Manila

Philippines / Luzon / Manila

OVERVIEW

Contraception (Birth Control)

General Note: There are many types of contraceptives, also known as "birth control," including IUDs, oral contraceptives, patches, shots, and condoms, etc. If you would like to view a full list, click here.

Laws & Social Stigmas

Contraception (or "birth control") can be purchased in the Philippines without a prescription. While you technically do need a prescription, this does not seem to be widely enforced. However, there have been many challenges to birth control access, especially from the powerful Filipino Catholic Church. For many years, birth control pills were not legal at all, and they were treated like illegal contraband, exchanged between women. When they finally were legalized, the Catholic Church strongly campaigned against their access. It is estimated that over 80% of the Filipino population is Catholic, and the Catholic Church is opposed to birth control. Today, 37% of married women in the Philippines use modern contraception and 12% use traditional family planning methods (like withdrawal, the rhythm method and periodic abstinence).

In 2000, the Mayor of Manila banned contraceptive distribution in all city-funded health centers, and the ban lasted for nearly a decade. In a turn of tide, the Filipino government signed the Reproductive Health Law, under President Benigno Aquino III, in 2012. This law required that schools provide sex education, and that health centers provide free condoms and birth control. This law was heavily challenged by the Church and religious organizations, such as the Alliance for Family Foundation Philippines, resulting in a 2-year legal battle. In the end, the Filipino Supreme Court upheld the Reproductive Health Law in 2014. Nevertheless, conservative forces managed to cut the government's budget for contraceptives, thereby making contraceptives more difficult for poor Filipino families to afford, soon afterward. Most recently, President Duterte has vowed to bring back family planning programs to the Philippines, insisting that Filipino families are too large and that the Catholic Church has kept the populace "in total ignorance" about birth control.

The Philippines has one of the highest birth rates and maternal mortality rates in Asia. Teenage pregnancy has doubled in the past decade, and 10% of Filipina teenagers are wives or mothers. Some of this can be explained by low levels of family planning knowledge and access. According to a Guttmacher Institute Study, "In the Philippines, 37% of all births are either not wanted at the time of pregnancy or entirely unwanted, and 54% of all pregnancies are unintended. On average, Filipino women give birth to more children than they want (3.3 vs. 2.4 children), highlighting how difficult it is for a woman to meet her fertility desires. This is particularly striking among the poorest Filipino women, who have nearly two children more than they intend to have (5.2 vs. 3.3 children)."

What to Get & Where to Get It

• In the Philippines, there's a rather large variety of hormonal birth control brands. Some brands you can expect to see in the pharmacies are the following: Althea, Ancea, Crimson, Diane-35, Mercilon, Marvelon 28, Yaz, Yasmin, Gestodene, Gynera, Micropil, Mocropil Plus, Microgyno 30, Cazul, Femme, Seif, Blush, Femenal, Nordiol, Charlize, Lady, Nordette, Rigevidon 21 + 7, Seif, Trust Pills, Logentrol, Gracial, Logynon, Trinordiol and Natazia.
• It appears that Nuvaring (or other ring-based contraceptives) is not carried in the Philippines, or at least in large pharmacies like Generics Pharmacy and Mercury Pharmacy.
• In the public health centers, you may be able to find Microgynon 30, Nordette and Trust Pills (which can also be used as emergency contraceptives).
• You may find that the pharmacies can wildly vary in terms of prices, so it's recommended to visit a trusted and larger-brand pharmacy. One of the most reliable is called Generics Pharmacy, which has locations all over the city (and in the Philippines in general). Mercury Drug is also a recommended pharmacy.
• If you're interested in IUDs, you can get them in the Philippines for about 2300 PHP, which includes the pre- and post-ultrasounds. Total cost is about 2500 PHP with the meds (7 days of doxycycline and plenty of mefenamic for the post-procedure pain).
• If you're interested in injectables, you can get them at public health centers, private clinics or women’s health clinics (with trained service providers). You should know that, in the Philippines, the injectables available are progestogen only, also known as depot medroxyprogesterone acetate (DMPA).
• If you're interested in implants, you should be able to get them at private clinics or women’s health centers and organizations, such as Likhaan, St. Lukes and UP-Philippine General Hospital. There are reports that public health workers in Metro Manila are still being trained in how to handle them properly. However, Implanon access has been challenged and is supposedly very difficult to access due to the Catholic lobby.

