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It is estimated that every year, between 400,000 and 800,000 illegal and unsafe abortions are performed in the country, and that of these, around 100,000 will result in hospitalisations. At least three women die every day due to complications from unsafe abortions. Pinsan, the Philippine Safe Abortion Advocacy Network, estimates that in 2020 1.26 million women and girls underwent unsafe abortions.

However, with a general election looming in May, there are signs the country’s attitudes may be beginning to change, albeit slowly, with various presidential candidates suggesting they might be open to reviewing the law.

That’s good news for women like Sarie, who currently must seek help in sketchy Facebook groups and online forums, and are forced to seek the services of backdoor abortionists because of the stigma – and illegality – surrounding the practice.

“I was very hesitant to ask my friends to look for abortionists around here. I didn’t want them to know, so I researched by myself,” Sarie said.

Women’s rights advocates hope that with political leaders signalling a willingness to relook at the laws, more light will be shone on an issue that remains largely taboo in society yet affects the health of hundreds of thousands of women. Data on abortion, for instance, is often outdated because much of the research is conducted by independent bodies and because women often do not feel safe telling their stories; indeed, many repress their memories of the procedure.

Jihan Jacob, senior legal adviser for Asia at the Centre for Reproductive Rights, said the “lack of access to emergency contraceptives, particularly for survivors of sexual violence” was just one of the ways vulnerable women were discriminated against.

“Women and girls still can neither freely seek nor immediately access abortion on any grounds. Fears of arrests and prosecutions are widespread given the regular media reports of women seeking abortions and people providing or assisting them being arrested,” she added.

Clara Rita Padilla, the spokesperson of Pinsan who drafted the Decriminalisation of Abortion Bill, said that she was glad abortion was becoming an election issue.

Where the candidates stand

At least three presidential candidates in the May 9 election have suggested they could review the law.

Ferdinand “Bongbong” Marcos Jnr, the front runner in the presidential election according to recent polls, has said he would back making abortion legal in “severe cases”.

Vice-President Leni Robredo, the lone woman running for the presidency, has said that as a devout Catholic she is “very conflicted” about her stance on abortion, but has also signalled a willingness to discuss its decriminalisation.

And Leody de Guzman, of the Partido ng Lakas ng Masa, has given his full backing to decriminalisation on the grounds that doing so would prevent the deaths caused by backstreet abortions.

However, their fellow candidates Isko Moreno, the Manila mayor, and Manny Pacquiao, the boxer-turned-politician who is a devout Christian, have both come out against decriminalisation, suggesting instead that the state should support women raising unwanted babies.

Another presidential candidate, Senator Panfilo Lacson, has said he needs more information before arriving at a decision.

Presidential candidates must tread a fine line in addressing the topic, balancing the views of the largely Roman Catholic population – who make up more than 86 per cent of the population, according to the Asia Society – with the views of pressure groups who argue that not only does the present situation threaten women’s safety, but counter-intuitively, works to increase the number of abortions.

These groups point to a comprehensive 2020 study in The Lancet, which found the abortion rate to be higher in countries that restricted access to abortion than in those that did not.

“High-income countries where abortion is broadly legal had the lowest unintended pregnancy rate, abortion rate, and proportion of unintended pregnancies ending in abortion,” according to the authors of the study.

Politicians also regularly face allegations that they themselves ignore the law. “The criminalisation of abortion is plain hypocrisy. Some of our lawmakers and famous politicians have used the abortion services of [providers] on our forum,” said a moderator of PinaysChoice, an online forum for Filipinos to discuss abortion.

Speakeasy

Sarie is among the many women to have sought help through PinaysChoice, a site formed in 2013 by health professionals, lawyers and programmers.

Moderators of the site emphasise that the forum isn’t meant to promote abortion but to offer a safe place where users can freely, safely and anonymously talk about their experience.

PinaysChoice aims to help women make informed decisions on sexual and reproductive health, and gives leads on where to find safe abortion services for those who do decide to undergo the procedure.

The forum has 8,374 members, mostly students, and around 500 active members.

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Before the pandemic, users were most active at the start of their college semesters – with many students falling pregnant during their holiday periods.

“The number of people looking for abortions fell because of the pandemic and we think it’s because of the online set-up of schools and work,” said a moderator. “However, during the pandemic, women with unwanted pregnancies were more at risk for not being able to seek safe reproductive health because they were kept at home ... They just resorted to home remedies such as overdosing on medicines and alcohol to cause unsafe abortions.”

PinaysChoice moderators said the worst part of the job was hearing about women who had died during the abortions. “Users [have] disappeared suddenly in the middle of their abortion experience-sharing,” a moderator said.

But what keeps moderators going is the knowledge they are helping women. “Philippine medical doctors are risking their names and licences just to save Filipina lives,” a moderator said.

Abortions via Facebook

Despite the law, and the stigma attached to abortion, it is relatively easy to find DIY kits on the internet.

A Facebook search on abortion pills can lead women to various accounts selling Cytotec. Before showing the results, Facebook advises the user to seek help for drug misuse.

Pills cost between 3,500 pesos and 6,800 pesos (US$67-130), depending on the stage of pregnancy. Sometimes, the Facebook pages of the firms selling the pills even include screenshots of their customers’ aborted fetuses to advertise their efficacy.

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Sarie herself searched for such abortion pills but did not trust the sellers enough to buy. “I wanted to ensure my safety, and after googling, I found a group of doctors who practise safe abortion,” she said.

Sarie expects to pay 60,000 pesos (US$1,160) for the whole procedure and – having found women in a similar position to her in Bacolod and Siargao – is hoping that they will qualify for a group discount.

“Never mind if it’s expensive, as long as a real doctor administers the procedure,” she said.

Catholic guilt

Charlotte*, a women’s rights advocate and health professional, said there was still a long struggle ahead to decriminalise abortion.

“Based on my experience as a health professional, women – even the ones who have had abortions – struggle to say they are in favour of abortion. It is because of the stigma that comes with it, on top of our country being devoutly Catholic,” she said.

Several women in urban poor communities told This Week in Asia they would be willing to keep their babies even if they had been raped – responses that put them in line with the policies advocated by the presidential candidates Moreno and Pacquiao. The women were also against abortion simply because it was illegal.

“I once accompanied a teenage survivor of rape who wanted to terminate her pregnancy because she could not carry the child. The doctors in the emergency room barely attended to her psychological needs and urged her to keep the baby,” Charlotte said.

She added that, given such ingrained attitudes, if abortion were to be decriminalised – either in whole or partly – there would also have to be a massive campaign educating the public and training health professionals.

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Sarie, who is Roman Catholic, said she wanted to decriminalise abortion but understood that people’s religious beliefs greatly shaped their decisions.

“Even if I’m in favour of abortion, it doesn’t mean that what I’m doing isn’t making me feel guilty,” she said.

Deep down, Sarie said she felt she had “sinned”. When she discovered she was pregnant, she went to church almost every day.

“Even though the procedure hasn’t taken place yet, I’m already asking for God and my child’s forgiveness,” she said. “But I am doing this so I could give my six-year-old the best life that I can give.”

Back in her hometown, Sarie and the three women she grouped up with to approach the abortion doctor are still waiting for their schedule.

“It will be done in a hotel room,” Sarie said.

*Names have been changed to protect identities