Devices of Death: Privileged speech of Cong. Karlo Nograles during the RH Bill hearing

From Mind Talk:

DEVICES OF DEATH

By: Cong. Karlo Alexei Nograles
Representative, Davao City, 1st District
(Privileged Speech delivered during the RH Bill Hearing, June 8, 2011)

Madam Speaker, Majority Leader, dear colleagues, good day.

I rise today on a subject that demands this august Chamber’s gravest concern: the dismal failure of a major government agency to discharge its mandated function in law to protect and promote the health of Filipino mothers, shield and protect motherhood from peril, and safeguard their maternal functions.The regulation of providers of drugs and medicines is reposed bylaw, R.A. No. 3720, the Food, Drug, and Cosmetic Act in the Food and Drug Administration or FDA, a regulatory agency under the Department of Health. It is mandated to ensure the safety, efficacy and good quality of all food and drug products being made available to the general public pursuant to Section 2 which provides: “It is hereby declared the policy of the State to insure safe and good quality supply of food, drug and cosmetic, and to regulate the production, sale, and traffic of the same to protect the health of the people.”

On April 19, 1992, the Consumer Act of the Philippines, R.A. No. 7394, went into effect. According to Article II, “It is the policy of the State to protect the interests of the consumer, promote his general welfare and to establish standards of conduct for business and industry. Towards this end, the State shall implement measures to achieve the following objectives: a) Protection against hazards to health and safety.”

After all, there is a clear and express constitutional mandate that: “The State shall protect consumers from trade malpractices and from substandard or hazardous products,” Article XVI, Section 9 of our Constitution.

Pursuant to Article VI of the Consumer Act, it is the Department of Health, through the Food and Drug Administration, that is responsible to the public with respect to drugs, devices and substances.

Section 4 of the Consumer Act defines “drugs” to mean articles recognized in the current official United States Pharmacopeia-National Formulary, official Homeophatic Pharmacopeia of the United States, official National Drug Formulary, or any supplement to any of them; and number two, articles intended for use in the diagnosis, cure, mitigation, treatment or prevention of disease in man or other animals.

Among the drugs, Madam Speaker, that fall under this definition are the oral contraceptives administered to women and mothers, the injectible contraceptive Depo Provera and the so-called “morning-after pill”.

The same section defines a “device” as an instrument, apparatus, implement, machine, contrivance, implant, in vitro reagent, or other similar or related article, including any component, part or accessory which is recognized in the official United States Pharmacopeia National Formulary or any supplement to them; two, intended for use in the diagnosis of disease or other condition or in the cure, mitigation, treatment or prevention of disease in man or other animals.

Among the devices administered to women and mothers as contraceptives are the Intra-Uterine Device or IUD, and in recent times, the suction device known as the Manual Vacuum Aspirator or MVA.Both are allowed to be used and actually form part of the family planning devices used by the Department of Health.

We shall now see, Madam Speaker, in what manner these contraceptive drugs, substances and devices are supposed to cure, mitigate, treat or prevent disease in women and mothers.

First, the oral contraceptives. The so-called high-dose contraceptive pills bring about changes in the environment of the endometrium, that is the uterine lining of the woman, making implantation more difficult. When the high-dose pill functions via this last mechanism, it is an abortifacient if the woman experienced a “breakthrough” ovulation.

These pills have, for the most part, been pulled from the United States market due to their dangerous side effects. Naturally, they are still dumped relentlessly on poor women in developing countries.

The low-dose biphasic and triphasic pills on the other hand function in essentially the same manner as the high-dose pill. However, a much higher percentage of ovulation occurs in women who use the low-dose pills. This means that women who use these pills frequently conceive,and that low-dose pills prevent implantation of the new human individual, thereby acting more often as true abortifacients.

The Mini-Combination Pill functions by inhibiting ovulation and causing changes in the cervical mucus. However, their primary mode of operation is abortifacient, because they prevent implantation by causing changes in the endometrium.

