VALLEHERMOSO remains one of the most densely populated barangays in Carmen. More than half of its population live below the poverty line. [photo by Avie Olarte]

AT VALLEHERMOSO, one of the barangays with a birthing center, the barangay midwife keeps track of all the pregnancies in the area. The health unit has on its white wall a pregnancy watch board that lists the names of pregnant women, together with the estimated date of confinement, last menstrual period, place and (estimated) date of delivery. There are also free pre-natal check-ups and some medicines, like iron tablets (many of Carmen’s women are anemic), are free as well.

Lilia Ancog’s barangay has no birthing center yet, so when time came for her to deliver her third child, she went to the main birthing center in town. Even then, she says her total bill came to only P500, or about 25 percent of the cost of a hospital-based delivery. She says that with her two older children, she had paid double that amount, and those deliveries were even done at home through a midwife.

“(It’s) high quality obstetric services at very reasonable amount,” says Jabonillo, who does not charge a doctor’s fee for the deliveries she does.

The doctor says that all the birthing center’s proceeds go to buying medicine and supplies like gloves and cotton, on top of the P1-million worth of drugs that the local government allocates for the RHU every year.

A patient in Carmen can even end up not paying anything at all. Last September, Carmen came up with a program for indigents with the government-run Philippine Health Insurance Corp. Through the program, a patient can avail of the Maternity Care Package that covers the first three deliveries, newborn screening, laboratory works, accommodation, medicine, and the P500 user’s fee.

That’s not all: Carmen is also one of only three towns in Bohol that have adopted a Reproductive Health Care Code; Bohol province itself has yet to pass one.

Carmen’s code mandates, among others, that women must have access to safe and quality reproductive healthcare services and that there should be a continuous planning, implementation, and monitoring of effective reproductive-health programs.

	HEALTH workers keep track of the condition of pregnant women in Vallehermoso. [photo by Avie Olarte]

The code also ensures a steady stream of funding for reproductive health services, on top of the P50,000 allocated for the reproductive health advocacy program. A look at the town’s spending pattern shows that it allots an average of nine percent every year for health services compared to an average of four percent for infrastructure. (In most towns in Bohol, as in many local governments, building roads and bridges is prioritized over health and social services.)

For sure, though, the code has its critics. Some church workers have called its proponents “devils” and even launched a radio program to discredit the local officials pushing for it. One official who suffered such a backlash is Nathaniel Binlod, a two-term town councilor and chairperson of the town’s health committee. He almost lost in the 2007 elections, he says, for openly advocating and raising awareness on reproductive health and population management.

“I’m not for abortion,” says Binlod, who was born and raised in Carmen. “What I’m campaigning for is responsible parenthood. Two to three children are enough.” (The average family size in Carmen at present is 5.3.)

ACCESS TO reproductive-health services in Carmen comes in the form of making contraceptives available to the public. Together with the United Nations Population Fund (UNFPA) — with which it has partnered for such things as the ambulances and setting up barangay birthing centers — the town has built a Pop Shop that sells condom and pills at lower prices than those at retail stores.

The RHU itself allots P50,000 to P75,000 a year for buying contraceptives alone. The award-winning facility even has a Family Planning Room where couples can consult with a doctor regarding which family planning method would be best for them.

More Pop Shops are already being put up in the barangays. But women like Beatriz Manda, a 44-year-old mother from Vallehermoso, are unlikely to step foot into one unless they visit a local health unit first.

Manda says the natural way doesn’t work for her and her husband, because she has irregular periods. They already have 11 children, with the youngest only five months old.

	CONDOMS and birth-control pills can be bought for a cheaper price at Popshops. [photo by Avie Olarte]

But it may take some doing before she and her husband consider artificial family planning methods. “I’m afraid of the IUD (intrauterine device),” says Manda. “My husband meanwhile doesn’t like the condom, he says it might slip off.”

Someone also told her that once she has had a ligation, she wouldn’t be able to help her husband in the farm anymore.

Manda confesses that she has not paid a visit to the barangay’s midwife, who could help clarify common misconceptions on artificial family planning methods. But she says she is planning to go one of these days.

If she opts to go to the RHU, she may just bump into Lilia Ancog, the mother who just gave birth there. Ancog is planning to visit the town doctor again as soon as she has had a few days of rest. She says she and her husband need a family-planning method aside from the natural way, which doesn’t seem to work for them. Her husband wants a fourth child, but Ancog says they can afford only three.

As for Jesusa Panes — the pregnant woman who with her drunken hilot walked all the way from her home to the barangay health center — she reached the place in one piece, the baby still safe in her tummy. And while she was sweating profusely when she arrived and was visibly worried that she would give birth any minute, she seemed to calm down somewhat after she downed a glass of spring water. As people fanned her, Panes politely declined offers to bring her to the nearest hospital, saying the midwife would take good care of her.

She later gave birth to a baby girl, her fourth child. Mother and newborn daughter are doing fine.