Costs

You can expect to pay between 40-900 PHP for a one month supply of birth control pills. For example, at Generics Pharmacy, here are some price quotes in 2016: Althea 21 (430 PHP), Diane 35 Pills 21 (636 PHP), Yasmin Pills 28 (905 PHP), Yaz (808 PHP), Nordette (200 PHP), Trust pills (43.75 PHP) and Lady Pills (44.75 PHP). For IUDs, you can expect to pay about 2300 PHP for the procedure and an addition 200 PHP for medications.

Emergency Contraception (Morning After Pill)

Important Notes: Emergency contraception may prevent pregnancy for three days (72 hours) and sometimes five days (120 hours) after unprotected sex. Take EC as soon as possible after unprotected sex. If you don't have access to dedicated EC, oral contraceptives can be used as replacement EC, but remember the following: 1) Only some contraceptives work as EC 2) Different contraceptives require different dosages and time schedules to work as EC 3) You must only use the first 21 pills in 28-day packs and 4) They may be less effective than dedicated EC. For general information on emergency contraceptives, click here and here.

Laws & Social Stigmas

In the Philippines, dedicated emergency contraception (the morning after pill) is not legal. However, women do manage to use oral contraceptives (birth control) as a replacement. To do this, they take a certain number of birth control pills, which has a similar effect as emergency contraception. You can see in the section below ("What to Get and Where to Get it") how this can done in the Philippines.

In the 1990s, Postinor (an emergency contraception brand) was registered in the Philippines. Yet, in 2001, Postinor was "delisted" by Filipino regulatory authorities. It is estimated today that 9.7% of Filipino women of reproductive age have knowledge of emergency contraception.

What to Get & Where to Get It

If you have had unprotected sex, you can get an IUD (which may protect you up to 5 days after unprotected sex) or take the morning after pill (which may protect you for 3-5 days after unprotected sex). There are no dedicated morning after pills in the Philippines, but you can use hormonal birth control as replacement emergency contraception instead. To do this, you can go to a pharmacy, like Generics Pharmacy, Mercury Pharmacy or Watson's, and ask for any of the following pills. It's especially common to ask for Nordette in the Philippines. Follow the instructions below, provided by the Princeton EC Website.

Oral Contraceptives used for EC / Progestin-Estrogen Combined Note: in 28-day packs, only the first 21 pills can be used For the following pills, take 2 pills within 120 hours after unprotected sex and take 2 more pills 12 hours later:

• Femenal
• Nordiol

For the following pills, take 4 pills within 120 hours after unprotected sex and take 4 more pills 12 hours later:

• Charlize
• Lady
• Nordette
• Rigevidon 21 + 7
• Seif
• Trust Pills

Costs

Nordette should cost you around 190-200 PHP.

Sexually Transmitted Infections (STIs/STDs)

Important Notes - Learn about PEP and PrEP: If you think that you've been recently exposed to HIV (i.e. within 72 hours), seek out PEP (Post-Exposure Prophylaxis). It's a month-long treatment to prevent HIV infection after exposure, and it may be available in your city. Take PEP as soon as possible. For more information, click here. If you are at risk of HIV exposure, seek out PrEP (Pre-Exposure Prophylaxis). It's a daily oral pill that can prevent HIV infection before exposure. To learn more about PrEP, click here.

Laws & Social Stigmas

There are no travel restrictions assigned to anyone with HIV or other STIs. As stated in the Republic Act, ""Nobody will be quarantined, isolated, denied entry to the Philippines or deported from the country due to a confirmed or suspected HIV infection." Furthermore, it is legal to import antiretrovirals for personal use (for up to 6 months), though you should carry a prescription from a doctor. However, if you are seeking legal residency in the Philippines, you may be rejected if you are HIV+.

