"So the least we can do - the least I can do - is to keep fighting." They won some, and they lost probably more, but they passed on to us better situations that they started out with." The work of improving access to birth control, Hontiveros said, "were passed on to us by those who came before us, they struggled, and they fought. Risa Hontiveros knows the limits of the laws, the complexity of the issue and the danger of losing hope. And the people who suffer are the urban poor. Yet the reproductive health laws in the Philippines - aimed at stemming population growth - are yet to have that impact. If households have fewer children, Perez said, it will improve the family members' chances of getting out of the mire of poverty. So after decades of policies that limited access to contraception informed by a Catholic ethos to procreate, government agencies are now acting with a new urgency to bring the birthrate down. The government now believes that the country's birthrate of 2.92 births per woman - among the highest in Asia - is holding back economic development. "We made a decision in this country that population is a problem," said Perez. Yet the current government wants to see changes. Joan can't imagine a different kind of life. The family is often hungry and thirsty, and survives by begging sailors for food and water.
Her father brings in some money doing odd jobs at the port. Her mother occasionally finds a day of work cleaning mussels on the concrete floor of the fish port. No woman close to her has ever had a good job. Like Joan, her older sisters had babies when they were young and left school before they graduated. Sisters Joan (left) and Jossa Garcia (right), both teen mothers, are seen in their home in the Navotas fish port with their children, Angela and JM, respectively. Two of her sisters' babies and a kitten nap on a pile of rumpled sheets against a particle board barrier to keep them from falling into the murky, gray water. Joan lives with 16 relatives on a small raft of bamboo poles and scavenged wood, tied to a broken cement pylon, bobbing behind a row of steel shipping vessels docked in Manila's fish port - a patchwork of spaces no larger than two king-size mattresses. Perez said the lower income continues further into adulthood. By age 20, a teenage girl in the Philippines who gets pregnant and drops out of school earns 87 percent of the average 20-year-old woman's pay.
That was the finding of a 2016 study by the United Nations Population Fund. "They cannot recover from being a child mother," he said. Perez said a teenage pregnancy has a significant impact on perpetuating poverty. To address the resulting uptick in adolescent pregnancies, lawmakers have introduced bills improving access to contraception, supporting sex education and making it illegal to expel girls from school should they become pregnant. The law improved access to birth control for women, but it became harder for teenagers to get birth control. Juan Perez III, executive director for the Philippine Commission on Population and Development. "It was one step back adolescent health," said Dr. Locals call it the "baby factory" â and the maternity ward is typically very busy. The Jose Fabella Memorial Hospital serves low-income communities in Manila, where the rates of teen pregnancy are high.