Then, of course, there is the Mini-Pill. The primary mechanism of these pills have not been pinpointed, although women who use them almost always ovulate. Therefore, these pills function primarily as abortifacients.It is known that pills which contain only progestin alter the cervical mucus. They also interfere with implantation by affecting the endometrium and suppressing ovulation in some patients by reducing the presence of follicle-stimulating hormone(FSH).

This mechanism, Madam Speaker, is confirmed by the United States Food and Drug Administration (FDA), which stated that “Progestin-only contraceptives are known to alter the cervical mucus, exert a progestinal effect on the endometrium, interfering with implantation, and, in some patients, suppress ovulation.”

The manufacturers of the minipills also acknowledge this mode of action. For example, Syntex Laboratory spokesman, Rush Wilks, announced that “its progestin-only pill “… did not interfere with ovulation… It seems to affect the endometrium so that a fertilized egg cannot be implanted.”

In other words, Madam Speaker, the pill is now truly “birth control” not conception control, as was originally intended.

According to United States Federal courts, the birth control pill has been classified as “unavoidably unsafe.” This means that, implicit in a woman’s consent to use the pill, even if she is not entirely informed of its dangers, is an acknowledgment of physical risk.

This legal classification means that women damaged by the pill have a much harder time recovering damages. Dr. John Hildebrand, an expert in the field, estimates that more than 500 women die every year because of pill-induced effects. This startling number is confirmed by figures provided by the Alan Guttmacher Institute and one of the foremost abortionists in the United States, Warren Hern.

It is ironic, Madam Speaker, that the same pill pushed so hard as part of the supposed solution to “excessive illegal abortion deaths” now kills five times as many women per year as illegal abortions themselves did before Roe v Wade.

The most dangerous and well-documented side effects commonly associated with the pill are heart attacks and strokes. The eight-year Nurse’s Health Study at Harvard Medical School found that pill users are 250% as likely to have heart attacks and strokes than those who do not use the pill because the pill excessively increases blood clotting ability.

Now, let us talk about breast cancer. The Fertility and Maternal Health Drugs Advisory Committee is a panel of medical experts that meet to advise the commissioner of the United States Food and Drug Administration.

The committee evaluated a study by Dr. Clifford R. Kay of the Royal College of General Practitioners of Manchester, England. Kay studied 46,000 women,half of which were pill users and half of which were non-users. He found that pill users were more than three times more likely to develop breast cancer than non-users between the ages of 30 and 34.

A second study by researchers at the Boston University School of Medicine, the University of Pennsylvania and New York’s Memorial Sloan- KetteringCancer Center completed in 1988, showed that the longer women took the pill, the greater their chances of contracting breast cancer. The risk of developing breast cancer was found to be twice as great by age 45 for women who had used the pill for less than 10 years and four times as great for women who had used the pill for more than 10 years.

Now, another type of drug, Madam Speaker, is themorning-after pill or emergency contraception. Postinor Levonorgestrel believed to act to prevent ovulation, fertilization and implantation. This was approved for sale and distribution in the Philippines by the Bureau of Food and Drugs as an emergency contraceptive. By reason of its abortifacient action, Abay Pamilya Foundation asked the Department of Health on May 8, 2001 to cancel its product registration.The public hearings conducted by the DOH revealed the following uncontroverted data about the morning-after pill, Postinor:

1. Levonorgestrel has a high pre-implantation emergency abortifacient action. According to authorities cited by the petitioners in DOH and based on learned medical treatises, the Levonorgestrel approach clearly has an anti-developmental impact on the endometrium of the woman.Work by Kubba, et. al.(1986), specifically referred to Levonorgestrel noting itsability to change the nature of the hormonal receptors within the endometrium.

Dr. Rabone (1990), reported that Levonorgestrel caused a reduction on the number of estrogen and progesterone receptors within the endometrium. The concentration of these receptors is critical for the normal development of endometrium to a stage that will support implantation.

Simon and co-workers have also reported that altered estradiol/ progesterone ratios or E2/P which will occur with high doses of Levonorgestrel are associated with the impairment of endometrial receptivity.

