Bioethicist warns against growing ‘contraceptive mentality’

A BIOETHICIST has warned about the harmful effects of a “contraceptive mentality” on human health and society, amid Western pressure on developing countries to allow widespread use of birth control to control population growth.

“For me, using contraceptives as a way to restrict population can instill a contraceptive mentality and may actually be detrimental for the country in the long term,” said Dr. Patrick Moral, head of the Faculty of Medicine and Surgery Bioethics Department, in an interview with the Varsitarian.

“Once we view having a big family as a problem, we now develop a contraceptive mentality. The concept now is that if you have more kids, you have more mouths to feed,” he added.

In countries like Japan and Korea, the problem has manifested in the phenomenon called “Double Income No Children” or DINC.

DINC is a coined term used to describe a group of professional couples who have higher disposable incomes but do not have children. The solution of the Korean and Japanese governments was to give incentives to couples to have children. But the efforts were unsuccessful.

In 2002, 1,156,000 babies were born in Japan, 15,000 fewer than in 2001, when the fertility rate per woman fell to a record low of 1.33, according to official figures. Given its birth rate, Japan's population will decline from a peak of 127.8 million in 2006 to 105 million in 2050, and will decrease by half at the beginning of the next century.

Meanwhile, according to the US Census Bureau, in 2014, 47.6 percent of American women ages 15 to 44 have no kids. In China, the number of DINCs rose from 600,000 in 2006 to 750,000 in 2016.

“At the moment, the Philippines will still thrive until 2050 wherein there will still be many young people. However, if the country is to develop a contraceptive mentality, this will cause serious consequences to the economy,” Moral said.

Increased life expectancy combined with declining birth rates have caused many people to worry about the impact of an aging population.

“The driver of the economy is the younger generation. That means for every person who retires, younger generations in the workforce will have to pay for their pension,” Moral added.

The impact of contraceptives on the country, therefore, may leave an imbalance between the aging and the young population.

Contraceptives and abortifacients

A contraceptive is an agent that prevents fertilization of an egg, inhibiting pregnancy. A pregnancy exists once a fertilized embryo is implanted in the uterus. Prior to that implantation, there is no viable pregnancy.

“Contraception means to prevent impregnation, hence, there is nothing to abort if there is no pregnancy to begin with,” Dr. Vianca Kamille Villarica, a Thomasian alumna and an obstetrics and gynecology resident at Cardinal Santos Medical Center, said in an interview.

An abortifacient is an agent that disturbs an embryo after a pregnancy has been established.

“When these contraceptives are used after fertilization, it will irritate the environment and may cause the loss of the embryo. This is when a contraceptive can be an abortifacient,” Moral clarified.

Dr. Maria Esperanza de Guzman, another Thomasian gynecologist, said: “There are many kinds of artificial contraceptives ranging from hormonal to barrier methods. These contraceptives prevent the union of the sperm and egg. No union means no conception.”

Barrier methods like condoms, diaphragms and spermicides are designed to prevent sperm from entering the uterus.

Hormonal contraceptive like pills are different. They alter a woman's body chemistry and physiology by manipulating the release of hormones in the body, thereby preventing the release of the egg into the uterus.

The morning-after pill, in a similar fashion, is a form of emergency contraceptive that prevents one from becoming pregnant after unprotected intercourse. It delays ovulation and irritates the lining of the uterus to inhibit implantation. There are also surgical methods like vasectomy and tubal ligation.

Natural methods

Fertility awareness or Natural Family Planning (NFP) is a method of birth control that does not use drugs or devices. Fertility awareness involves being able to identify the signs of fertility during the menstrual cycle to plan or avoid pregnancy. When practiced properly, NFP is as effective as any artificial birth control method.

“Unlike artificial contraceptives, natural family planning requires both members of the couple to be aware. The woman becomes educated about her body and the man learns to control himself. It requires a partnership,” Moral said.

Moral added that Natural Family Planning is a necessity to educate every couple to be responsible parents.

By reducing unintended pregnancies and abortions as well as facilitating family planning, effective family planning provides health and social benefits to mothers and their children.

An estimated 600,000 women die each year of pregnancy-related causes. Ninety-nine percent of all maternal deaths occur in developing countries like the Philippines.

The most common causes of maternal deaths are postpartum bleeding complications from unsafe abortion, hypertensive disorders of pregnancy, postpartum infections and obstructed labor.

“When a woman suffers from medical problems such as diabetes or asthma, it may lead to a high-risk pregnancy. This is when contraceptives are medically needed,” de Guzman said.

Poorly timed pregnancies also contribute to high infant mortality rates. Family planning lets women plan their pregnancies so they can make sure the baby will get the best care before and after birth.

However, there are numerous risks in artificial contraceptive use. Common side effects include menstrual spotting, nausea, breast tenderness, headaches, weight gain, mood changes and missed periods.

“Hormonal contraceptives, like the pill, can form blood clots that are risky for some individuals because it changes the hormonal system of the body,” Moral said.

Users of the pill who smoke or have hypertension have a significantly higher risk of suffering stroke or heart attack.

Moral added that intrauterine devices or IUDs, which are barrier contraceptives, might cause infections.

“We have to discuss the reasons why we have to prevent pregnancy. It may be a societal reason, a public health concern like overpopulation, or for personal decisions on the part of a family,” he added.