Saturday, June 23, 2018
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Medical Files

RH a personal, informed decision

Just when we thought everything would be smooth sailing after the enactment of the Reproductive Health Law by President Aquino a few days before Christmas, the raging debates have reemerged and it seems, we’re back to square 1.

This time, the venue of the debates is not in the plenary halls of Congress or the Senate but in the august halls of the Supreme Court, and in what could be one swift blow, 15 justices will decide the fate of the RH Law which took our senators and congressmen close to 14 years to deliberate on and pass.

After the law has been passed last December, the law’s critics, armed with 15 anti-RH petitions, won a temporary victory when the Supreme Court issued on March 19 a status quo ante order, preventing the government from implementing the law for 120 days starting March 30.


The same arguments pro and against the RH Law have been resurrected and it revolves around the question: “When does life really begin? Is it from the time of fertilization when the sperm ‘meets’ the female’s ovum or egg and they fuse as one cell, or is it at the time of implantation on the mother’s womb?” From this basic question arises the other contentious issues: “Are contraceptives abortifacients?” and “Are we violating the right to life mandated in our constitution?”

Our Supreme Court justices are supposed to give an expert opinion on this basic question of when life starts, a question which not even the most scholarly of scientists, biologists, and medical experts could reach a consensus on in many forums. The majority of these experts believe life begins during implantation, although the pro-lifers among them think it starts with fertilization.

Purely scientific postulate

With all due respect, our justices may indeed be scholars of the law, but the constitutionality of the RH Law being questioned hinges on a purely scientific postulate, and the assumption of a sound stand on it could only be attained through a clear and sound understanding of complex scientific data and ultramicroscpoic mechanisms which I myself, after being a doctor for 35 years, still find difficult to fully understand.

After sexual intimacy, fertilization happens first followed by implantation when favorable factors are present in the womb. Some birth control methods prevent fertilization but not implantation. This includes the natural family planning or rhythm method, condoms, diaphragm, cervical cap and spermicide agents. There should be no question about aborting life with these methods since neither fertilization nor implantation has occurred.

Other birth control methods target both fertilization and implantation, with some of them allowing fertilization but preventing implantation. The intrauterine device (IUD) causes an inflammatory reaction within the female organs and reduces the sperm’s ability to fertilize, and should it occur, the site of implantation in the uterine wall is not conducive to allow implantation.

There are so-called hormonal IUDs and other forms of hormonal contraception that prevent ovulation, make the cervical mucus so thick that it bars the entry into the uterus of the millions of sperm cells ejaculated after sexual intimacy; and should ovulation and fertilization occur, they also prevent implantation.

Experts’ stand


Various medical and scientific communities, including obstetricians and gynecologists who are supposed to be the experts on conception and pregnancy, have made their stand on this issue; and they state that pregnancy begins with implantation. This being so, the use of contraceptives which can prevent both fertilization and implantation, is not abortive.

On the other hand, pro-life groups believe that pregnancy begins with fertilization, and preventing its implantation on the womb is already considered abortive.

At the end of the day, one’s decision to use contraception or not is a purely personal one. Since even scholars and experts are divided on which postulate is scientifically, morally and ethically correct, whatever decision a couple makes should be based on their personal beliefs and conviction—with no one forcing a them what to do. What is important is that they are properly informed and educated, before making the decision.

And if only for this purpose of equipping women and couples with whatever information they need to know to arrive at a sound decision whether to use contraception or not, we should give the RH Law the break it deserves. Let not our justices be overwhelmed by contentious issues on saving sperms and ovums, or what fertilization and implantation imply. May they focus on the question of “when life starts” as the ordinary unschooled woman sees it to be, dictated upon by no one else and nothing else, except by her conscience.

Let it be; and let life be as enlightened couples believe and wish it to be.

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TAGS: beginning of life, Health, reproductive health issue
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