Introduction

Over the last four decades there have been improvemnets in awareness, availability, options, and cost of contraception in the Philippines. However even with some relative success in increasing access and options, the fertility rate remains high compared to that of its neighboring countries. Research has shown that large family size, a major factor in high population growth rates, contributes significantly to poverty levels in this country. There is a preponderance of evidence that the vast majority of Filipinos know about at least one method pf modern family planning. The puzzle that remains is why the prevalence of modern method use remains low even in the face of high levels of knowledge?

The 2003 National Demographic and Health Surveys (NDHS) in the Philippines show that the overall prevalence of family planning practice is only 32% among all women of reproductive age, and an even lower 22% report on modern methods of contraception. Among married women (age 15-49), 49% are on some methods and 33% are on modern methods. In comparison, use of any method in Thailand and Indonesia are 79% and 60% respectively, and use of modern methods is 79% and 57%. Use among married women in the USA is 73% of any method and 72% of modern methods.

The research described in this bried was conducted to advance our understanding of the factors women and men take into account when considering use of family planning methods to space or limit pregnancies. It explores how Filipinos think about and understand fertility, family planning, contraception and sexual relationships. By producing meaningful descriptions of attitudes and beliefs about contraception, we an clearly identify psychological barriers to use (e.g,. perceived social norms regarding use of specific contraceptives, perceived norms about controlling family size, knowledge (whether accurate or not) and beliefs about modern method side effects, and perceived risk of pregnancy with each instance of intercourse). Hopefully, results of this study will help guide communication campaigns in choosing the strategies, arguments, and messages that will most likely lead to behavior change.

Data for this study were drawn from available national survey and primary data collected through qualitative individual interviews and focus group discussion (FGDs). National survey data utilized include the NDHS and the Young Adult Fertility and Sexuality (YAFS) Study. Long who do not have a college degree. In all ten FGDs snd over 60 individual this study. Interviews were conducted in Metro Manila, Mindoro Oriental, Pampanga, Sorsogon, Albay and Isabela. Respondents had an average household income of PhP 6,000 a month, 13% are elementary graduates 38% have some years of high school, 22% completed high school, and the rest have less than an elementary education.

FIRST SEXUAL EXPERIENCE AND FIRST CHILD

Interviews reveal that for women the first sexual encounter is almost always unplanned. It is too frequently not a products of reasoned decision-making, but one of emotional coercion and spontaneous action. Costs and consequences of initiating a sexual relationship are not considered until right before or immediately after having unprotected sex for the first time. While women generally express regret at their decision to go ahead wth sex, men do not take it as seriously. Men do not consider costs of unplanned first pregnancies, even in retrsopect. There is in fact a preponderance of faulty logic among the men in their rationalizations for their first sexual encounter with their girlfriend. Even when they admit that they prodded their girlfriends for sex, they will still claim that sex happened suddenly (nabigla), unplanned.

The language used by both men and women when they describe the circumstances of their first pregnancy suggets that they believe their having gotten pregnant was beyond their control, and there was nothing they could have done about it. Since they did have sex, pregnancy was a risk they took and they accept it. There are strong indications throughout the interviews that these young people initiating sexual relationships do not consider "safe sex," that is, sex with no risk of pregnancy, as an alternative. They appear to believe that there is nothing they can do, short of abstinence that will keep them from getting pregnant once they begin having sex.

From many perspectives, the main risk of having sex without the benefit of contraception is the risk of getting pregnant at a young age when neither of the partners are prepared for nor have planned parenthood. Is this their main consideration when entering a sexual relationship without contraception? No, there are two reasons clearly stated by the women interviewed. First, the community will find out that she was having sex, leading to shame and worthlessness as a woman. No man will wants her now that she has been "used". Second, she will be an unmarried mother or that her boyfriend will leave her the full responsibility of taking care of the child. Conspicously absent is an expression from either the men or the women that theor potential for future achievements in education and/or career and opportunities is severly diminished. Thus the cost of getting pregnant before marriage and at an early age is not understood the same way by scholars and by the individuals interviewed.

Given how young girls understand or value the cost of getting pregnant, then take responsibility for the baby, the cost is reduced significantly. They do not think about the different trajectory that their lives will take and they do not consider the diminished potential to achieve educational and career goals. We must consider the possibility then, that young girls may not have clears goals and ambitions, at least not enough to increase the perceived cost of getting pregnant as a teenager. In the absence of personal ambitions for achievements in career or finances, there is no real "opportunity cost" to getting pregnant as long as the father of the child takes the responsibility.

For women in particular, sex is not something they feel they can "plan". It is not something that they are supporosed to plan because it must not be an option for them as planning to have sex means planning to make the wrong decision. Having it "happen to them" is more easily rationalized in their minds; they reframe the experience as something thay had no control over. Both men and women will say it happened suddenly (nabigla lang), they had not planned on it.

The full study can be downloaded for free at htttp://pcpd.ph