DEBATE ON CONTRACEPTION

POSITION PAPER

I. What is Contraception?
Contraception is the act of preventing pregnancy. This can be a device,
a medication, a procedure, or a behavior. Contraception allows a woman
control of her reproductive health and affords the woman the ability to be an
active participant in her family planning. There are many different types. Some
are reversable, while others are permanent. Some types can also help
prevent sexually transmitted diseases (STDs).

II. Why is contraception important?

According to the World Health Organization (WHO), The prevention of
unintended pregnancies helps to lower maternal ill-health and the number of
pregnancy-related deaths. Delaying pregnancies in young girls who are at
increased risk of health problems from early childbearing, and preventing
pregnancies among older women who also face increased risks, are important
health benefits of family planning. By reducing rates of unintended
pregnancies, contraception also reduces the need for unsafe abortion and
reduces HIV transmissions from mothers to newborns. This can also benefit the
education of girls and create opportunities for women to participate more fully
in society, including paid employment.

Family planning programs have been developed and supported to provide people
with a means to achieve the number of children they desire and to reduce unwanted
pregnancy, as a means of improving the health of women and children, and to
contribute to slower population growth and more rapid economic development.
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It was concluded by the Working Group on the Health Consequences of

Contraceptive Use and Controlled Fertility that family planning programs
contribute to the improvement of the health of women and children in developing
countries by providing safe and effective means for women to reduce the number
of births and high-risk pregnancies they have.

REPRODUCTIVE PATTERNS AND MATERNAL

HEALTH
Research conducted in developing countries demonstrates that maternal
age and parity are associated with maternal health. In particular, maternal mortality
may be reduced by:
• Reducing the total number of pregnancies each woman has;
• Reducing the number of high-parity births;
• Reducing the number of births to very young and older women;
• Reducing the use of abortion to terminate unwanted pregnancies in countries in
which safe abortion is unavailable; and
• Reducing the number of pregnancies to women with major health problems.

CONTRACEPTIVE RISKS AND BENEFITS

Modern contraceptives are an important means through which women
in developing countries control their fertility. Declining fertility will improve the
health of women in a society by reducing the number of pregnancies and births and
therefore the exposure to risk. On the basis of the review on the scientific evidence
concerning the risks and benefits of contraception, it was concluded that the risks
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associated with the use of currently available modern contraceptive methods are
considerably lower than the risks associated with pregnancy, labor and delivery,
particularly in developing countries. Moreover, research has increasingly
demonstrated the direct health benefits of contraceptive use. Although these results
are based largely on studies conducted in the developed world.

TYPES OF CONTRACEPTIVE METHODS

There are many different types of contraception, with varying rates of
effectiveness depending on correct usage. Some methods may be obtained over the
counter, others may require medical advice or even surgical intervention.

Healthcare providers play an important role in helping people find and use a
method that is both effective and acceptable. Methods include:

Hormonal contraceptive methods

Hormonal methods of birth control (contraception) contain either estrogen plus
progestin or progestin only; they are a safe and reliable way to prevent pregnancy
for most people. Hormonal methods include an implant, an intrauterine device
(IUD), injections, pills, vaginal rings, and skin patches.

Intrauterine devices (IUDs)

An intrauterine device (IUD) is a type of contraception (birth control). IUDs are
small devices that are placed inside your uterus (womb) to prevent pregnancy.
IUDs are effective and reliable, lasting for 5 years or more. There are 2 types of
IUD — the hormonal IUD and the copper IUD.

Emergency contraception
Emergency contraception refers to methods of contraception that can be used to
prevent pregnancy after sexual intercourse. These are recommended for use within
5 days but are more effective the sooner they are used after the act of intercourse
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Barrier Methods
These include condoms (both external and internal) as well as the diaphragm,
cervical cap, sponge, and vaginal spermicides. Condoms are also known as
"barrier" methods of birth control; they physically block or otherwise prevent
sperm from entering the uterus and reaching the egg for fertilization.

Lactational amenorrhea method

A temporary method of contraception for new mothers whose monthly bleeding
has not returned. During this period, eggs are not released, so pregnancy cannot
occur.

