PRES
Ke + ON
REG filVERy

Republic of the Philippines
Congress of the Philippines
Metro Manila
Eighteenth Congress
First Regular Session

House Bilt Nese

Introduced by:

Juan Fidel Felipe F, Nograles
Second District
Province of Rizal

Explanatory Note

In 2008, the Department of Health (DOH) issued Administrative Order No. 2008-
0029 entitled “Implementing Health Reforms for Rapid Reduction of Maternal and
Neonatal Mortality.” This Administrative Order seeks to promote facility-based
childbirths in view of the Millennium Development Goal (MDG) of enhancing the
accessibility of health services, and of lowering maternal and neonatal mortality. In 2011,
the DOH issued the “Maternal, Newborn, and Child Health and Nutrition Manual of
Operations” where the DOH, in addition to reiterating its support to facility-based
childbirths, imposed a prohibition on TBA-assisted deliveries. TBA stands for Traditional
Birth Attendants which covers hilots and babaylans in Indigenous people communities.

While the DOH does not expressly prohibit home births, several LGUs enacted
“No Home Birthing Ordinances” which prohibit mothers from giving births at their
homes. These “No Home Birthing Ordinances” impose different penalties on different
persons, and can be categorized into four (4) groups: (1) ordinances which absolutely
prohibit home births, and which impose penalties on the pregnant woman who gave
birth at home, her relatives, and the traditional or skilled birth attendant who assisted her
with her child birth, (2) ordinances which impose penalties on the same group of persons
but provide exceptions for emergency cases and for women living in far-flung areas, (3)
ordinances which penalize the skilled or traditional birth attendant but provide
exceptions for emergency cases and for women in far-flung areas, and (4) ordinances
which absolutely prohibit home births, and impose penalties on traditional birth
attendants. The penalties imposed by these “No Home Birthing Ordinances” can be in
the form of imprisonment, fine, or denial of registration of birth.

It is submitted that these “No Home Birthing Ordinances” violate the principle of
non-coercion under The Responsible Parenthood and Reproductive Health Act of 2012


(RHLaw). This principle of non-coercion provides that individuals have the right to make
decisions concerning reproduction “free of discrimination, coercion, and violence,” and
that “The right to make free and informed decisions, which is central to the exercise of
any right, shall not be subject to any form of coercion and must be fully guaranteed by
the State.” The “No Home Birthing Ordinances” do not merely prohibit women from
giving birth at home. They also coerce them into giving birth at a health facility by
penalizing the mothers, their relatives, or any birth attendant for attending a home birth.

Meanwhile, Section 5 and Section 7 of the RH Law are not specific in recognizing
the right to reproductive self-determination of women with no clear guidelines providing
for the choice in the means and method of childbirth for women.

In spite of the principle of non-coercion under the RH Law, it is submitted that
there is a need to further strengthen, enhance, and modernize the RH Law in order to
protect the rights of pregnant women. According to the Supreme Court, while the RH
Law contains special provisions on maternal health, the bulk of the RH Law merely refers
to family planning. The absence of a legal framework for promoting and protecting
reproductive rights in the RH Law will provide LGUs with unbridled discretion in
formulating and implementing maternal health measures.

In view of the above, the proposed policies will strengthen, enhance, and
modernize the RH Law by setting standards in the regulation of childbirths so as to
protect reproductive rights. This Act will also focus on health empowerment, informed
choice, accessibility, and community-based care.

Rizal, District 2


Republic of the Philippines
Congress of the Philippines
Metro Manila
Eighteenth Congress
First Regular Session

6477
Introduced by:

Juan Fidel Felipe F. Nograles
Second District
Province of Rizal

AN ACT STRENGTHENING AND EXPANDING THE REPRODUCTIVE RIGHTS
OF WOMEN PROVIDING FOR A NATIONAL POLICY ON HOME BIRTHS

Be it enacted by the Senate and the House of Representatives of the Philippine Congress
assembled:

SECTION 1: Short Title - This Act shall be known as the “EXPANDED
REPRODUCTIVE RIGHTS OF WOMEN ACT OF 2020.”

SEC. 2. Declaration of Policy. The State recognizes and guarantees the human rights of
all persons including their right to equality and nondiscrimination of these rights, the
right to sustainable human development, the right to health which includes reproductive
health, the right to education and information, and the right to choose and make decisions
for themselves in accordance with their religious convictions, ethics, cultural beliefs, and
the demands of responsible parenthood.

It is the policy of the State to recognize the right to reproductive self-determination of
individuals where they have the right to make decisions concerning reproduction, free of
discrimination, coercion, and violence.

Pursuant to the declaration of State policies under Section 12, Article II of the 1987
Philippine Constitution, it is the duty of the State to protect and promote the right to
health of women especially mothers in particular and of the people in general and instill
health consciousness among them. The State shall likewise protect and advance the right
of families in particular and the people in general to a balanced and healthful
environmentin accord with the rhythm and harmony of nature. The State also recognizes
and guarantees the promotion and equal protection of the welfare and rights of children,
the youth, and the unborn.


Moreover, the State recognizes and guarantees the promotion of women empowerment
and dignity as a health and human rights concern and as a social responsibility. The
advancement and protection of women’s human rights shall be central to the efforts of
the State to address reproductive health care.

The State likewise guarantees universal access to medically-safe, effective, legal,
affordable, and quality reproductive health care services, and relevant information and
education thereon according to the priority needs of women, children and other
underprivileged sectors, giving preferential access to the marginalized.

The State shall eradicate discriminatory practices, laws and policies that infringe on a
person’s exercise of reproductive health rights.

The State shall the promote childbirth policies with emphasis on a women’s autonomy
‘on matters concerning her own childbirth with focus on the accessibility and quality of
health care.

