Alondra is 19: In mid-April, she gave birth to her second child.

Alondra is 19: In mid-April, she gave birth to her second child.

Foto:

Kimberly dela Cruz / DER SPIEGEL

When Children Have Children The Consequences of Reproductive Ignorance in Happyland

Abortion is illegal under any circumstance in the Philippines. For years, contraceptives were only available to women who are 18 or older. The results of those policies are quite visible in one quarter in Manila.
By Maria Stöhr and Kimberley dela Cruz (Photos) in Manila
Global Societies

For our Global Societies project, reporters around the world will be writing about societal problems, sustainability and development in Asia, Africa, Latin America and Europe. The series will include features, analyses, photo essays, videos and podcasts looking behind the curtain of globalization. The project is generously funded by the Bill & Melinda Gates Foundation.

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Happyland isn't an easy place to get to, unless you happen to have been born into it. A broad road runs like a moat along its outer edge, with trucks trailing clouds of dust as they pass. Along the road is a wall of shacks and small houses with awnings of canvas or corrugated metal, dogs at the alert. Huge piles of garbage line the slum, sorted by type – plastic, cardboard, food scraps and metal. And there are colorful posters everywhere of politicians demanding change – posters that have been used to cover up cracks in the cement walls of the residences.

The streets of Happyland in the Tondo quarter in Manila

The streets of Happyland in the Tondo quarter in Manila

Foto: Kimberly dela Cruz / DER SPIEGEL

Manila, the capital of the Philippines, is a megalopolis of 20 million, a collection of several large cities that have grown into one. Happyland can be found in Baranguay 105, in Tondo, a neighborhood crowded along the industrial port of Manila Bay. In local dialect, the word "hapilan" means stinking garbage, and it is basically an inhabited garbage dump. The waste that ends up here mainly comes from the city's large fast food chains – gnawed chicken bones, cold rice and fermented lettuce.

Happyland is a place where many many girls become mothers. The number of teenage pregnancies is high everywhere in the Philippines, but numbers are particularly extreme here. The national Commission on Population and Development, known as PopCom, has called  the huge number of teenage pregnancies a "national emergency." According to its data, from 2009 to 2019, 1.2 million minors gave birth in the Philippines. And around 30,000 of these young mothers got pregnant more than once, according to the commission.

Some of the alleys are so narrow that a wheelbarrow barely fits through.

Some of the alleys are so narrow that a wheelbarrow barely fits through.

Foto: Kimberly dela Cruz / DER SPIEGEL

Alondra is one of the young mothers who lives in Happyland. When she was five months pregnant at the age of 16, she said: "Soon, I will have my own little angel."

Thirteen-year-old Leng, when she felt her fetus move in her belly for the first time, said: "I really am going to be a mother."

The Philippines has one of the world's strictest abortion bans; there are no circumstances under which it is legal to terminate a pregnancy. Women who dare to get an abortion risk years in prison, as do the doctors who perform them. The legislation is driven by the Catholic Church, which has massive influence in he country and to which the vast majority of its 110 million citizens belong.

Informational brochures at the counseling center for women run by Likhaan, an NGO that provides youth in Happyland with contraceptives and check-ups

Informational brochures at the counseling center for women run by Likhaan, an NGO that provides youth in Happyland with contraceptives and check-ups

Foto: Kimberly dela Cruz / DER SPIEGEL

Gynecologists say the abortion ban hasn't resulted in an end to abortions, only to that of safe abortions. They say that around 600,000 women a year search underground for ways to end their pregnancy. They turn to self-proclaimed healers, ingest medications that have not been certified and undergo potentially deadly procedures. The number of women who die from unsafe abortions each year runs into the thousands, according to estimates from the Guttmacher Institute, a think tank focusing on reproductive health.

Nevertheless, bishops from the Catholic Church have called proponents of condoms "terrorists." For several years, contraceptives have been freely available to women in the Philippines – provided they are over the age of 18. As Philippine gynecologist Junice Melgar of the organization Likhaan explains, minors cannot be given the pill without parental consent. There have even been cases, such as one in Mindanao, where couples have had to show their marriage certificate to purchase a pack of condoms at the supermarket.

"And even the laws that are in place are in constant danger of being rolled back ever further by ultra-conservatives and the church," Melgar says. As a result, the lack of knowledge and shame surrounding sex, contraception and birth control are so great that many young people continue to have sex without protection.

Alondra

Alondra: "I'll have my own little angel soon."

Alondra: "I'll have my own little angel soon."

Foto: Kimberly dela Cruz / DER SPIEGEL

It's the end of April and Alondra is sitting on a wooden bench in front of the shanty where she lives. She's wearing red leggings and a pink shirt that says, "take up a new habit, take shopping." The 19-year-old's hair is pinned back. She has 12 siblings and grew up in an apartment not far away.

She talks about her husband, Alfredo, a construction worker who is three years older and is gone every day from 7 a.m. to 5 p.m. Alondra was 14 when they met.

They fell in love immediately, Alondra says, but didn't know anything. When her period failed to appear one month, she wondered: Is this normal? She took a pregnancy test and then went to the doctor. She says she was both nervous and excited – and had no idea what giving birth might actually be like. At 16, she gave birth to her son, Alexander, her angel.