2. Inhibition of implantation. The administration of relatively large doses of estrogen or “morning-after” pills for several days beginning shortly after unprotected sexual intercourse usually does not prevent fertilization but often prevents implantation of the blastocyst. Postconception administration of hormones prevent implantation of the blastocyst and is sometimes use in cases of sexual assault or leakage of acondom.

3. The abortifacient action of Levonorgestrel was not denied by its Philippine importer. The drugs inserts submitted by the importer-distributor, Euro-Generics International, Philippines, reads: Clinical Pharmacology, Levonorgestrel is believed to act to prevent ovulation,fertilization and prevent implantation.

4. Gedeon Ritcher Ltd., the drugs manufacturer, was aware of the moral and ethical implications of Levonorgestrel. The 2001 petition in the DOH, citing Thaler Gy, stated, “Gy. Thaler of Gedeon Richter, Limited, the manufacturer of Postinor (Levonorgestrel 0.75 milligrams), has unwittingly acknowledged the seriousness of this debate by noting that the promotion and use of the morning-after pill involves ethical and moral questions.”

Thus, the morning-after pill, Levonorgestrel, whether marketed as Postinor or some other brand, and any estrogen or progesterone with an abortifacient action is not registrable under Philippine law.

However, Madam Speaker, Levonorgestrel Mirena, as an IUD or intra- uterine device, can be ordered by an OB-gynecologist through the medrep. And Levonorgestrel is also available in several other names here in the Philippines, namely: Logynon, Nordet, Charlize, the Trust pill and Lady.These are all available in your local drugstore.

Now, Republic Act No. 5921, or an Act Regulating the Practice of Pharmacy and Setting Standards of Pharmaceutical Education in the Philippines, provides in Section 37 that “No drug or chemical product or device capable of provoking abortion or preventing conception as classified by the Food and Drug Administration shall be delivered or sold to any person without a proper prescription by a duly licensed physician.”

The reality, however, the reality, however, Madam Speaker, is this—contraceptive pills can be purchased by any person regardless of age, sex or civil status over the counter. I have personal experience purchasing contraceptive pills myself without prescription, Madam Speaker, when I purchased several birth control pills on May 25, 2011 and again on June 2, 2011 just to prove how easy it is to purchase these pills.

More dangerously, Madam Speaker, in the May 30, 2011 Senate committee hearing, last week, that discussed three Senate bills protecting the unborn, former DOH Secretary Alberto Romualdez stated, under oath, that contraceptive pills can also be ingested as emergency contraception by altering the dosage. Let me just say this, Madam Speaker, birth control pills, purchased very easily without prescription, can be used for abortion by just doubling the dosage for a period of five days.

Let me go to another drug, the Depo-Provera injectible. Depo-Provera was banned as a contraceptive in the US in 1978. While this is so, it is endorsed by agencies such as the International Planned Parenthood Federation and the World Health Organization for use in the Third World. But our Consumer Act, our Consumer Act states in Article XXXIII that “Banned or severely restricted drugs for health and safety reasons in their country of origin shall be banned and confiscated, or its uses severely restricted, whichever is appropriate, by the Department. The Department shall monitor the presence in the market of such drugs and cause the maintenance and regular publications of an updated consolidated list thereof.”

Madam Speaker, Depo-Provera is imported, available and administered widely in the Philippines.

But warnings on its safety are not unknown to the Department of Health: Loss of bone mineral density, thromboembolic disorders, cancer risks, ectopic pregnancy, anaphylaxis and anaphylactod reaction, convulsions, bleeding irregularities, excessive weight gain, fluid retention—these are among the drug’s dangerous effects. Banned in the United States, Depo-Provera can be purchased in your favorite drugstore for P117.00. And it goes by the names, Depotrust, Lyndavel, and Provestin.

Apart from the drugs, let’s now talk about devices; namely, the intrauterine device and the manual vacuum aspirator.

