Families of poor grow as church and state in stand-off over contraception
Losing battle ... mothers with their babies in a ward of the Jose Fabella maternity hospital in Manila. There are 300 mothers in the ward. Between 75 and 100 babies are born there every day. Photo: Reuters
By lunchtime doctors have delivered 57 babies and still they keep coming.
In wards with peeling paint, more than 300 mothers wearing gowns nurse their newborns, three or four to a bed.
''It's always busy here … there's not enough beds for the mothers,'' says a nurse in Manila's Dr Jose Fabella hospital, known here as the baby factory.
Philippines government officials point to these scenes to justify a controversial proposed law to make contraceptives freely available to the poor in a country that has one of Asia's fastest-growing populations and where millions live in chronic poverty.
But the move has brought the Philippines President, Benigno Aquino, into confrontation with the powerful Catholic Church.
Elena Penavosa, 33, and her family sleep under a railway bridge in a Manila slum. She struggles each day to scrounge enough food to feed her eight children, aged four to 13, and her sick husband. Life would be much easier with fewer children, she says, but she has never thought of using contraceptives.
''If the Lord wants me to multiply, I will multiply … we are guided by him,'' she says as a train roars past.
Nearby in the same slum a Reuters photographer captures Liza Cabiya-an, 39, rousing her 14 children, the youngest just 11 months, in a room nine square metres, shortly after dawn.
The children huddle together waiting for breakfast, which on a good day is pan de sal, or Filipino salt bread, which they dip into hot instant coffee. Mrs Cabiya-an works part-time as a laundry woman and home help.
''It's tough when you have so many children,'' she says, with a shy smile. ''I have to count them before I go to sleep to make sure no one's missing.''
At one time Mrs Cabiya-an had access to contraceptives but the Manila mayor, Jose Atienza, a devout Catholic, swept them off the shelves of city-run clinics in 2000. Since then she has struggled to limit the size of her family, resorting to illegal abortion more than once.
Mr Aquino, a Catholic, is strongly backing a reproductive health bill before the Philippines Senate that aims to give poor couples free access to family planning methods, including contraceptives and condoms, and would require schools to teach sex education.
The legislation was first drafted 14 years ago but proved too difficult for previous governments as the country has grown to be the world's 12th most populous nation with almost 100 million people.
Mr Aquino says his conscience would not allow him to stand aside on the bill, despite defying the church, which was behind the popular uprising that propelled his late mother, Corazon Aquino, into power in 1986.
''Every child who would not be brought up properly or would not be given the opportunity that is their inherent right would be a burden that I couldn't bear,'' he says.
But the Catholic Bishops Conference has vowed to oppose the bill, even though legislators have watered it down to appease the church, removing references to a two child per family policy. ''We are still for scrapping the bill. It is not necessary,'' Archbishop Jose Palma, the conference president, says. Some priests have even branded support for the bill a ''serious sin'' punishable with excommunication, reflecting how conservative the church has remained in the Philippines, the sole Catholic nation without a divorce law.
But private polls show that about 68 per cent of 76 million Filipino Catholics favour the government distributing free contraceptives to those who want them.
Contraceptives are available in most places but most poor people cannot afford them.
The Philippines population is increasing by 1.9 per cent a year, compared with 1.2 per cent in Indonesia and 0.9 per cent in Thailand. Authorities say the population rate will have to decrease for the economy to grow at the level required to lift people from poverty.
''If you increase access to contraceptives for women … you will have births averted,'' says Josefina Natividad, director of the University of the Philippines' Population Institute.
Despite the church's tough stand, there is support for some kind of family planning measures among senior Catholic clerics.
Father John Carroll, founding director of the Institute of Church and Social Issues at Ateneo de Manila University, says the church is in ''no win'' situation. If the bill is not passed, ''I fear a powerful backlash … [and] the beginnings of anti-clericalism'' that swept the church from a position of influence in Spain and Ireland, he says.
Father Shay Cullen, an Irish-born priest who has campaigned for children's rights and worked among impoverished families in the Philippines since 1974, says both sides of the controversy have exaggerated their positions, but insisted, ''I don't want to get involved in the politics of it.
''There needs to be some means of family planning because you just can't let the population grow to the extent it is.
''There are reportedly 16 million malnourished children in the Philippines and the population is said to be 100 million. We see the population as one of the main causes of poverty in this country and it needs to be controlled.''
In the 1960s, then dictator Ferdinand Marcos made reining in the population a priority and enshrined family planning in a 1973 constitution.
Ironically, it was Mr Aquino's mother who, mindful of the church's help in her gaining power, scrapped the clause when the constitution was rewritten in 1987. The bill is likely to be voted on by the end of the year.