Rovelie Zabala is in an advanced stage of pregnancy. She is expecting her tenth child, a surprise conceived during one of the strictest confinements in the world, that of the Philippines.
During our conversation, the 41-year-old leans at an awkward angle, leveraging her back to carry her ninth calf in her arms.
“Carl, Jewel, Joyce…” As Rovelie names her children, 6-year-old Charlie throws a disgusted look at her mother. “Sorry, his name is Charlie,” Rovelie says innocently.
Rovelie already had seven children before she knew about family planning , but this latest pregnancy occurred during lockdowns, with soldiers patrolling the streets in armored vehicles, police checkpoints to restrict movement with permission for only one family member to leave to buy food.
The lockdown also meant that hundreds of thousands of women have not had access to contraception, resulting in unplanned pregnancy situations like Rovelie’s across the country.
Indeed, there are an estimated 214,000 additional, unplanned babies for next year, according to projections from the Population Institute of the University of the Philippines and the UN Population Fund. These babies will be born in hospitals that are already overwhelmed with 1.7 million births annually, mostly in families with financial difficulties.
Because the pandemic is not the only reason the Philippines is facing a population crisis. A closer look reveals a problem that has been brewing for years.
The capital of the Philippines is a city about to burst, with 13 million people wedged between Manila Bay and the Sierra Madre mountain range. On average, more than 70,000 people live crammed into each square kilometer, according to 2015 data.
Overcrowding can be felt everywhere, from traffic congestion to prisons, where inmates sleep like sardines in cells that are three times their capacity.
And it is the poor who live in the most overcrowded places, where some are reduced to eating meat recovered from garbage dumps .
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Some experts argue that part of this poverty is directly related to the country’s high birth rate, while research indicates that a fertility rate of almost two children per mother – that is, a population that neither grows nor decreases – promotes the development of a country by reducing the number of people born into poverty.
In turn, a more refined population receives a larger portion of the national budget, improving the opportunities for support for all.
The government of the Philippines also recognizes that. Since the 1960s, he has worked to reduce the fertility rate with some success. So while the population may have tripled from 35 million to 110 million today, the rate has dropped from 6.4 in 1969 to 2.75 in 2020.
However, they have been much less successful in the same period than Thailand, a neighboring nation in Southeast Asia. That Buddhist country reduced the fertility rate from 5.8 children per mother in the late 1960s to 1.5 in 2020, according to UN data.
Its poverty rate is currently 10%, compared to the Philippines’ 17%.
But why such a difference? In part it is due to the highly influential Catholic Church in the Philippines, which leads the opposition against contraception by encouraging procreation with the verse: “Be fruitful and multiply.”
In a video call, Father Jerome Secillano of the Philippine Conference of Catholic Bishops notes that they are “naturally” opposed to contraception.
“It is part of the mandate not to allow these so-called reproductive pills … the so-called ‘moral suasion’ is there to remind people of the moral impact, the negative impacts it will have on us. But if people don’t adhere to our call, so be it”.
Despite the Church’s doubts, the Philippines had been managing to handle things. Ernesto Pernia, former Minister of Socioeconomics of President Rodrigo Duterte, argues that recent achievements in poverty reduction are directly due to greater government implementation of the Reproductive Health Law of 2012 (LSR) , which provided more free sex education and contraceptives for the poor.
“We will lose the full four years that we have been working on the program,” says Antonio Pérez, executive director of the Population and Development Commission (POPCOM). “We will have more unplanned pregnancies, at this moment the rate is three out of 10 are unplanned, it could rise to half of the pregnancies next year, in the worst case.
The staff of the Dr José Fabella Medical Hospital is used to being busy. In 2012, the hospital attended 120 deliveries a day , which led to its former maternity ward being dubbed “The Baby Factory.”
Things have improved, with the number falling by almost half since the passage of the LSR in 2012. But now they are preparing for the “baby boom” (birth explosion).
Upon entering Pavilion One, we are greeted by a cacophony of childish crying.
A room, the size of half a soccer field, has rows of metal-framed cots, arranged in pairs. The fans hum but hardly relieve the heat and humidity. Mothers, dressed in birthing gowns, masks and masks, lull their newborns.
“For now, there are only about three or four patients sharing two beds together,” says Dr. Diana Cajipe. “Unfortunately we don’t have space, many more patients will come. We are already well over the capacity of the hospital. It can go up to six or seven per pair of beds .
But the virus is not just causing a numbers problem: Last month the hospital had to temporarily close after seven residents and a nurse tested positive for COVID-19. In such tight spaces, it is not difficult to see how quickly the virus would spread.
The hospital administration hopes that a new building will provide more beds, but it is not finished yet.
Covid-19 has also put enormous pressure on the limited national budget, which will cause more problems, Pernia notes.
“We will need at least 2,000 million pesos (US $ 41.5 million) a year to fully implement the population program,” he says. “But the budget given to the population commission is about 500 million (US $ 10.4 million), about a quarter of what is needed.”
The president is a family planning enthusiast, Pernia says, but is “more focused on drugs and corruption,” alluding to the bloody and violent measures against drug users and traffickers.
The LSR has also faced lawsuits from organizations affiliated with the Catholic Church, with the result that the morning-after pill remains illegal and family planning denied to minors without parental permission.
It should be noted that the Philippines has the second highest rate of teenage pregnancy in Southeast Asia. The pandemic could see that rate rise to 20%, POPCOM warns.
While individuals and organizations discuss poverty, Revelie knows no more than that. He lives in Baseco, Tondo, one of the most densely populated places in the world.
But you also know the Catholic Church and its teachings on contraception and against the termination of pregnancy.
“When I was a month pregnant, I told my partner that I wanted to have an abortion because life is difficult,” he admits. “But he assured us that we could survive. So I continued instead of committing a sin.”
Wiping her tears she tells us that almost three months ago they separated and now she worries about the options her children will have.
“That is my main concern, if I will be able to sustain her education,” says Rovelie