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The Philippines has one of the highest birth rates in the world with many families unable to support all their children.
Critics blame the government for its failure to promote and supply birth control. People & Power's Aloke Devichand reports from Manila.
Yolanda Nez needs two hands to list the names of her immediate family.
"My first born is Maria Christina," she says. "Next Mary Ann, Alexander, Mark Jospeh, April Joy, Lemuel, Jasmin and John Loyd. I have one grandchild named Akira."
In total there are nine children in the thirty-six year-old's home in the Philippine capital Manila as well as her husband.
Such are large families are common in the Philippines where two million children are born every year in a true population explosion.
Yolanda collapsed last month and doctors removed a tumor in her intestines, and told her it was essential to avoid physical exertion for at least a year.
She says with nine children to feed and her husband only working two days a week that will be impossible.
Like many families in the neighborhood, she did not intend to have such a large family. She says Lito Atienza, the former mayor of Manila, took the choice away from her.
Atienza issued an order eight years ago that effectively banned city-funded health centres from providing modern contraceptives such as condoms, birth control pills and sterilisation.
Yolanda says she asked for free contraceptives in the past from her local health centre but was refused because the centre came under mayoral jurisdiction.
|Families like Yolanda's are common in Manila
Her situation prompted Yolanda and 20 other families to file a lawsuit against the mayor’s office to get sexual protection devices back in the clinics.
They lost in the court of appeals but are now contemplating taking their case to the supreme court.
"Do we need to have more children begging in the streets?" asks 34-year-old Lourdes Osil who organised the petition. "Who can't be supported by their parents to go to school? Do they want that? Those who are able to use contraceptives can plan their families, so they can send their kids to school.
"I was planning to only have four children, instead I have seven."
Yolanda says such a large family and limited resources to provide for unplanned children has forced her to make tough decisions, particularly over her family’s education.
"One of the children is in high school," she says. "I've made the other stop because I can't afford to send them both. I don't know what kind of life they’ll have because they are uneducated."
Atienza, now the Philippines minister for the environment, defends his order, saying the aim was to prevent government funds and facilities being used for birth control purposes which goes against the protection of the value for life enshrined in the constitution.
"One [person] complaining, or several complaining, cannot compare to the thousands we have saved from the destruction of their reproductive systems, destruction of their values," he says.
The central government has been more intent on promoting natural methods of family planning then modern contraceptives, for which services are left largely to the whim of local councils.
"Who knows – the life you are preventing could be the saviour of not only the Philippines, but the whole of mankind"
Lito Atienza. Philippines environment minister
Atienza says rather than looking at new births as a problem his country's population growth makes economic sense.
"Where are the most successful economies that we can really model ourselves to? China is booming economically, India is booming on the other side.
"These are the most heavily populated countries in the world. And I believe their numbers have played a major role in their economic success."
However, a survey conducted in 2006 suggests that despite economic growth, poverty is on the rise in the Philippines and many economists believe rapid population growth is overwhelming the country.
"I think the economy and society would have done better, significantly better, if we had addressed this problem two or three decades ago," Ernesto Pernia, an economics professor, who used to teach economics to the current president of the Philippines, Gloria Arroyo.
Contraception and birth control are controversial issues in the Philippines.
The Catholic Church backed the uprising that ousted Joseph Estrada, and brought Arroyo to power in 2001 and although prominent bishops have been critical of alleged corruption in her administration, the church’s support has also helped the president withstand pressure to resign.
But critics say in return, the church has gained influence over certain policy areas and it has been particularly vocal about birth control.
The church believes that artificial means of birth control goes against natural law but a recent survey indicated that 70 per cent of Filipinos believe the government should be required by law to distribute contraceptives.
"We are a Christian nation to start with. We are a very strong Catholic nation. And we believe life comes from only source. The divine creator himself," Atienza says.
"So it's not within the powers of man to prevent the birth of a child simply because of material reasons. Who knows – the life you are preventing could be the saviour of not only the Philippines, but the whole of mankind."
The Philippines is a predominantly Catholic nation and discussions about contraception are often linked with the issue of abortion.
"A society that practices population control, birth control, anti-life attitude immediately thereafter transforms into an abortion demanding society," Atienza claims.
But despite the fact it is illegal abortion is already happening on a huge scale in the Philippines with the UN population fund estimating almost half a million terminations take place every year.
Women are often injured in the process by untrained practitioners, and have to visit regular hospitals for emergency treatment.
"Minor complications will be bleeding, infection, GI disturbances." Dr. Kay Panlilio, from the Dr Jose Fabella Memorial Hospital.
She says many of the women she has treated have risked an illegal abortion because they simply could not provide for another child.
|Atienza says a growing population
is good for the economy
"We do favour family planning. Oral contraceptives will definitely help in reducing abortions."
A group of federal politicians has now submitted a bill to the Philippines Congress. If passed it would compel the national government to promote contraceptives.
"Everyday, every week – though a few may fall by the waste side into the hands of the bishops – more and more members of the house are coming on, not only to say I want to vote for this bill, but I want to sign on as a co-author," says Risa Hontiveros-Baraquel, a popular news anchor turned politician, who is at the heart of this movement.
As momentum behind the bill has grown, so too has the opposition of the Catholic Church.
"They have actually been sustaining a quite aggressive campaign against the bill," Hontiveros-Baraquel says.
"Immense pressure has been brought to bear, especially on district congresspersons. There have been noises made by denying the Catholic authors of the bill Communion in mass."
While politicians and the church continue to clash, some ordinary women have already reconciled any conflict between their faith and birth control.
"It's a sin against God to use artificial contraception because you're killing a person. You're killing a child," Yolanda Naz says.
"I think it's more sinful to have children and not be able to provide their needs."
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