Abortion and Reproductive Justice: The Unfinished Revolution IIInternational Conference2-3 June 2016Ulster University, Belfast, Northern IrelandGood afternoon everyone. I have been thinking a lot about what binds those of us who have come to this conference and others like us who are not here. What are we trying to say to the world?I believe it is this: abortion, if made accessible within a package of other reproductive and sexual health and rights initiatives and elements would allow women to control their bodies and sexuality. Such control is central to ending inequitable structures that oppress women now. Structures that, to appropriate an old feminist phrase, we would rightly call the four horsemen of the apocalypse: neoliberalism, patriarchy, racism and heterosexism. Of course, as the Bible needs updating, I would add others, such as ageism, sizeism or ableism.We know this and we have been saying it before we came here, as we have gathered together in Belfast: it is the right of women to control their bodies. Full stop.Whatever words we use to call it: control of one’s body, choice, self-determination, reproductive and sexual health and rights and freedom, what we mean is that if we are to end oppressions in this world it can only be done if women are given a full range of health services including abortion. Abortion, like any technology, if properly ensconced in programmes, policies and systems of justice will ensure that women will not be forced to carry an unwanted pregnancy to term.A woman’s right to control her reproductive destiny is central to our efforts for equity and justice. Justice – the necessary condition to achieve human liberation but also the outcome of that liberation.We know this and I believe that those invested in systems of oppression also know this to be true. At one level, it is very clear that there is something fundamentally transformative of our lives, our communities and our societies if women are able to choose to give birth or not.Little wonder that this struggle, women’s rights to bodily self-determination, has been met with the full force of hegemonic power. And this is what we need to do: resist hegemonic power in its myriad iterations in the terrains of the particular, the quotidian, the everyday. In culture, in law, in the economy, in church, in academe, in bathrooms, and in clinics. We need to be everywhere (and we are).The power of the medical establishment has been used to keep women from accessing safe abortions. And so we have activists, many of them health care professionals and organizations that dare and risk and innovate. Some bypass medical gatekeepers altogether, some mesmerize the gatekeeper and some become the gatekeeper in order to throw the gate wide open.Where the law makes abortion a criminal act, activists fight for its decriminalization. And we are very pragmatic. If the law does not allow for abortions in the morally indefensible extremes of rape, fatal fetal malformation, threat to the life of the woman, then we work to decriminalize that. If these exceptions are made. we work to decriminalize all the other abortions. And where abortion is decriminalized, we work to make it legal. Where it is legal, we work even harder to demand that laws ensure it is safe, accessible.And religion? Oh, that. Much to the disgust of the patriarchs who thunder at us, we thunder back at them. Asking: who do you think you are? Why do you think you can impose your religious interpretations on our secular representatives? And why do you make such silly interpretations of scripture anyway? Why shouldn’t more women, especially feminist ones, be allowed to interpret scripture? You see, what you find immoral and appalling, we find rather moral. And either it isn’t our religion or it is our religion too. So whatever space you think you are occupying, well, move over.In the academe we are told not to be ideological or political or too feminist because scholarship is about neutrality and objectivity and disciplinal constraints and canons. And so we say, but that is really a very interesting interpretation of scholarship, and one which has a long tradition that we understand. But now, in the true spirit of the word academic, let us tell you how we can make this system of knowledge production and application better. Let us show you how engaged scholarship leads us to ask questions you would never have dreamed of asking, find answers that ring so true, you wonder why people whose job it is to be smart never thought of it. Let us tell you how we help movements with our research and teaching, and how movements help us in return to be better scholars. Let us hold a reproductive justice conference in Ulster University where nerdy activists and activist nerds come together to assess important and ground-breaking stuff and create new and important and ground-breaking more stuff.And lest you think that our ability to meet you at the level of the everyday, such as when we fight to bring people through a phalanx of abortion protesters, tires us out. Well, no, it doesn’t. We are keeping an eye on your neoliberal erosion of the welfare state too, with your austerity measures and moves to deprive women of health care, reproductive health care, abortions, education, and all other aspects of social security.And everywhere you seek to stigmatize our sexuality, we are there to tell you – our sexuality is the good stuff. So go deal with your envious, restrictive, violent complexes and leave us to our pleasures – our myriad pleasures, which we intend to enjoy without your guilt tripping, thank you very much.Let me now identify an important aspect of the truth-saying of these last two days. Which is that we say things in context. I am deeply grateful that the organizers have given me the privilege of giving you the only context that I can talk about with authenticity – mine. The realities of the Philippines, a poor developing, post-colonial society. And right away let me thank the other Filipina who is here for allowing me to describe and interpret