First, the IUD. What is an intrauterine device? The intrauterine device is a foreign body made of a non-reactive plastic such as polyehtylene inserted in the uterus of the woman to prevent implantation of the developing human being. Some IUDs include active chemicals such as progesterone or copper which slowly diffuse into the uterus for an enhanced abortifacient effect. How do IUDs work?The different IUDs have different modes of action.They prevent sperm from fertilizing ova, release ions, primarily copper, that interfere with fertilization.They thicken the cervical mucus and inhibits sperm capabilities. These are all contraceptive effects. But IUDs also irritate the endometrium or the lining of the uterus of the woman and make it inhospitable for the blastocyst or the very early developing human being. Thus, an abortifacient effect. There is some disagreement among medical authorities over the contraceptive effects of IUDs, but these experts do agree that IUDs prevent implantation.

The American Medical Association’s Committee on Human Reproduction has said that, “The action of IUDs would seem to be a simple local phenomenon. That these devices prevent implantation of an already fertilized ovum has been accepted as the most likely mechanism of action.”The U.S. Food and Drug Administration, FDA, which studies birth control methods before releasing them to the market, has observed that “IUDs seem to interfere in some manner with the implantation of the fertilized egg in the lining of the uterine cavity. The IUD does not prevent ovulation.”

The other device as I mentioned, is the manual vacuum aspirator,known more popularly as the MVA. This is a device for uterine evacuation.Meaning, suction of the contents of the womb. The MVA uses an aspirator with a cylinder, a plunger, and a bulb attached to the cannula with one or two apertures. According to literature describing and marketing the device, the indications for uterine aspiration using this device are : number 1, endometrial biopsy; number 2, treatment of incomplete abortion; and number 3, Madam Speaker, first-trimester abortion.

If the device is an instrument to procure an abortion, then it falls under the definition of an imminently hazardous product defined in Section 4 of the Consumer Act Section 4 of the Consumer Act, to wit, and I quote: “Imminently hazardous product means a consumer product which presents an unreasonable risk of death, serious illness or severe personal injury.”

A device of death, the MVA is purchased by local DOH agencies in some local government units.

In a case study in the Philippines entitled: Planning for a Sustainable Supply of Manual Vacuum Aspiration Instruments, a Guide for Program Managers, it appears that in this country, the key partners in the importation and use on the abortive device MVA are the DOH, Pangasinan Province, the NGO EngenderHealth, the local commercial distributor, the Packcard Foundation, and U.L.S. A.I.D. The local direct contractor of the MVA in the Philippines is BDM Enterprises.

I therefore ask, Madam Speaker, do these oral contraceptives, the morning-after pill, depo-provera, the IUD and the manual vacuum aspirator, cure, mitigate, treat or prevent disease? Are they safe for women and mothers?

Madam Speaker, no government can bargain away the public health. The people themselves cannot do it, much less their servants. And as public officers, our health officials can only execute the law, not disobey it. How can our government officers, whose sworn duty is to protect and preserve the health of our countrymen, allow such hazardous drugs and devices, abortifacients and carcinogens to be openly sold and distributed in our country?

I therefore call on this House to initiate an immediate investigation on the serious failure of our health agencies in exercising its strict mandate to defend and safeguard the health of Filipinos, particularly our women, in accordance with the letter, spirit and intent of our laws.

Thank you, Madam Speaker. Thank you, dear colleague.

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Draft for an anti-RH Bill: Maternal Health Bill of 2011

The Catholic Church and anti-RH bill lawmakers have always been on the defensive after years of siege by the proponents of the RH Bill. The RH bill forces will never tire: they have the funding of multinational pharmaceuticals who make contraceptives, abortion companies like Planned Parenthood, and UN commissions who push for reproductive health.

