By Kristelle Ann A. Batchellor
HARMFUL to women, harmful to children.
This was how doctors described hormonal contraceptives that will be distributed nationwide using taxpayers’ money, once the controversial “reproductive health” (RH) bill hurdles Congress.
For the unborn, the devastating effects stem from the fact that contraceptives do not always prevent ovulation. A woman could still be under a contraceptive regimen not knowing that she had already conceived.
In this case, contraceptives will affect the development of an infant particularly during the formation of the organs, said Dr. Edna Monzon, bioethics department chair of the Faculty of Medicine and Surgery.
“[The contraceptives] will have congenital effects to the baby,” Monzon told the Varsitarian.
Dr. Rene Bullecer, director of Human Life International-Filipinas, echoed Monzon, saying that less than six percent of women still ovulate despite use of contraception—a phenomenon called “breakthrough ovulation.”
“The newly conceived child, which is now implanted in the uterus, is abnormally exposed to a very high level of estrogen [due to contraceptives],” he said in an interview.
Bullecer added that the fetus is most fragile and vulnerable to fetal abnormalities during the first three months of conception.
Citing a study by Ohio State University in 1995, Bullecer said pre-natal exposure to female hormones could lead to 26 percent and 33 percent chances of major and minor malformations, respectively.
Side effects
Monzon noted that the RH bill is being touted as a measure for the welfare of women and children by making contraceptives widely available. But the side effects of synthetic hormones outweigh the benefits.
“The users are not being informed about the possible side effects of all these methods,” she said. “There are many adverse effects,” she said.
For Dr. Angelita Aguirre, Faculty of Medicine and Surgery professor, the RH bill contradicts the original Hippocratic Oath, under which doctors promise to save lives and practice medicine ethically and honestly.
“They keep on talking that this is for the benefit of women but in fact, all of these contraceptives are potentially harmful to them,” Aguirre told the Varsitarian.
Dr. Josephine Lumitao, another Medicine professor, said contraceptives are not medicines but agents that wreak havoc on the normal reproductive functions of women.
“The fertility of a woman is a normal expression of her healthy reproductive system and not a disease or injury that needs treatment,” she said in an email to the Varsitarian.
Lumitao explained that contraceptives disrupt the natural process of a woman’s reproductive cycle by three mechanisms— prevention of ovulation, or the release of the egg cell; thickening of the cervical mucus, which retards sperm transport and penetration; and production of an endometrial bed with exhausted and atrophied glands, which are not receptive for blastocyst implantation.
The third mechanism expels a fertilized ovum, an early form of abortion that runs afoul of the 1987 Constitution, which protects human life from conception.
“How can these effects be considered as benefits when they are not therapeutic?” Lumitao asked.
Cancer, heart disease
Meanwhile, Bullecer said it has been scientifically proven that contraceptive use could cause cancer and other illnesses, citing the Physicians’ Desk Reference, the bible of every physician.
Dr. Buena Apepe, obstetrics and gynecology specialist at UST Hospital, said studies show that women who use contraceptives are at risk of breast cancer, cervical cancer, and benign liver tumors.
Last year, the World Health Organization’s International Agency for Research on Cancer released a report retaining “oral combined estrogen-progestogen contraceptives” on the list of “Group 1 carcinogens.” Group 1 carcinogens have the highest level of evidence of cancer risk.
“There is sufficient evidence in humans for the carcinogenicity of oral combined estrogen-progestogen contraceptives,” the report said. “Oral combined estrogen-progestogen contraceptives cause cancer of the breast, in-situ and invasive cancer of the uterine cervix, and cancer of the liver.”
In a study by the Fred Hutchinson Cancer Center (FHCC) in Seattle, Washington published last April, women of age 20-44 who used Depo-Provera, an injectable type of contraceptive, were found to have increased chances of having breast cancer.
Dr. Christopher Li, breast cancer epidemiologist at FHCC and leader of the study, said the adverse effects of the contraceptive should not be ignored.
“Our findings emphasize the importance of identifying the potential risks associated with specific forms of contraceptives given the number of available alternatives,” Li said.
Apepe added that contraceptives could also cause stroke, blood clots, and jaundice.
She cited findings of a Dutch study that women taking oral contraceptives had a five-fold increased risk of blood clots compared with non-users. The risk differed according to the type of progestin.
Meanwhile, a study by Mahyar Etminan, et. al. of the University of British Columbia found that women taking ethinyl estradiol combined with one of seven progestins between 1997 and 2009 had a greater risk of developing gallstones.
Bullecer also said the American Heart Association had found that oral contraceptives increased the risk of heart diseases by 20-30 percent for every 10 years of usage. This could lead to heart attacks, strokes, thromboembolism, and pulmonary embolism.
RH bill supporters have downplayed the health risks of hormonal contraceptives by saying that even regular medicines have side effects.
Ma. Graciela Gonzaga, dean of the Faculty of Medicine and Surgery, agreed that all medications, including paracetamol, have adverse effects.
“But remember, when you’re using paracetamol, you’re treating an illness,” she told the Varsitarian. “However, with contraception, you’re not treating any disease.”
‘Undemocratic’
Gonzaga said maternal mortality, which will purportedly be reduced by the RH bill, can be solved by improving the country’s health facilities and sending more doctors to rural areas.
“How many obstetricians are in the barrios to deliver [babies for] patients who are pregnant? Puro midwives lang ‘yon. It (RH bill) will not solve the problem,” Gonzaga said.
Medical practitioners are also concerned over provisions that may violate their conscience.
Section 28 of the RH bill states that it respects “the conscientious objection of a healthcare service provider based on one’s ethical or religious beliefs,” yet it requires doctors to refer patients demanding “emergency” RH services to other doctors, or face penalties.
Monzon said the clause renders the RH bill unconstitutional, because it does not respect religious beliefs and conscientious objection.
“If I know it is wrong, why would I let others do it?” she said. “And if I don’t refer the patient to another doctor, I would be imprisoned, and would have to pay P100,000.”
Likewise, Aguirre said RH bill would coerce doctors to act against their beliefs.
“So where is freedom there?” she said. “If I refer [my patients to other doctors], I would be a cooperator to what is wrong.”
Gonzaga warned that the “undemocratic” clause could lead to the exodus of good doctors.
“From a moral or economic standpoint, Filipinos would be the losers [if the RH bill were passed],” Gonzaga said.
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