what is also her reality, and all the other women here from similar contexts for their generosity in allowing me to name the realities that put us in similar positionalities across class, caste, national and racial divides.Here is where I come from: for more years than I care to remember, I had been dreaming of coming to a conference where extremely restrictive abortion policies would be a common theme. I would then set up discussion groups of increasing similarity – say all Christian countries with extremely restrictive laws with a strong Catholic flavour thrown in, and where perhaps the Catholic Church has had an intense, multifaceted and extremely mediated and nuanced role in the history and identity of the people.This is the Philippines essentially. Of our population of 100 million people, 92.3% are Christian, of which 82.9% are Roman Catholic. Another 4.65% practise Islam.Spain introduced Christianity to the Philippines in 1565 with the arrival of Miguel Lopez de Legaspi. Earlier, beginning in 1350, Islam had been spreading northward from Indonesia into the Philippine archipelago. Actually, the Spanish did not come upon a country, but a set of islands and communities practicing various animist religions, except of course in those communities practising Islam. Spanish colonialism, if I am to believe our Southeast Asianist colleagues, was unique in the Philippines for the length of and depth of its penetration. For over 500 years, Spain held us as a colony and at the end of it every local town had its colonial overseer, usually a very corrupt Spanish friar. Literally, my nation became one because of a sense of unity built on a common desire to rid ourselves of Spanish colonialism, which we succeeded to do in 1898.As bad luck would have it, our revolution succeeded at the time of the Spanish-American War. Having lost the islands, the Spanish turned around and sold us to the USA for $20 million in a package deal that also included Cuba and Puerto Rico. The US subsequently engaged in a war of pacification at the turn of the 20th century. We became a colony again, until we were given formal independence in 1945. The US brought various Protestant denominations with its occupation, but its approximately 50 years of control could not compete with 500 years of Catholic proselytization. A common way of summarizing our colonial history is rather witty: we spent 500 years in a convent and 50 years in Hollywood.Aside from its deep entrenchment in Philippine society and culture, however, the Catholic Church has always participated in Philippine politics. In recent history, after a period of collaboration, it helped to lead the People Power Revolution that toppled the 20-year dictatorship of Ferdinand Marcos. That bought it a lot of credibility. It continues to weigh in on social issues with a somewhat progressive stance, such as its position on land reform (it is one of the largest landholders still, but Church lands remain exempt), the struggle for a Freedom of Information Law, the banning of the death penalty.This would all be nice for progressives, I suppose, except that the Catholic Church has taken fundamentalist positions on all things women, all things reproductive, and all things sexual. But I will return to this later.Philippine women’s healthPhilippine maternal mortality ratio in 2006 stood at 162 deaths per 100,000 live births. Under the MDGs, the goal was to reduce this to around 52 by 2015. Yet according to our Department of Health, the country’s maternal mortality ration increased to 21 deaths per 100,000 live births for the period 2006 to 2011.There is a large and unmet need for family planning in the Philippines. As of 2011, one in five married women wanted to space or stop childbearing but were not using any contraceptive method. Fifty per cent of unmarried women who were sexually active (as of 2008) but did not want to get pregnant were not using a contraceptive method. Seventy per cent were not using a modern method.Little wonder that unintended pregnancies in the Philippines are 54% of all pregnancies, or around 1.9 million per year. One outcome of this is that Filipino women give birth to more children than they want. The other is that Filipino women are seeking abortions even if in the Philippines it is banned for all circumstances. It is banned under the centuries-old penal code which we inherited from Spain. Also enshrined in our Constitution is a provision that the state will “equally protect the life of the unborn and the mother from the moment of conception”.The most recent estimate of abortion incidence in the Philippines, in 2000, using indirect estimation techniques and hospital records, is 27 abortions per 1,000 women of reproductive age. This translates into around 610,000 abortions in 2012. In 2008, 90,000 Filipino women were hospitalized for abortion-related complications, and over 100,000 women in 2012. The 2008 estimate for abortion deaths in a year was around 1,000 women, amounting to about half of our maternal deaths per year.Typically the women who seek abortions are like most Filipino women, Catholic, already with 2 or 3 children, with a high school education and poor. Indeed, roughly two-thirds of the women seeking abortions were poor.The illegality of the abortion as well as the poverty of the women seeking abortions results in very unsafe situations, where methods can include the insertion of foreign objects such as catheters into the uterus, deep massages that can be very damaging, etc.But the typical reproductive injustice we see in the abortion picture is true for the entire reproductive health situation of Filipino women. Those who die in childbirth are also the poor. Maternal mortality too is very much a class and ethnicity issue in my country. Maternal mortality ratios in the wealthy neighbourhoods of Manila are similar to those of say, Northern Ireland, at around 8 per 100,000 live births in the period 2003-2007 according to the report I read. Our national average stands at 162 per 100,000 but it can be twice that among