It is the duty of the State to protect and promote the right to health of mothers, the
centrality of women’s human rights in the reproductive health efforts of the State, and
universal access to reproductive health services.

SEC. 3 Guiding Principles. This Act declares the following as guiding principles:

a) The right to make free and informed decisions, which is central to the exercise of any
right, shall not be subjected to any form of coercion and must be fully guaranteed by the
State;

b) The right to choose modes of neonatal care and modes of birthing free from State
penalty and coercion;

) Respect for protection and fulfillment of reproductive health and rights which seek to
promote the rights and welfare of every person particularly women;

d) Informed choice and voluntarism shall be promoted by all public and private health
care providers rendering reproductive health care.

SEC. 4. Home Birth Policies of LGUs. There shall be an immediate ban on Local
Government Units on No Home Birth Policies. Under the right to reproductive self-
determination, women shall have the right to make decisions concerning reproduction
free of discrimination, coercion and violence and the right to make free and informed
decisions without coercion from the Local Government Units (LGUs) as to the form and
means of childbirth which shalll be the choice of the woman.


No ordinance shall be passed by LGUs that violate the right to life of women by
penalizing home birth assistance even in life-threatening and emergency cases. There
shall be no ordinance to be passed that violate the right to culturally-sensitive health care
and the right to religious freedom of Indigenous Peoples women, in relation to the
Indigenous Peoples Rights Act (IPRA) or Republic Act No. 8371 recognizing the right of
indigenous persons.

LGUs shall refrain from coercive healthcare measures, except on an exceptional basis for
the treatment of mental illness or the prevention and control of communicable diseases.

SEC 5. Development and Review of Guidelines on Home Birth. The Department of
Health (DOH) shall to develop safety guidelines addressing home birth issues and review
current policies that are contrary to this Act. These guidelines shall include eligibility for
home births, training; skills and competency building, and qualifications of health care
professionals; sectoral strategic plan for population at risk; and risk management
strategies, including measures to ensure that all childbirths whether home or health
facility-based meet safety standards.

‘The DOH and the LGUs shall promote programs for the improvement of home birth
conditions by providing skilled birth assistance and maternity care services at home.

The DOH shall also develop guidelines to LGUs that prohibit public officers from
depriving women for their freedom to choose their mode and manner of childbirth.

SEC. 6. Information, Education and Communication Campaign. The DOH and the
LGUs shall promote and empower women as to their choice of childbirth and shall
promote and implement projects and policies that promote the right of women to choose
their means and method of childbirth. They shall initiate, sustain, and heighten a
nationwide multimedia-campaign to raise the level of public awareness on the protection
and promotion of women’s reproductive health and rights, including, but not limited to,
maternal health and nutrition, among other primary consideration of maternal and
neonatal care.

They shall develop education, information and communication materials in all mediums
which shall be reviewed regularly to ensure their effectiveness and relevance, consistent
with the Reproductive Health Law and Universal Health Care Law and their
implementing rules and regulation.

Specifically, the DOH and the LGUs shall enact policies for mandatory childbirth
education to inform pregnant women of the benefits and risks of various childbirth
options, such as home births versus facility-based births based on scientific and objective
evidence.


SEC. 7. Funding for Basic Emergency Obstetric Care (BEMONC) Facility, Barangay
Health Stations and Other Health Facilities in Rural and Geographically Isolated and
Highly Disadvantaged Areas (GIDA). The Department of Health and Department of
Public Works and Highways shall prioritize the building of BEMONC and maternal and
neonatal care health facilities especially in rural and GIDA areas. The DOH and DPWH
shall be tasked to provide a comprehensive mapping of areas in the Philippines where
there BEMONC, Barangay Health Stations, and other health facilities are lacking and the
corresponding strategic plan to fill the gap in supply and demand in maternal and
neonatal care services.

SEC 8. Program for Community Midwife and Traditional Birthing Attendants (TBAs).
The DOH and the LGUs shall review and provide a comprehensive plan to increase the
number of community midwives and TBAs through capacity building and training and
keep them abreast of acceptable quality standards in health care, taking in consideration
cultural sensitivities of the trainees. They shall endeavor to provide strategies and
guidelines for the establishment of community midwifery programs where health
workers can be licensed as community-based midwives and traditional birthing
attendants are respected. The training for indigenous people's birthing assistants shall be
voluntary.

SEC 9. Culturally-Sensitive Childbirth Policies. The DOH and the LGUs shall issue
policies that respect the rights of indigenous peoples in their cultural expression even in
childbirth and in relation to the IPRA Law.

SEC. 10. Implementing Rules and Regulations (IRR). ~ Within thirty (30) days from the
effectivity of this Act, the DOH Secretary or his/her designated representative as
Chairperson, the authorized representative/s of Department of Social Welfare and
Development (DSWD), Philippine Commission on Women, and Department of the
Interior and Local Government, together with at least two representative from NGOs,
faith-based organizations, people's, women’s and young people's organizations to be
selected by the DOH Secretary, shall jointly promulgate the rules and regulations for the
effective implementation of this Act.

SEC. 11. Separability Clause. In any clause, sentence, paragraph, or any part of this Act
shall be adjudged by any court of competent jurisdiction to be invalid, such judgment
shall not affect, impair or invalidate the remainder of this Act, but shall confined in its
operations to the clause, sentence, paragraph or part thereof directly involved in the
controversy.

SEC. 12. Repealing Clause. All laws, orders, issuances, decrees, rules and regulations
inconsistent with the provisions of this Act are hereby repealed or modified accordingly.


SEC. 13. Effectivity. This Act shall take effect fifteen (15) days after its publication in the
Official Gazette or in at least two (2) newspapers of general circulation.