What the anti-RH Bill forces need is a counter-attack on the RH-Bill forces’ flanks.  We must fight the RH Bill by proposing a contrary bill (read the parable of the unclean spirit (Lk 11:24-26)).  The Reproductive Health Bill is a misnomer and a lie: the bill does not concern reproduction but contraception and contraceptives endanger the woman’s health.  The Maternal Health Bill that I propose is really for maternal health, which concerns both the mother and the child:  the word “maternal” does not only refer to the woman but also to her child, for how can a woman be a mother, a “mater”, if she has no child?  A woman’s right over her body should never trample on the rights of the child in her womb over his body.

This anti-RH bill shall divert the time and resources of the pro-RH forces, for one cannot fight at the same time both the impregnable wall that is the Catholic Church and the new menace that may spell the doom of RH in the Philippines.  (News Flash: Cong. Manny Pacquiao’s anti-RH bill  knocks out Sen. Miriam Santiago’s RH bill).   And if this anti-RH bill becomes a law, it will be one layer of defense wall against the renewed assault of the pro-RH bill forces in the future.  As Gandalf would said to the Balrog in the battle of the Bridge of Khazadum: “You cannot pass!”

Below is a draft of the bill that I propose, following the outline of the Consolidated RH Bill,  House Bill 4244, “The Responsible Parenthood, Reproductive Health andPopulation and Development Act of 2011” and Senator Miriam Santiago’s Senate Bill 2378, The Reproductive Health Act.  I hope a congressman or senator can improve my draft bill and sponsor it as a congressional or senate bill.  Please spread the word.

Dr. Quirino Sugon Jr., Monk’s Hobbit

St. Albert the Great, pray for us.  

St. Bobo, pray for us.

Section 1.  Title

This act shall be known as the “Maternal Health Bill of 2011”.

Section 2.  Declaration of Policy

“The state recognizes the sanctity of family life and shall protect and strengthen the family as a basic, autonomous, social institution. It shall equally protect the life of the mother and the life of the unborn from conception. The natural and primary right and duty of the parents in rearing of the youth into civic efficiency and the development of the moral character shall receive support from the government.” (1987 Philippine Constitution Art. II, Sec. 12)

Section 3.  Guiding Principles

This act declares the following as guiding principles:

