If you want to have sex without getting pregnant (or getting someone pregnant), you have to be circumspect about it if you live in the Philippines, where despite inroads in recent years, barriers remain to accessing birth control, reproductive health advocates said.
Though Filipinos have become relatively more open to discussing sex and its attached issues, cultural roadblocks remain, affecting not just the general attitudes of people but also laws that are supposed to provide the protection that would enable them, especially women, to have control over their lives.
"You really have to learn how to take matters into your own hands because the state doesn’t protect you that much," said Dr. Junice Melgar, a community-based health program practitioner who helped make the Philippines' Reproductive Health Law a reality.
As founder of Likhaan Center for Women's Health, a non-government organization that promotes and pushes for the sexual health and reproductive rights of women, particularly marginalized ones, Melgar has seen firsthand the devastating effects of unwanted and unintended pregnancies on the lives of women and the people around them.
She imparted her knowledge and wisdom for this #ReportrGuide, offering practical advice for those who want to enjoy their sexuality, but do not have the physical, emotional, mental, and economic capacity to risk bearing a child.
What are your birth control options?
Based on a guide provided by the World Health Organization, one can choose from a variety methods of contraception, which have different mechanisms of action and effectiveness in preventing unintended pregnancy:
If you live in the Philippines, they aren't all readily available to you, even if you're one who can afford it, said Dr. Melgar.
"The RH Law is really a product of compromises. Even if there’s a description there of universal access to all safe and modern methods of contraception, it didn't really guarantee that," she said, noting for instance, the lack of access to a dedicated emergency contraception pill in the country.
In 2001, Filipino authorities cleared the EC pill Postinor for importation and sale, but was later overturned by the Food and Drug Administration, citing its “abortifacient effect” (can cause abortion). But the WHO has long disputed this.
Melgar said the drug is only delisted from the country's essential drugs list and not entirely banned, which means that if one can afford and has the means to secure it from a legitimate provider (i.e. abroad), they can technically still use the pill here.
If you're minor seeking free contraception, the law requires you to secure your parents' consent first before you could avail of the government's free services. If you have traditional Filipino parents, this is hard even if you're of age, but according to Melgar, there's a way to get around this.
"The RH Law is silent on non-government and private providers," she said, noting that if one cannot buy it themselves for privacy or economic reasons, they can come to any of Likhaan's centers that are deliberately located in Manila's slum communities, where they provide a variety of birth control options for free.
(For an extensive breakdown of common birth control options, Cosmopolitan Philippines laid them out here.)
Other things to consider
Choosing a birth control method is hard for most people, as each comes with their own risks (hormonal pills can cause weight gain, mood swings, nausea, etc.).
Each contraceptive method is not one-size-fits-all, nor is any of them fool-proof (condoms could break, one can forgot to take their pill, etc), which is why Melgar recommends layering or combining methods of contraception for that extra security.
For instance, if you're already on the pill, using a condom helps as an added later of protection (not to mention, condoms reduce the risk of sexually transmitted disease). It also pays to be more mindful of your ovulation, or when you are most fertile.
"You have to be careful still about what you're doubling, as layering in an irrational way does not help," she said.
If you had unprotected sex, there's still a way for you to get help, even with the absence of a dedicated EC pill in pharmacies. Try the Yuzpe method, or the use of everyday birth control pills as an emergency contraception.
With an 88% chance of preventing a pregnancy, you need to:
- Take four (4) Ethinyl Estradiol 30mcg/Levonorgestrel 150mcg, Ethinyl Estradiol 30mcg/Levonorgestrel 125mcg, or Ethinyl Estradiol 30mcg/Norgestrel 300mcg pills as soon as possible.
- Follow this with another dose of four (4) pills 12 hours later.
Below is more detailed guide by DoItRightPH:
Dr. Melgar warned against using birth control brands Althea, Daphne, Cybelle, and Diane as they have not been proven useful for the Yuzpe method. She said one should also expect more intense side effects, like nausea, abdominal crams, and vomiting (if this happens, one has to repeat taking the pills again for it to work).
For health activists like Melgar, abortion's decriminalization in the country has always been the aspiration for decades, and while the work to make it a reality continues, one should take charge of their own sexual and reproductive health.
Men should also do their part, she said.
"Even if there has yet to be a contraceptive for them, they can already do a lot for their partners, starting with just understanding how difficult a pregnancy is so they can support their partners better," she said, noting for example how one can offer to pay for their partner's contraception.
"It's so important to be very disciplined about sex. We cannot be flippant about this because our circumstances here are really dire... You're lucky if you have the resources, but for the ordinary person, you may enjoy your sexuality, but always take care and be smart."