SIGNIFICANCE

Effective contraception provides social and health benefits to mothers and their
children by reducing unintended pregnancies and abortions and facilitating family
planning. Effective contraception indirectly helps in improving the overall health
status of infants and children.

In addition to preventing pregnancy, the correct and consistent use of male

condoms (a barrier method) reduces the risk of HIV and other STDs including
infections like chlamydia, gonococcus, and trichomoniasis. Although hormonal
contraceptives and IUDs are highly effective at preventing pregnancy, they do not
protect against STDs, including HIV.

By reducing unintended pregnancies and abortions, and facilitating family

planning/spacing of births, effective contraception provides both health and social
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benefits to mothers and their children. According to worldwide estimates, some

600,000 women die each year of pregnancy-related causes, and 75,000 die
following unsafe abortions. At least 200,000 of these maternal deaths are
attributable to the failure or lack of contraceptive services. In addition to
preventing mortality, effective contraception improves maternal health. Data from
the well-controlled Intergenerational Panel Study of Mothers and Children, a 31-
year longitudinal survey of 1113 mother-child pairs, indicate that unwanted births
can lead to nonpsychotic major depression (postpartum depression), feelings of
powerlessness, increased time pressures, and a reduction in overall physical
health. Finally, effective contraception improves the social and economic role of
women and enables them to participate in society fully.
SIGNIFICANCE

Infants and children also derive benefits from effective contraception. As modern
contraceptive methods have become more widely available throughout the world,
infant mortality has decreased from approximately 150 deaths per 1000 live births
in the 1950s to 80 deaths per 1000 live births in the 1990s. In developing countries,
53% of married women plan family size, and 90% of them use modern birth
control methods such as female sterilization, oral contraceptives (OCs), and
intrauterine devices (IUDs).

According to Population Action International, infant mortality in developing

countries could be decreased by one-third by increasing the spacing between births
to 2–4 years. The health status of infants and children is also improved as a result
of effective contraception. In the 31-year mother-child survey, unwanted children
had more health problems, such as lower birth weight and higher mortality, than
those who had been wanted. Mothers who had an unwanted birth also had a poorer
quality relationship with all their children, tending to spank them more and spend
less leisure time with them. In addition, evidence indicates that children from large
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families generally receive less education.

CONTRACEPTIVE USE IN THE PHILIPPINES

Although year-to-year variations are not significant, the CPR has exhibited a
generally increasing trend (Figure 1). In the late 1960s and early 1970s, fewer than
two in 10 married women used any form of contraception. The contraceptive
prevalence rate rose during the late 1970s. By 1993, two in five women were
practicing contraception. Since the mid-1990s however, a fairly steady figure of 45
to 50 percent of married women of reproductive age have been reported using
some form of family planning in successive Demographic and Health Surveys and
Family Planning Surveys.

Fluctuations in the CPR can be attributed to the erratic trend of the prevalence rate
of traditional methods. In contrast, the prevalence rate of modern methods had
generally increased. In 2011, the prevalence rate for modern methods was 13 times
the estimate for 1968, which was 2.9 percent.
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THE USE OF TRADITIONAL

CONTRACEPTIVE METHODS IN THE
PHILIPPINES

Traditional contraceptive methods include periodic abstinence or rhythm,

withdrawal, and folkloric methods. Periodic abstinence or the calendar
method (rhythm) has been widely used among Filipino couples. Earlier
studies on family planning behavior have noted that even without any effort
from the government to promote periodic abstinence as part of the family
planning program, it was a popular method among Filipino couples (Laing
1987). It was often practiced in combination with withdrawal and with
modern methods such as condom or foam. In a study on contraceptive use in
1978, more than a quarter of Filipino couples were practicing one form or
another of this method (Verzosa et al. 1984). Alongside periodic abstinence,
there was also high reliance on withdrawal as a family planning method.
This stems from the fact that withdrawal does not entail cost and can be used
spontaneously by couples. Withdrawal as a method also upholds the belief
of men’s power in reproductive decision-making (Verzosa et al. 1984)

