Family Planning Fund Update

I learned that the Marie Stopes Clinic (initially mentioned here) is actively involved in abortion advocacy around the world and apparently does "medical abortions" in the Philippines. Not a big surprise since it is a secular organization that helps "support vital sexual and reproductive healthcare programmes in some of the world’s poorest regions" but it means that we can no longer advertise their services publicly at Glory Reborn(GRC) where I work. I especially can not publicly offer to fund ligation for our patients at their clinic. I completely understand how promoting an organization that actively advocates for the "protect[ion of] women from unwanted pregnancy" could not only jeopardize much of the funding GRC depends on but also presents a moral dichotomy within an openly Christian clinic that values the life of every embryo and fetus. I have been advised against giving out their brochures and detailing their available services during our group teaching times which I respectfully agree to and understand. I am disappointed however that one of the most accessible family planning options won't be available to as many women as I initially thought.

There are other family planning services available in Cebu City that I still need to learn about including at least one private hospital that apparently provides some discounted family planning services. Of course there is always the option of hiring one of our OB docs to perform ligation in the hospital but this will cost more than $150 as opposed to the $10 procedure at Maries Stopes. Unfortunately I'm finding these other options to be more difficult to make easily available to our patients. I do intend to research more fully about these other options but frankly I just don't have the time to commit to that right now.

Since learning more about Marie Stopes I have wondered what it means in terms of utilizing their extremely useful and inexpensive ligation services for the fertile, impoverished women I meet at GRC. Especially since I had already agreed to arrange ligation for one of my patients (read on for more about her situation) as soon as she delivers her 7th child later this month.

After thinking about it and given the inability to find another inexpensive option quickly I have decided that I am willing to take advantage of their ligation service for the few women that I personally encounter and whom I feel compelled to support in this way (at least until I can find a more ideal option). My heart still goes out to these women. Just last night I delivered an 8 pound 1 ounce baby boy to a 35 year old woman who was no taller than 5 feet. It was her 6th baby. She gave birth to her first baby at the age of 15. Given the size of her baby and her subsequent difficult delivery (I'll write about that in another post) we are suspecting gestational diabetes. She is one of many women in a similar situation whose risk of death in childbirth increases with each subsequent pregnancy. Thankfully, both mom and baby are going to be fine but what about my patient experiencing her 10th pregnancy?

I have mentioned her before. I'll call her Day. She goes to our church and we are in the same home group together. Her family is desperately poor as her husband does not work (Arghh!!) and the burden is on her to scrape money together to feed her family by sending her 13 year old son to collect garbage and by herself finding jobs doing other peoples' laundry. She is 41 years old and is due in the next week or two. Out of her 10 pregnancies, two babies were lost to miscarriage (which she had D&C afterwards each time) and another baby lost to premature labor at 5 months. Just her age and parity make her pregnancy a high-risk one. Add to that unrelenting anemia (her hemoglobin has actually gone done during her pregnancy despite FeSo4 supplementation), and polyhydramnios (too much water in the womb) which is likely related to gestational diabetes. The recent result of a glucose challenge test indicates this is the case. Also, according to a recent ultrasound the estimated weight of her baby is already more than 7 pounds and specifically the abdominal circumference of the baby is measuring large for it's gestational age (also consistent with gestational diabetes). My patient is about 4 feet 10 inches tall and weighs right around 100 pounds. This is a big baby considering her size. She is only just now 37 weeks and the baby will likely grow bigger in the coming weeks until she delivers. The weights of her previous babies have gotten bigger and bigger with each pregnancy. She has +1 edema in both legs and is extremely tired. About a month and a half ago she almost went into premature labor due to a urinary tract infection. We were able to diagnose and treat it in time to stop her contractions.

Just last week, I referred her to our OB doc as it became increasingly clear that she is too high-risk to deliver at GRC. She is now under the care of the (SCARY) city hospital which you can read about here. It is her only option. Well technically she could choose to deliver at home with a "hilot" or untrained birth attendant. Keep in mind that she has NO money. We have been covering all of her pregnancy/childbirth related costs (labs, meds, etc...) and have been providing food for her family since she found out she was pregnant. We have agreed to pay for all of her expenses at the hospital as well, otherwise she would have no way of accessing the needed care.

It seems the Lord has led me to take on patients that end up with complications and needing hospital care. They are patients that could barely afford the basic requirements to be a patient at Glory Reborn. I really don't know what these women would do otherwise. This is another area you could consider donating to as I feel compelled to support such families. I did it with Emily. I'll do it for Day. And I'm sure another will come along as there are plenty to choose from at any given time. So far, I've taken on those women that I feel God placed in my path for that reason - usually via meeting them at church and discovering they aren't undergoing any prenatal care and have no plans to deliver with a trained attendant because of poverty.

So my point in all of this is that Day desperately needs a solution to her fertility problem. Her life depends on it. Her husband is unwilling to undergo (free!) vasectomy and Day isn't even willing to try to talk him into it. The burden lies on her. She really needed ligation after her last baby (who is now age 2) and desired it but couldn't get the money together for it. Her family (especially her eldest daughter who is under a lot of pressure to provide for the family) couldn't believe she was pregnant the last time, much more so with the present pregnancy. Everyone in our church community was flabbergasted that it happened yet again. Day herself was very distressed at the news of another pregnancy. It is possible that if she didn't get ligated or do something else that it could happen again! At her age and given what her uterus has been through (add to that the anemia) she is at very high risk of hemorrhaging to death in childbirth. Especially after being stretched by a big baby and too much water, it will be that much harder for her uterus to contract properly which can cause failure to progress in labor and bleeding to death once the baby is born and her placenta separates from her uterus.

Given the need for it, I am currently willing to utilize the ligation service at Marie Stopes for Day and possibly other women like her (separate from GRC) until I can find a more suitable option. I have to be honest though that I am not completely comfortable with it as I know that surplus funds from the UK clinics (a large part likely from abortions done in the UK), go to funding the services I am interested in in the Philippines. I just wish it was much simpler but despite feeling torn, I don't know what else to do right now. It's still better than abortion profits just going into the pockets of doctors. At least its being used to go toward something that can prevent the desire for an abortion in other women here in the Philippines and around the world. Abortion is rampant in the Philippines but it is illegal and so many women take cytotic drugs to abort their babies. Sometimes it works, sometimes it doesn't. Some women experience life-threatening hemorrhaging in the process. This is a tough issue to work through.

Having said that, I completely understand if you do not want your donations to go to services at Marie Stopes. Just let me know and I will make sure your donation goes to another service provider (if I can arrange that) or to another pregnancy/childbirth-related need for an impoverished family.

I welcome any input, thoughts, advice, suggestions that you may have. I am open to hearing your thoughts and opinions, even if you don't agree with my decision to arrange for Day to be ligated at Marie Stopes. As I said, I am working through these issues myself and am open to discussion and appreciate what you can offer.