  1. A human being is formed when a sperm fertilizes an egg.  Many contraceptive pills are actually abortifacients because they prevent the fertilized egg to cling to the uterine walls and the fertilized egg dies.
  2. Every child has a right to be conceived in his mother’s womb through the union of his father’s sperm and his mother’s egg through sexual intercourse.
  3.  Every child conceived has the right to be born alive.
  4. The use of condoms and contraceptive pills makes fornication and adultery easier because the woman involved will not get pregnant and the scandalous affair is not brought to light.  Fornication leads to low marriage rates and adultery increases the breakdown of marriages.
  5. The use of condoms and and contraceptive pills contributes to environmental pollution.  In particular, when the contraceptive chemicals are excreted from the woman’s body through urine, these chemicals enter the sewage  system,  down to our rivers and streams, and back to our drinking water.  The female sex hormones in the water contributes to the impotence of males.
  6. Contraceptive pills interrupt women’s natural fertility cycle. Furthermore, the use of contraceptive pills has been shown to increase the risk of breast cancer.
  7. The use of condoms and contraceptive pills lessen the respect of the husband to the wife, making her an object to be used anytime, anywhere, without regard to her natural fertility cycle.
  8. The use of condoms increases the risk of sexually transmitted diseases: those who use condoms think that having sex is safer, so they increase the frequency of their sexual intercourse and the number of their sexual partners.
  9. The use of condoms and contraceptive pills leads to a notion that a child is not a gift but a burden, so that if the contraception fails and a child is conceived, the next recourse is abortion.  Countries who made contraception into a law ended up making abortion into a human right.
  10. Willful abortion is a criminal offense because a human being is killed.
  11. Growing population is not a problem, but graft and corruption.  Decline in population leads to a graying population which would decrease the number of taxpayers and increase the numbers of old pensioners, leading to economic collapse.
  12. The children are the hope of our country, said Dr. Jose Rizal. It is not the duty of the state to mandate the number of children per household, but to provide opportunities for each child conceived to grow to become responsible citizens of the country.
  13. Those who contribute to the pollution of our environment or to the destruction of our families must be must be the one who shall be taxed in order for the government to clean up the mess.
Section 4. Definition of Terms
  1. Maternal health refers to the biological capacity of a woman to do the all of the four functions: (a) conceive a child through sexual intercourse with a man, (b) carry the child in her womb for nine months, (c) give birth to the child through normal delivery, (d) and breastfeed the child immediately after birth until the child does not anymore need breastmilk.
  2. Maternal death is defined as the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes (World Health Organization)
  3. Marriage is the union of a man and a woman as witnessed by the State for the the purpose of raising a family.
  4. Fornication or pre-marital sex is the sexual intercourse between the unmarried man and an unmarried woman
  5. Adultery is the sexual intercourse with a partner who is married to another.
  6. Contraceptives are devices or chemicals that hinders the meeting between the sperm and egg during sexual intercourse
  7. Abortifacients are substances or chemicals that induce abortion.
  8. Sex hormones are sex-specific chemicals that are naturally produced by the human body.  Males have male hormones, females have female hormones.
  9. Abortion is the killing of an unborn child in the womb.
  10. Fertility cycle is the reproductive cycle of which define the days when she is fertile and when she is not.
  11. Natural family planning refers to the study of the woman’s fertility cycle to determine the proper times for sexual intercourse for the proper spacing of births.
  12. Sexually transmitted diseases refers to diseases that are transmitted through sexual intercourse, such as AIDS and HIV.
Section 5.  Contraception, Abortion, and Fertility Treatments
  1. Contraceptives imported from other countries are subject to 100% tariff. Contraceptives donated from other countries will also be subject to 100% tariff based on their estimated value.  Thirty-five percent (35%) of the tariff shall go to the National Treasury, 30% shall go to the Department of Health (DOH) for its Maternal Health Programs, 15 % shall go to the Department of Environment and Natural Resources, and 15% shall go to a special research fund of the Department of Science and Technology (DOST).  This special research fund shall be awarded to research proposals for development of ways to monitor and remove women sex hormones in rivers, lakes, and drinking water.  These funds shall be included in the yearly appropriations of the Philippine government budget.
  2. Contraceptives produced in the country are subject to 50% production tax.  Contraceptives sold in the country are subject to 50% sales tax.
  3. Contraceptives that do not require surgery or taking in of chemicals can be purchased over-the-counter in pharmacies, e.g. condoms.  Contraceptives that require the absorption of chemicals in a man’s or woman’s body can only be bought through doctor’s prescription.  Contraceptives that require surgery shall be considered contraband goods.
  4. Ligation in men and women as a form of contraception shall not be allowed.  Doctors and nurses who took part in  these surgeries shall have their medical licenses revoked for three (3) years.
  5. The Department of Health shall provide a list of chemical contraceptives that are abortifacients.  The importation, manufacture, and sale of these contraceptives shall be prohibited and these contraceptives shall be considered contraband goods.