indigenous peoples, who are also some of the poorest.Let me now shift my story again, and talk about a non-governmental organization I helped to start in 1995 called Likhaan.In 1995, aware of the dire health situation of Filipino women, a couple of women, myself included founded Likhaan. Our core programme has always been to work with poor communities in order to deliver reproductive health services to women.We thought we were doing quite well as a little NGO and had begun advocating for a repeal of the restrictive laws on abortions. Our initial discussions were that we would seek exceptions from penalties in the cases of threat to the life to the woman, severe fetal abnormalities, and for rape and incest. At the insistence of our staff and board members who came from poor communities, we added a fourth exception, for economic reasons – in other words, in cases of poverty.We had an advocacy campaign which included romantic novels, plays, information articles, and so on. We rushed to support this crazy Congressman who, for reasons unfathomable to us, tabled a bill to legalize abortions and helped him craft a bill for the exemptions we thought would be a reasonable first step. The man was a typical macho warlord, by the way. He had no fear of losing his district because his family had controlled the voters there since forever. He owned a yellow Mercedes sports car and packed a 45-calibre pistol. He liked the female attention we gave him because of his bill. In fairness, though, he merely flirted with some of us. I guess it was enough that we defended him in the media, newspapers, etc. The bill never progressed, of course. I think he was the only author.Despite these early struggles, in 1999 we abandoned the campaign altogether and instead decided to work for a reproductive health law that did not change the draconian abortion law at all.We decided to advocate for a reproductive health law that included the major elements of reproductive health delivery, including the care and management of post-abortion complications. The only element missing in the services we included in the law was access to a safe and legal abortion.The reason we decided to shift from health delivery to legislative advocacy was that we were increasingly seeing large scale bans on contraceptives and other reproductive health services in the country as religious fundamentalism also rose. One of the most famous ones was a ten-year ban in the city of Manila imposed in 2000 by the Mayor. The Mayor’s reason was that he was pro-life. The ban on contraceptives was total and included harassment of non-governmental organizations and private pharmacies.Such moves were increasing in number and in their nature. In 2008, we learned quite by accident that the emergency contraceptive Postinor had been banned by our food and drug administration at the behest of a group whose stated goal was to uphold family values. Their legal counsel also counselled with the Catholic Bishop’s Conference of the Philippines.We needed a law that would stop the situation from deteriorating. We needed a law that would protect whatever headway women’s groups were making in delivering services and influencing government policy at the local and national levels.And the only way we could have such a law was to stop our advocacy on abortion. The level of stigmatization of abortion is so high in the Philippines that no other legislator (except the crazy guy I told you about) would dare touch the law and hope to survive. Even among women’s groups the larger ones would not work with us on the abortion issue.Imagine, if you will, a woman’s movement faced with such choices. One cannot rationalize it from absolutist moral positionings of what is politically pure but only from a pragmatic politics standpoint. We can grasp it fully, analyze it fully, critique it fully, I believe, only from within a reproductive rights framework.What would have been the choice of the women’s groups working on abortion in such a repressed circumstance? Would the Jane collective, who had been performing safe and clandestine abortions before legalization in the US have opted to join the struggle for an RH law or would they have decided to remain quiet knowing that to speak out, even on something like contraceptives, would have led to a raid of their clinic?Thus, needless to say, hard choices were made, and we yielded on the issue of abortion. It took us 16 years to get the Law, which included a challenge in our Supreme Court. Interestingly, the challenge was based on the claim by pro-life groups that contraceptives caused abortions. The bill passed into law in December 2012 and was declared not unconstitutional by our Supreme Court in 2014. The Court did, however, strike down certain important provisions, mostly around our attempt to limit the grounds for conscientious objection.
The RH Bill passes 29 Dec 2012It is also interesting to note that from start to finish the bill was challenged as an abortion bill. In the early stages, the opposition, mainly the Roman Catholic Church, its allied groups and legislators went so far as to misinform the public that the bill was meant to legalize abortion.Allow me to illustrate this by also bragging a bit. I think I made history as the first and one of few women entered into the records of the Philippine Senate as an abortionist. A certain Senator who opposed the bill named me in his privileged speech as being the Chairperson of the Women’s Global Network for Reproductive Rights (true at that time) which advocates for access to safe and legal abortion worldwide (true again). To him, this was proof positive that I was an abortionist. The Senator then added that according to his intelligence work, I was close to the main author and main champion of the bill in our House of Representatives. The speech of course was complemented with pictures and slides. His other bombshell was to quote Likhaan’s translation into Filipino of the Hesperian book, Where Women Have No Doctor, which has a rather excellent discussion, I must admit, of