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| Human ovum examined fresh in the liquor folliculi. Source: http://en.wikipedia.org/wiki/File:Gray3.png |
by Alan S. Cajes
The
Responsible Parenthood and Reproductive Health Act of 2012 (RPRHA) or R.A. No.
10354 “recognizes and guarantees the human rights of all persons” (Sec. 2)
pursuant to the duty of the State to “equally protect the life of the mother
and life of the unborn from conception” (Sec. 12, Art. II, 1987 Philippine
Constitution). It defines an abortifacient as “any drug or device that induces
abortion or the destruction of a fetus inside the mother’s womb or the
prevention of the fertilized ovum to reach and be implanted in the mother’s
womb upon determination of the FDA” (Section 4a).
The
RPRHA also defines modern methods of family planning as “safe, effective,
non-abortifacient and legal methods, whether natural or artificial, that are
registered with the FDA, to plan pregnancy” (Sec. 4(l)). In Sec. 9, the law
mandates the National Drug Formulary to “include hormonal contraceptives,
intrauterine devices, injectables and other safe, legal, non-abortifacient and
effective family planning products and supplies”. The same provision emphasizes
that the concerned offices “shall not purchase or acquire by any means
emergency contraceptive pills, postcoital pills, abortifacients that will be used
for such purpose and their other forms or equivalent.” In Sec. 19, the FDA is
mandated to “issue strict guidelines with respect to the use of contraceptives,
taking into consideration the side effects or other harmful effects of their
use”.
First Point: The RPRHA
recognizes that life begins at fertilization and equates conception with
fertilization.
That
there is an ongoing debate on the question of when life begins is true. But the
law concedes that conception is fertilization. This is quite clear in the
provision that excludes abortifacients among the family planning products and
supplies. Abortifacients include those drugs or devices that prevent the
implantation of a fertilized ovum. This view is different from that which equates
conception with implantation.
Conception
as implantation is prevalent in the medical community, at least in the United States :
“Pregnancy is established when a fertilized egg has been implanted in the wall
of a woman's uterus. The definition is critical to distinguishing between a
contraceptive that prevents pregnancy and an abortifacient that terminates it.
And on this point, federal policy has long been both consistent and in accord
with the scientists: Drugs and devices that act before implantation prevent,
rather than terminate, pregnancy.”[1]
However,
this understanding of conception as implantation is not clearly shared by other
states, which equate conception with fertilization. A study pointed out that: “At
the state level, however, definitions of pregnancy—generally, as part of larger
measures enacted to regulate abortion or prescribe penalties for assaulting a
pregnant woman—vary widely. Some of these laws say that pregnancy begins at
fertilization, others at implantation. Several use the term
"conception," which is often used synonymously with fertilization
but, medically, is equated with implantation.[2]
In
brief: “According to both the scientific community and long-standing federal
policy, a woman is considered pregnant only when a fertilized egg has implanted
in the wall of her uterus; however, state definitions of pregnancy vary widely.”[3]
A
statement from the American
College
“To
be sure, not every act of intercourse results in a pregnancy. First, ovulation
(i.e., the monthly release of a woman's egg) must occur. Then, the egg must be
fertilized. Fertilization describes the process by which a single sperm
gradually penetrates the layers of an egg to form a new cell ("zygote").
This usually occurs in the fallopian tubes and can take up to 24 hours. There
is only a short window during which an egg can be fertilized. If fertilization
does not occur during that time, the egg dissolves and then hormonal changes
trigger menstruation; however, if fertilization does occur, the zygote divides
and differentiates into a "preembryo" while being carried down the
fallopian tube toward the uterus. Implantation of the preembryo in the uterine
lining begins about five days after fertilization. Implantation can be
completed as early as eight days or as late as 18 days after fertilization, but
usually takes about 14 days. Between one-third and one-half of all fertilized
eggs never fully implant. A pregnancy is considered to be established only after
implantation is complete.”[4]
In
other words, fertilization occurs when the male sperm combines its DNA with
that of the female egg. Its process is completed in about 18 hours and results
in a zygote. The zygote will mature as it travels to the uterus. After about 6
days, the zygote becomes a blastocyst, which, in the process of implantation,
attaches itself to the lining of the uterus. Accordingly, implantation “can be
prevented by regular use of birth control pills or by taking emergency contraception pills.”[5]
Second Point: The challenge is
determining which of the modern methods of family planning are safe, effective,
non-abortifacient and legal.
Under
the RPRHA, the allowed modern methods of family planning are those that are
safe, effective, legal and prevent the union of the male sperm and the female
egg or those that suppress ovulation and inhibit sperm penetration. The law,
therefore, prohibits drugs and devices that prevent implantation, i.e., disallowing
the formed zygote to attach itself to the lining of the uterus.
The
problem, of course, is that at least one combined oral contraceptive has other
“possible mechanisms” that “may include…endometrial changes that reduce the
likelihood of implantation.[6]
According to the American College of Obstetricians and Gynecologists, “Food and
Drug Administration–approved contraceptive drugs and devices act to prevent
pregnancy in one or more of three major ways: by suppressing ovulation, by
preventing fertilization of an egg by a sperm or by inhibiting implantation of
a fertilized egg in the uterine lining.”[7]
This
problem is compounded by other claims stating that the use of “birth control
pill before or after a pregnancy is confirmed will not abort the fetus. Oral
contraceptives don't cause miscarriages because they do not have any effect on
a fertilized embryo. Birth control pills — generally made of estrogen and
progestin (synthetic progesterone) — essentially prevent pregnancy by
inhibiting ovulation and/or causing the cervical mucus to thicken. It is also
unlikely that taking the pill will have any effect on fetal development.”[8]
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