The way Alondra is sitting there on the bench, one knee drawn to her chest as the hustle and bustle of the slum hums around her, it is impossible to tell that her second baby was born just five days before our meeting. Then Alondra's little sister arrives, herself a mother of two, with a bundle swaddled in white, which she places in Alondra's arms. Five-day-old Aldrin was born on April 18, 2022, at 7 a.m.

Alondra, Alfredo, Alexander and Aldrin. Now, there are four.

Alondra says this birth was far more difficult than that first. Her sister, she says, took her to the nearest public hospital. For the last two days, Alondra has been wearing a hormone patch on her upper arm. A local NGO, called Likhaan, gave it to her. It works like the pill and keeps her from getting pregnant again.

"I could have had the patch much earlier, but my family says that part of living with a man is first having children with him," she says.

Since the pandemic, though, their money has become so tight that they can't afford another child for now, Alondra says. Her husband earns 3,000 pesos a week, the equivalent of 50 euros, and they have to borrow money to get by. She says no one ever spoke to her about contraception, and she didn't dare to ask about it herself. But then, one day, people from Likhaan visited Happyland. Now, many of her friends wear the same patch on their arms.

Likhaan has moved into a small infirmary in Happyland where they provide education, check-ups and urine and blood tests. They say their biggest challenge is convincing girls in Happyland to use the hormone patches or other contraceptives before they get pregnant for the first time and making clear to them that having a baby as a teenager means you can't finish school and you can't start a new job. That you will earn no money and will have no freedom.

Many in Happyland believe that having a boyfriend is synonymous with getting pregnant. The older generation tells young people that having a child is a gift from God that must be accepted. And young men believe that having a child is part of being a man.

What no one is saying, though, is that pregnancy and childbirth are incredibly dangerous for teenage girls because their bodies aren't fully developed yet. Indeed, it is among the leading causes of mortality in this age group.

Leng

Leng is 13 years old and in the sixth grade. She is in her sixth month of pregnancy in this photo.

Leng is 13 years old and in the sixth grade. She is in her sixth month of pregnancy in this photo.

Foto: Kimberly dela Cruz / DER SPIEGEL

Leng, a girl who many in the neighborhood describe as beautiful, says she only knew in theory that she could get pregnant. But she didn't use contraception because she didn't know how.

Leng is 13 years old and she's in the sixth grade. She says she's glad that classes are still online as a result of the coronavirus, because what if her classmates saw her belly?

Leng is six months pregnant when she invites us into her home in April; the baby is due at the end of July. She is living together with her boyfriend Jasper, who is 19, the two of them occupying a room on the upper floor of the house. Leng has to sit a lot, with the heat becoming difficult to bear at this stage of the pregnancy. Her belly is visible under her red shirt.

There's a bunk bed in one corner of the room and a toilet with a curtain in front of it in the other. The couple have hung the things they own on the ceiling with strings. The room is dark and stuffy, and a large wooden cross hangs from the door. There are stairs leading up to the room, but Leng now has trouble using them, so she hardly goes outside.

Leng is also afraid people will talk. She's 13 and pregnant, just like her mother was, who also gave birth to her child at a very young age. Leng is afraid of how her parents might react. When she stopped menstruating and a test confirmed that she was pregnant, she moved in with her boyfriend. His parents are tolerant of the couple and accept their relationship.

Jasper says he cried when he found out he was going to become a father. He says he was nervous and happy in equal measure, but also proud. Jasper wants to work a lot so that his family can make ends meet. They have been lent some baby supplies that they have collected on the windowsill: a bottle, some wipes, a onesie.

Leng and her boyfriend Jasper live together in a room in Happyland.

Leng and her boyfriend Jasper live together in a room in Happyland.

Foto: Kimberly dela Cruz / DER SPIEGEL
"I'm so afraid of giving birth," Leng says.

"I'm so afraid of giving birth," Leng says.

Foto: Kimberly dela Cruz / DER SPIEGEL

According to the World Health Organization, girls who get pregnant before the age of 19 are more likely to drop out of school and less likely to get a job. They are also more likely to be exposed to abuse from their partner or spouse.

Leng says she's still not used to the idea that she'll soon become a mother. She hadn't actually wanted a baby until she was 20 and had hoped to become a stewardess, to move away and see the world. Singapore, especially, because she heard it was beautiful there. Still, Leng says, she has never even thought of not carrying her baby to term.

Still, she adds: "I'm so afraid of giving birth."

There are many maybes in this story. If given the choice, would a 13-year-old not become a mother, or maybe wait until later? Would she think differently about the future and what she could do with it if those in power in the Philippines gave her that opportunity? Would she maybe then find a way out of Happyland?

Making your way across cardboard-covered ground to Alondra and Leng, it becomes impossible to avoid another, rather uncomfortable question: Is more importance attached to giving birth to a child of one's own in places where everything else one possesses is used, soiled or borrowed?

Maybe.

What is certain, though, is that Alondra, Leng and the others have been cheated out of the chance to truly make one of the most important decisions of their lives for themselves.

This piece is part of the Global Societies series. The project runs for three years and is funded by the Bill & Melinda Gates Foundation.

The Global Societies series involves journalists reporting in Asia, Africa, Latin America and Europe on injustices, societal challenges and sustainable development in a globalized world. A selection of the features, analyses, photo essays, videos and podcasts, which originally appear in DER SPIEGEL’s Foreign Desk section, will also appear in the Global Societies section of DER SPIEGEL International. The project is initially scheduled to run for three years and receives financial support from the Bill & Melinda Gates Foundation.

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