What to Get & Where to Get It

Testing Facilities

Home Test Kits

• HIV Test Kit: The website seems to be down but the company may still exist. This is a Filipino website/company that allows you to take an HIV test and see the results in the privacy of your own home.
• Here's more information on home test kits. And here's the Oraquick website, which is one of the largest companies known to give kits for at-home HIV tests.

Free Testing Sites

"These HIV testing sites are satellite clinics of RITM or Research Institute for Tropical Medicine which is the main HIV research center in the Philippines. Testing is free and staffs are a little bit friendlier than the stressed out staffs in the hospitals but then again, Lines are usually long as they serve hundreds of clients a day and it might take 2 hours before getting tested."

• Love Yourself Testing: Has a few locations in the Philippines. In Metro Manila, their location is in Pasay City. "Do you need assistance in getting yourself tested for HIV? It is completely ANONYMOUS, CONFIDENTIAL, and FREE. Our trained and certified HIV educators and counselors are willing to assist you privately and discreetly."
• RITM Satellite Clinic: Free and confidential HIV test. Address: #1850 Leon Guinto Street, Malate, Manila, Phone: 353-8922

Public Facilities

Note: If you go to a public facility and test positive for HIV, it's very likely that the facility will ask about your sexual history, put your information on government record and potentially try to monitor your sexual practices.

• Social Hygiene Clinic:
  • Manila: Operating hours, Mon – Thu: 8:00pm to 3:00pm. Free HIV testing. Results in 10-15 minutes. Confidential consultation and STD meds, HIV/AIDS testing and post-test counseling, dissemination of informational materials, referrals to other hospitals and peer counseling groups. You can ask for Dr. Diane Mendoza – Social Hygiene Clinic Physician. Address: 208 Quiricada Street, Sta. Cruz. (in front of San Lazaro Hospital), Phone: (2) 711 6942 | +63920 577 9074, Email address: manilasocialclinic@yahoo.com.
  • Makati City: Address: Social Hygiene Clinic, JP Rizal Street, BarangayPoblacion, Makati, 1200 Metro Manila, Philippines, Phone: +63 2 870 1615
  • Pasay: Address: Room 106, Pasay City Hall, F.B. Harrison St, Pasay, Metro Manila, Philippines, Phone: +63 2 551 4180
• San Lazaro Hospital - Department of Health: "San Lazaro Hospital is a referral facility for Infectious/ Communicable Diseases. It is one of the retained special tertiary hospital of the Department of Health." Address: Quiricada St, Santa Cruz, Manila, Metro Manila, Philippines, Phone: +63 2 732 3777.

Private Facilities

These facilities will cost more than the public clinics. But they will be more efficient and confidential.

• St. Luke's Medical Center HIV Clinic: Locations in Quezon City and Global City. "St. Luke's Medical Center will be an internationally recognized academic medical center by the year 2020. We are committed to deliver state of the art healthcare because at St. Luke’s Medical Center, the needs of our patients come first."
• The Medical City I-REACT Clinic: "The Medical City (TMC) has distilled 48 years of experience in hospital operation and administration in the establishment of its world-class healthcare organization that serves some 40,000 inpatients and 400,000 outpatients a year. The main facility is located on a 1.5 hectare property along Ortigas Avenue in the business district of Pasig City, Metro Manila. It is composed of 115,000 square meters of floor space, and includes two Nursing Towers with capacity of up to 800 beds, joined by a Podium, bridge ways and a Medical Arts Tower." Address: Ortigas Avenue, Pasig City, Metro Manila, Philippines, Tel. Nos. (632) 988-1000, (632)988-7000, Email us: mail@themedicalcity.com.

Support

According to HIV Travel: "Treatment is very expensive. Foreigners won't get any public financial support. Public hospitals cannot be recommended. The treatment is cheaper in public hospitals, but foreigners still have to pay for themselves."