abortion, including the safe methods.When we started to promote the bill in 1999, we got shut down at the Committee stage in the House of Representatives. By 2011, a reputable polling company, the Social Weather Station, was showing large levels of support for the bill and its controversial provisions, including 82% saying family planning is a personal choice, 73% wanting information on legal methods from government, and 68% saying government should fund all means of family planning, whether artificial or natural. A plurality of 46% disagreed that youth would be promiscuous if given sexuality education.I cite these statistics because they also indicate what the opposition had managed to make controversial about the bill: that women should have personal control over their bodies, that they should be given information and services that would help them achieve that choice, that government should pay for the contraceptives so that poor women who are the majority in the country could have them, and that schools were going to talk openly about sexuality to young people.As a result of this law, however, we are beginning to see positive change. A Likhaan Board member, a former Secretary of Health and our Executive Director, are now government officials working to implement the Law. Although there is still much to do, I believe indeed that despite the lack of an abortion provision, we are in a far better position to achieve the goals of reproductive justice with a law in place. One of our platforms was that the law has always been a law about social equity. Rich women don’t need the law. They can have access and pay for all the services the law provides for and travel abroad to get their abortions.As many in this conference have said, it is not merely making abortion legal that necessarily makes it accessible. Nor is it helpful to focus only on abortion as a right if the larger goals of justice, reproductive justice in particular, are to be met.The struggle for a reproductive health (RH) law was difficult for us because a small band of committed advocates began an effort that would eventually necessitate that we take on the most powerful social institution in the country. Ones with tremendous wealth and deep social capital, which included being the main education provider for the wealthy elite who rule the country.The Catholic Church fought us with all its power, including threats of excommunicating anyone who supported the bill, including the Philippine President. Pastoral letters were repeatedly read throughout all the parishes in the country, calling on the flock to vote against pro-RH politicians – using their role as spiritual advisors to gain unprecedented access to decision makers and endless and persistent abortion-tagging. The situation also mobilized international resources. An analysis of the arguments of the Church shows they are strikingly similar to those used to oppose abortion in other contexts across religious denominations.It presented us, the people, with a social ideology that understood the linkages between our goals to achieve reproductive health and our goals of reconceptualizing the area of reproduction, sexuality and the family, closer to feminist visions. The Church, for example, warned that the reproductive health law was merely a precursor to other laws that would allow for same sex marriage, legalize abortion, euthanasia and divorce (yes, we are the last country in the world which has no law on divorce). It hammered us repeatedly, that we were imposing bad sexual morals on young children and encroaching on the right of adults, as guided by the Church, to decide on what they should teach their children. It warned that we were setting up women to be promiscuous and destroying the family.When you come to think of it, my answer would now be, as the bill has now been passed – well, why not!But, seriously, to achieve our goal we managed to put together a very broad movement for RH. It encompassed many sectors of society, including media and business as well as various groups working on secularism, LGBT groups, progressive groups working on issues like tobacco and alcohol taxation, most of the Protestant denominations, Muslim imams, LGBT groups, groups working on secularism, policy wonks, groups working on poverty issues, government leaders at lower and higher levels of the bureaucracy, and, of course, most of the women’s groups in the country, small and huge, of urban poor women, peasant women, working women and so on. It also allowed to us, and by this I mean the poor women of Likhaan and its allied organizations, to gain sophistication in legislative advocacy, social media, theological argumentation and so on. It fostered a respectful alliance between academics who followed each and every turn of the discourse to come up with data, research and analyses that would be used by these activist women, many of whom did not have many years of formal education.In the end the pro-RH movement sparked a national debate that led to awareness on the part of more than 90 per cent of our people, not just about the issues of reproduction, sexuality and women’s rights but of the particular provisions of the bill. And we learned so many lessons that can be brought to bear as we move forward.I do not know whether it is worthy, then, to ask the question: does the victory of the RH Law put us in a better position to change the abortion situation in the Philippines? I don’t know the answer to that one. Or perhaps the answer is a solid and definite “maybe”.Focusing on abortion alone, I know that frameworks of justice we have always brought to our health work and to the RH Law must be brought to bear again. For one thing, we know we cannot compromise on human rights standards, rights to health standards and social justice standards when we advocate. Likhaan, my organization, has always said that just because women are poor doesn’t mean that we should not give them the highest standard of health care we are capable of providing. That would be true of any abortion