  6. Willful termination of a normal pregnancy (abortion) is a criminal offense.  The doctor or nurse who took part in these surgeries shall be tried in a criminal court.
  7. Fertility treatments which require fertilization outside the woman’s womb shall not be allowed in the country.  Doctors and nurses who took part in these treatments shall have their medical licenses revoked for three years.
  8. Contraceptives shall not be classified as essential medicines and their purchase shall not be covered by PhilHealth.  No government fund must be used for the purchase of contraceptives or for the promotion of their use.  Government funds shall only be used by DOH for Natural Family Planning and other Maternal Health Programs.
  9. Hospitals shall be required to have pregnancy crisis centers for counselling women who are thinking of aborting their child due to rape, incest, abandonment, etc.  These centers will be staffed by DOH and DSWD personnel or DOH and DSWD-accredited personnel.  They shall also be funded by donors from the private sector and NGO’s.  The purpose of these centers is to convince the women to let their baby live, and give it up for adoption at least.  The women shall be shown the ultrasound–in 4G if possible–what their baby looks like in the womb–pointing out the head, the arms, the feet, fingers, and toes.  Once the baby is delivered, the mother of the baby may decide to keep the baby or give him up for adoption.
  10. The DOH and DSWD shall publish a joint list of accredited pregnancy crisis centers and child adoption centers.  This list shall be made available to all hospitals.
Section 6.  Marriage and Sex Education
  1. All couples who wish to get married must attend lectures on possible sources of conflicts in marriage and how to resolve them to make marriage and family life wonderful.  The Department of Social Welfare and Services (DSWS) shall conduct these lectures at least once a year.  The DSWS can also accredit centers who shall do these lectures.
  2. The couples who wish to get married must also take lectures on natural family planning, fetal development, breastfeeding, and child development.  The Department of Health (DOH) shall conduct these lectures once a year.  The DOH can also accredit centers who shall do these lectures.
  3.  Sex education in elementary and high schools is only limited to that body’s fertility cycle, sexual reproduction, and child development as taught in Biology.  The harmful effects of chemical contraceptives may also be taught.  The use of condoms should not be taught in elementary and high school.
  4. Values formation classes should stress the dignity of marriage, the gift of a child, and social responsibility.  These classes should discuss the problems  resulting from the contraceptive mentality such as pre-marital sex, adultery, and divorce, and abortion.  These classes should discuss how these things destroy family and society.  The Department of Education shall review the existing curriculum on values education and incorporate these topics if these were not included before.
Section 7.  Maternal Health
  1. Couples may use PhilHealth for the ultrasound imaging of a developing fetus in his mother’s womb, provided that such a procedure is prescribed by a doctor.
  2. The benefits of paternity and maternity shall be availed by the couples as stipulated in the existing laws.
  3. The delivery efficiency of midwives shall be labeled in their DOH certified identification card.  The delivery efficiency is the ratio of two numbers: total live births delivered divided by total births delivered, computed since the start of her career.  Both the fraction and percent efficiency should be displayed.  Midwives with the highest yearly number of live births  assisted with 100% delivery efficiency shall be given an award by the provincial DOH at least Php 10,000 in cash and a plaque of appreciation.
  4. All midwives, nurses, and doctors who have assisted delivery cases wherein the infant or the mother died or both shall inform the DOH.  A  DOH personnel shall interview the medical practitioners involved on the sequence of events and the possible causes of death.  These interviews shall be recorded in text, audio, or video.  The transcribed interviews shall be sent to provincial DOH centers for making a yearly report.  From this data, midwifery practices that are shown to correspond higher incidence of infant and maternal deaths shall be eliminated or modified.  DOH shall then issue revised protocols on child delivery and maternal health.
  5. All hospitals in a province are required to submit to provincial DOH centers the statistics on infant and maternal mortality, starting from the child is in the womb until the child is released from the hospital.
  6. At the end of each year, the provincial DOH centers shall make a summary report of the child mortality per hospital and and health center.
  7. Doctors, nurses, and midwives must see to it that the newborn child is breastfed by the mother.
  8. Hospitals should only display the benefits of breastmilk in posters.    Dairy products should not be prominently advertised in hospitals as breast-milk substitutes.  Purchase of breastmilk substitutes require a doctor’s prescription.
  9. Malls must have designated breastfeeding stations where a mother can breastfeed her child in private.  These stations should be clearly marked and its location should be available in the information booth and the mall map.  Mall owners shall be given a year to comply to this requirement.  Malls that fail to comply shall have their business permit revoked .
Section 8. Separability Clause, Repealing Clause, and Effectivity
  1. Separability Clause.  If any part of this act is considered invalid or unconstitutional, other provisions not affected thereby shall remain in force and effect.
  2. Repealing Clause.  All other laws, decrees, ordinances, rules and regulations which are inconsistent with the provisions of this Act are hereby repealed, amended, or modified accordingly.
  3. Effectivity.  This Act shall take effect fifteen (15) days after its publication in at least two (2) newspapers of general circulation.