• Makati Medical Center: 2, Amorsolo Street, Makati City, Metro Manila, Phone: +632 815 9911, +632 892 5544
• Dr. Peter Kaliski: Medical Towers Makati, Herrera Corner Ormaza Street, Legaspi Village, Makati, Suite 615, Metro Manila, Phone: +632 817 7172
• The Health Action Information Network (HAIN): "HAIN serves research, information and education needs of Philippine and international agencies in health and development."
• Remdedios AIDS Foundation, Inc
• Network of Asia Pacific Youth (NAPY) (Quezon City)

Medications & Vaccines

Menstruation

Note: In addition to pads and tampons, you can also use menstrual cups and menstrual underwear for your period. To learn more about menstrual cups, click here. To learn more about menstrual underwear, click here.

What to Get & Where to Get It

In Manila, you should be able to find pads, pantyliners and tampons. However, pads and pantyliners are much more common than tampons, and they're worn by the majority of Filipina women. If you want tampons, you should look for them in larger stores, especially international and chain stores, like Rustan’s Supermarket, Watson’s, Mercury Drugstore, S&R and the SM Department Stores. If you're interested in menstrual cups, one of the main sellers in the Philippines is Mama Baby Love, which sells Lunette in the Philippines, or LiveLoveLuna, which sells Lunette out of Singapore and ships throughout Asia. However, if you want to purchase other brands, like DivaCup, MoonCup, LadyCup or other brands, there are no Filipino sellers, so they should be purchased online.

Gynecological Exams

Pregnancy

Abortion

Important Note: There are two main types of abortions: medical (also known as the "abortion pill") and surgical (also known as "in-clinic"). For medical abortions, you take a pill to induce abortion. For surgical abortions, a procedure is performed to induce abortion. For general information about medical and surgical abortions, click here.

Laws & Social Stigmas

In the Philippines, abortion is generally illegal. According to the Philippine Constitution, "Section 12. 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."

Abortion is potentially only permitted to save the life of a woman, and this is debatable. While no Filipino laws authorize abortions for women whose lives are endangered, "It may be argued that an abortion to save the mother's life could be classified as a justifying circumstance (duress as opposed to self-defense) that would bar criminal prosecution under the Revised Penal Code. However, this has yet to be adjudicated by the Philippine Supreme Court."

In all other cases, such as to preserve physical health, to preserve mental health, rape or incest, fetal impairment, economic or social reasons or upon request, abortion is unquestionably illegal. If an abortion is illegally performed, the person performing the abortion may be subject to imprisonment. If the woman consented to the abortion, the prison term is typically six months to six years. If the woman did not consent to the abortion, the prison term is six years to twelve years. If the woman performed the abortion on herself, she may also be subject to prison time.

Despite the general ban, abortions are still performed in the Philippines every year. In 2012, it was estimated that 610,000 women in the Philippines received abortions. An underground economy of abortions exist, in which women typically pay 2000-5000 PHP for the procedures. These procedures are often unsafe, leaving many women in unhealthy and vulnerable positions, with an estimated rate of 1000 deaths due to underground abortions per year.

As found in a UN Report, "...illegal abortion is performed in a climate of fear and shame resulting from strong cultural, religious and legal prohibitions. Surveys indicate that women resorting to abortion are often from economically disadvantaged groups and take this step because they are unable to provide for another child. Surveys also indicate a high incidence of repeat abortion. In a context of poor health conditions and widespread malnutrition, and where some 76 per cent of deliveries occur at home and only 21 per cent are attended by a physician, induced abortions are poorly performed and result in high maternal mortality and morbidity."

The Reproductive Health (RH) Law allows women to receive humane medical care in the event of abortion complications, but this does not mean that all women receive proper care. In fact, the Philippines has a high maternal mortality and morbidity rate. This is worsened by the fact that many women, who have endangering conditions, are routinely denied abortions. As reported in the Rappler, "some medical health care providers erroneously deny life-saving procedures even in cases of intrauterine fetal death where therapeutic abortion is needed to save the life of the woman." Furthermore, "Expressing negative views on abortion is dangerous because it maintains the status quo where many medical providers threaten women with prosecution in cases of intrauterine fetal death, spontaneous abortion, abortion due to trauma from intimate partner violence and self-induced abortion."

Advocacy & Counseling