service we would give or advocate for. In fact, poor health services are just another way of disempowering women and reinforcing their oppression.I also know that if we take the post-abortion provisions of the RH law seriously, we are putting technology for pregnancy termination willy-nilly into the hands of a cadre of hopefully trained health workers.I also learned that advocates need to think out multi-layered messages that are suited to different audiences. We already confronted that in the RH struggle. And I can transpose it to our abortion debate. Will it be about health and medical ethics? Yes. Will it be about women’s bodies? Yes. Will it be about sexual morality? Yes. Will it be about religious doctrine and the interpretation of that doctrine? Yes. Will it be about national development? Yes. Will it be about secularism? Yes. Will it be about national identity? Yes. Will it be about feminism? Yes. Will it require that we act locally but expect that we fight a global institution or set of institutions with a global mindset and ideology? Yes.Composing multiple messages and engaging in various struggles assumes, of course, a basic trust in people. That painstaking and reasoned education is eventually appreciated and can change people’s minds and empower them to turn away from given knowledge and opt for change.My opinion is that we must start again to build another movement, and we are again at the dawn of a new struggle. We may need to start all over again, but somehow I believe we start from a better place.Allow me now to go back to our conference, in the light of what I learned as an activist who joined a dangerous anti-dictatorship underground at age 13, set up community-based health programmes, worked to help rehabilitate the people that the dictatorship had raped and tortured, and then, when that dictatorship crumbled, decided to work in yet more activities that fascists also dislike whether they are in power or not.What I learned is that all resistance starts at the level of the quotidian, the small, the everyday and the grounded. But these resistances become a struggle when they engage that which is hegemonic. In other words, we must not allow ourselves to be distracted by the seemingly limited, compromised and often contradictory work we need to do in the contexts in which we work.In this conference, I have heard people ask themselves important questions – such as whether it is OK to shift our focus from legislative advocacy to mass mobilization. Does our advocacy for abortion exceptions in the case of rape and incest, for example, set up the argument that there are good and bad abortions? Do the statements of the UN, that the denial of abortion for certain types of women constitutes torture, make things worse for those of us who want an abortion for a myriad other reasons that we deem sensible? What about the tricky issues of euthanasia, sex selection abortions, or even the unsaid: that race, class, sexual orientation, gender identity, caste, disability, and age discrimination also divide us?My thoughts are that of course these things divide us, are compromises, are trade-offs. But this is not a problem. Because, as our struggles show us, the first step of any hegemony is to homogenize us in a fundamental way. It sets us up as either this or that and nothing else in between. How often have I heard the argument that I am not really a Filipina because I believe in sexual rights? As if all women are this way so that if we do not be this way then we are bad. If we are Catholic, we must all be like this or we are bad Catholics. If we are true feminists then… oh well, don’t you just want to meet this true feminist leader? The one who has it all: lesbian, raped, illiterate, botched abortion, colored, disabled, fat, living in the slums, living with HIV, a sex worker. I could go on and on.In truth, there is something about the beast we fight, in that we are all complicit and implicated. This is what defines the arena and parameters of our struggle. Defines whether a Filipina who gave up abortion advocacy is acceptable to be a keynote speaker at an abortion conference.It is this insidious attempt to force us into a politics of “either/or” that is problematic. Because as we have seen in this conference, the politics we practise are the politics of “and”, “by the way”, and “that too”.Our struggle flows here and there, ebbs here and there. Sometimes we need to be apart and contradictory because our contexts and passions make us different. Sometimes we need to be apart even if we had been together before. And then again, we often find each other again. Each change we make is indeed co-opted – or perhaps had been co-opted from the start. Because there is no stepping outside hegemony and pulling the rest of the world into the new ground where we stand apart. Instead, historical processes, our very own actions, make that new ground emerge from the reality that encompasses us always. Yet it is these conscious actions that (if successful and therefore demand co-optation) change the parameters of the game, allowing for a different set of possibilities of unities, alliances, contradictions and differences.As a final thought, I have become convinced because of being with you here that we have so many things in common across our seemingly unique situations. When I get home I will again deal with all the small, ordinary and daily tasks that face an academic who is also an activist. But I will take home with me what I have learned yet again in Belfast. That the dreams I have for the women and men of my country are dreams that actually know no national boundaries, dreams that do not recognize divisions of class or ethnicity or race or other markers of individual identity. That I will find in our struggles for reproductive justice passive and active, willful and unplanned support from various others who are also fighting for the same things, and that I must return that solidarity in equal measure.Thank you and good afternoon.PHOTO: Elizabeth Lolarga, 2012Conference Programme