PROBLEM IN THE PHILIPPINES

REGARDING THE CONTRACEPTION
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More recent studies have looked into the reasons why women or
couples shy away from more effective modern methods of contraception
(e.g., Abejo et al. 2006; Williamson et al. 2009; PSA and ICF International
2014; Cruz, Marquez, and Kabamalan 2016). The most common reasons are
fear of their side effects, lack of knowledge on different methods, and
inconvenience of use, in contrast to the relative ease in adopting traditional
contraceptive methods. A study of urban poor women in Manila found that
traditional contraceptive methods, particularly withdrawal, are preferred
because of their absence of side effects, safety, agreeability with partner, and
ease of use (Cruz, Marquez, and Kabamalan 2016). Similarly, in a study of
the use of periodic abstinence among Beti women in Cameroon, Johnson-
Hanks (2002) found that women preferred the method because of the
absence of negative side effects as well as a perception that periodic
abstinence is an indicator of one’s self-discipline.

A review of qualitative studies on the nonuse of modern contraceptive

methods among young women in developing countries pointed to factors
such as lack of knowledge and poor access to services, a common perception
that modern family planning methods and services are only for married
women, as well as the negative social norms around premarital sexual
activity. The difficulties that young women often encounter in accessing
modern contraceptive methods lead many to use traditional methods instead
(Williamson et al. 2009). Such observations are pertinent to the Philippines,
where social norms discourage sexual activity outside of marriage.

In addition, reproductive health services are provided mainly to married

women/couples. The RPRH Law requires parental consent for women below
age 18 to access family planning services from public health facilities. Thus,
it is not surprising to find that a larger proportion of sexually active
unmarried women than currently married women are using traditional
contraceptive methods (PSA and ICF International 2014).

CONCLUSION
The conclusion from the provided context is that effective contraception
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plays a crucial role in improving the health of women and children, reducing
unintended pregnancies and abortions, and facilitating family planning. It
has been found to contribute to the overall health status of infants and
children, reducing infant mortality and improving maternal health.
Additionally, effective contraception provides social and economic benefits
to women, enabling them to participate more fully in society. The use of
modern contraceptive methods has been associated with lower risks
compared to the risks associated with pregnancy, labor, and delivery,
particularly in developing countries. However, in the Philippines, there is a
preference for traditional contraceptive methods due to factors such as fear
of side effects, lack of knowledge about modern methods, and social norms
discouraging premarital sexual activity. Access to reproductive health
services for unmarried women and adolescents is limited, reflecting the need
for improved education and access to modern contraceptive methods.
Overall, the conclusion emphasizes the importance of effective
contraception in improving reproductive health outcomes and calls for
addressing the barriers to modern contraceptive use in the Philippines and
globally.

References

1. https://www.glowm.com/section-view/heading/The%20Importance%20of%20Contraception/
item/373?fbclid=IwAR3aNVpESd9_I0U_F7ttBTzHJULBcMpiCEO-3ctBN6P2Jo-
3RPGg8x95xXY

2. https://www.who.int/news-room/fact-sheets/detail/family-planning-contraception?
fbclid=IwAR1Wvoe-HNm8jLFuz8vr9tiJOgzyu6FfmfMrtpCDM9CMxU3IA5tubUf0Zgg

3. https://psa.gov.ph/statistics/family-health-survey/node/42096?
fbclid=IwAR0xcvYIynh9BPELrW3lKHITjKFK0o0HuAoNGbiJ9ZeRmx4HJy-
q8LK55OU
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4. https://www.ncbi.nlm.nih.gov/books/NBK536949/#:~:text=Contraception%20is
%20the%20act%20of,participant%20in%20her%20family%20planning.

5. https://dhsprogram.com/publications/publication-wp130-working-papers.cfm

6. https://www.who.int/health-topics/contraception?
fbclid=IwAR1C8wD9c5slN76fQFvTAhWv_dD82HOLvMEC58xbDNS2WgBPpiTOWc
lhiD4#tab=tab_1

7. https://www.healthdirect.gov.au/intrauterine-contraceptive-device-iud#:~:text=An
%20intrauterine%20device%20(IUD)%20is,IUD%20and%20the%20copper%20IUD.

8. https://www.uptodate.com/contents/hormonal-methods-of-birth-control-beyond-the-
basics/print#:~:text=Hormonal%20methods%20include%20an%20implant,birth
%20control%20that%20are%20available.