which included threatening Philippine President Benigno Aquino III with excommunication. Just months after its passage, Roman Catholic groups managed to halt the new law's scheduled March 31 implementation by petitioning the Supreme Court.

Archbishop Socrates Villegas, who was elected president of the Catholic Bishops' Conference of the Philippines last week, said he and his fellow prelates are attending the opening hearing as "conscience troublemakers."

"We want to trouble consciences so every conscience listens to the voice of God," said Villegas, according to the Philippine Daily Inquirer.

The law would bring free or subsidized birth control options (condoms, birth control pills and intrauterine devices) to government health centers, including remote areas where some of the poorest live. It provides family-planning training for community health officers and requires sex education in public schools. It would also vastly improve maternity care for poor women. Abortion and abortifacients would remain illegal.

International medical charity Merlin and its Philippine partner, Likhaan, said in a statement, "In the Philippines we lose 14 to 15 mothers a day due to pregnancy-related complications. But with this law, we are closer than ever before to being able to provide a low-cost solution which will directly save the lives of women and their babies, whose loss to their families and communities cannot be quantified."

The medical journal The Lancet recently reported that "the three pillars of maternal health (access to contraception, provision of skilled attendance at birth, and high quality emergency obstetric care) needed to support a drop of pregnancy-related deaths cannot be established without" the reproductive health law.

According to the United National Population Fund, half of the 3.4 million pregnancies in the Philippines each year are unintended. The Philippines has one of the highest birthrates in Asia and a population of almost 100 million. By 2080, demographers predict that population could swell to 200 million. Right now, more than a quarter of Philippine people live on the equivalent of 62 cents a day, according to government data.

The slums of the Philippines are already overcrowded. Families stand in line for more than 12 hours for a government assistance check. Some soup kitchens are forced to limit their guests to street children, the elderly and homeless people with severe disabilities.

As I have written previously, the desperation of starving families is creating rampant overfishing. Some use dynamite or cyanide to find and kill fish, which has a devastating effect on the reefs in fishing villages. Also, with an increase in population comes an increase in waste materials thrown into the environment, causing a further deterioration of nature.

Although proponents of the reproductive health law say expanding access to contraception could significantly slow population growth, The New York Times reports that the Aquino administration believes the measure's primary purpose is "to offer poor families the same reproductive health options that wealthier people in the country enjoy."

Pope Francis has been highly touted for his criticism of institutional evils that create poverty. But there is something deeply troubling about a church leadership that rails against poverty and institutional sin while using its resources to defeat civil laws aimed at alleviating the suffering of the poorest.

If the pope and his brother bishops are to be fully honest about roots of poverty, they must take an honest look at the ways in which the policies and agenda of their institutional church contribute to inadequate medical care for mothers, the starvation of families, the swelling of the slum population, the spread of HIV/AIDS, and environmental degradation.

I realize Pope Francis cannot change the contraception teaching overnight, but he could call the bishops of the Philippines to cease this relentless, well-funded campaign. The institutional church now stands as the lone impediment between poor Philippine mothers and adequate maternal health care. The hierarchy's lobbying has kept mothers and fathers from raising families they can afford, families small enough to allow children to be fed and educated.

Although the Philippines is 80 percent Catholic and its people are known for their deep piety, the majority of Filipinos do not seem to find a conflict between their faith and the use of contraception. According to a 2011 poll by Social Weather Stations, a local Philippine social research institution, 82 percent of Filipinos say family planning is a personal decision of couples, and no one should interfere. Sixty-eight percent believe the government should fund both natural and artificial means of family planning.

As has been in case in the United States since the 1970s, the majority of Catholics in the Philippines have not received the Roman Catholic church's teaching on contraception.

Many who are privileged enough to be able to afford birth control and defy Roman Catholic teaching have expressed joy at Pope Francis' acts of humility and passion for the poor. In our zeal for this pontificate, it is important to make the connections between Roman Catholic doctrine and the suffering of the poor and sick globally.

For the privileged, the Roman Catholic contraception debate is ultimately a social issue and a doctrine we can easily circumvent. But in the Philippines, like other poverty-stricken countries, access to contraception is a grave issue of justice. Until this doctrine changes, the Roman Catholic church's unyielding ban on birth control will continue to be a matter of life and death for pregnant women, mothers and the families they hope to raise.

[Jamie L. Manson received her Master of Divinity degree from Yale Divinity School, where she studied Catholic theology and sexual ethics. Her NCR columns have won numerous awards, most recently second prize for Commentary of the Year from Religion Newswriters (RNA).]

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