By lifting the ban on emergency contraceptive (EC) pills, the Food and Drug Administration (FDA) could help curb high rates of teenage pregnancy in the Philippines, according to reproductive healthcare and family planning advocates.
“EC pills, which are one possible solution to the teen pregnancy crisis, are taken within 72 hours of sexual activity, but they’re not available in the Philippines,” said Hyam Asher Bolande, chair of DKT Philippines Foundation, a nonprofit organization that works with community health workers to increase contraceptive uptake.
Teenage pregnancy in the country affects 6% of Filipino girls, the second highest rate in Southeast Asia, he said at a March 15 virtual forum, citing a 2019 report by Save the Children.
In 2021, President Rodrigo R. Duterte signed an executive order declaring the prevention of teen pregnancy a “national priority.” Since then, the government has tried to ramp up sexual and reproductive health education among the youth.
EC pills, or morning-after pills, are an undervalued solution that should also be looked into, according to DKT. These have been banned in the Philippines for 20 years.
“The EC pill is a readily available solution that’s safe, effective, and widely used worldwide (in 147 other countries),” said Mr. Bolande. “Usage studies overseas have shown that young women and girls, in particular, favor this contraceptive method.”
The last time an EC pill was approved for importation and sale in the country was 2001, when the Bureau of Food and Drugs declared the pill Postinor as “abortifacient,” meaning it causes abortion, and revoked its registration.
A study by the DKT Philippines Foundation conducted in October 2021 found that 68% of medical doctors involved in family planning believed that the FDA should remove the ban, while 22% were undecided and 10% were opposed to it.
Experts said that having an EC pill available on the market would help address teen pregnancy, which is projected to bounce back due to the easing of lockdowns.
“The root causes of the problem [teenage pregnancy] were never addressed. We just had a respite in 2020 because the quarantines kept teenagers at home,” said Dr. Mario Festin, a family planning specialist from the University of the Philippines College of Medicine.
He added that Levonorgestrel, a component of many oral and hormonal contraceptives, implants, and intrauterine devices (IUDs), is scientifically proven to be safe.
PURSUIT OF WOMEN’S HEALTH
Mona S. Diones, the Iloilo chapter manager of the Family Planning Organization of the Philippines, shared in a BusinessWorld B-Side podcast episode that opposing views on sex and reproductive health present challenges in a predominantly Catholic country like the Philippines.
“Our conservatives, they bend towards pro-life policies, which are, most of the time, at odds with pro-choice advocacies,” she said. “The pursuit of women’s health and well-being — we are all promoting the right [of] being empowered women.”
It is especially difficult to talk about contraceptives, especially for young people who need to access such services. Despite World Health Organization (WHO) guidelines stating that EC pills don’t end pregnancy but just prevent it by delaying the release of eggs from the ovaries, many conservative Filipinos will still oppose their return to the market.
A previous study done by DKT found that 68% of 500 unmarried, sexually active women aged 18 to 29 have experienced unprotected sex, but only 1 in 4 were aware of EC pills as a means of contraception.
When told about such pills, 73% of respondents said they would be interested in using them if ever they would become available in the Philippines.
“EC pills are good for those who don’t have sex often because you will only need to take the pill in the occasions you have sex,” said Dr. Junice L.D. Melgar, director of the Likhaan Center for Women’s Health. It’s also used when other contraception methods fail, such as in cases when a birth control user forgets a dose or a condom slips or breaks during sex.
Yuzpe Method is the alternative that’s prescribed here in the Philippines since EC pills are not available, she added. Approved by the Department of Health, it involves taking two enlarged doses of daily combined oral contraceptive pills.
However, since these are not made with that purpose, severe side effects like nausea and vomiting are common among those who resort to the method.
“This is the motivation for women who, regardless of the non-availability for now of the more effective and more convenient Levonorgestrel, nagtiyatiyaga sa (choose to bear with) side effects ng Yuzpe because it’s the only thing they have,” said Dr. Melgar.
“The thing they need to balance with that is, what if they get pregnant if they don’t use anything? That’s a big burden to women, especially young women.”
For this reason, the WHO recommends EC pills over the Yuzpe Method. A 2019 analysis of published research by the Cochrane Database of Systematic Reviews also found that the EC pill is overall more effective at preventing pregnancy.
Dr. Melgar added: “Yuzpe is good but it’s really a crime that there is technology that has been available for many years and it’s just denied to women here.” — Brontë H. Lacsamana