Having a baby when you want it, and are ready for it.

This doesn’t sound like much to ask for, but growing up in the Philippines, Annabelle Agustin-Alazar didn’t think she had these choices.

For young women living in rural Palawan — some in their teens — having one child after another was the norm, regardless of the impact on their health, or finances. “There were a lot of women here who had eight or nine children,” says Annabelle.

With her husband working as a fisherman and herself juggling odd jobs, Annabelle hoped not to go down the same path. “Our life is hard, we don’t have permanent jobs. We didn’t finish any education too so we couldn’t apply for good jobs, so I didn’t want many children. I also think of their future.”

Contraceptives could have helped Annabelle achieve her family planning goals, but for her and her peers, such methods were a distant concept to be feared.

For example, many believe that birth control pills do not dissolve in the body and have to be flushed out, and that injectable contraceptives cause tumours. “I was afraid to use them too, because I didn’t have any idea about contraceptives,” shares Annabelle.

Neither are contraceptives readily available — supply is limited in a region that is conservative due to religion.

After having her first child, Annabelle had hoped to wait seven years before having a second, so that her first child would be settled in school by then. But she became pregnant after four years, catching the family by surprise and straining their finances.

It was during her second pregnancy that she was invited to an outreach session by Roots of Health, a non-profit tackling unplanned pregnancies and reproductive health in Palawan.

The talk was an eye-opener for Annabelle, who attended all 19 modules about family planning. “I wished someone had talked about it to me, so that I could have delayed my pregnancy,” she says.

When Roots of Health called for volunteers to act as Community Health Advocates (CHA) to reach out to more women, Annabelle eagerly signed up, even though she had just given birth.

The root of the problem

Founded in 2008, Roots of Health provides sexual and reproductive health education to youth and women, as well as access to contraceptives and maternal healthcare.

Teen pregnancy is an especially pressing issue in Palawan — one in four girls will be a mother by the time she turns 19, compared to one in six nationally, and one in 10 globally. Girls who become pregnant not only face health risks; they have to drop out of school, affecting their job prospects and trapping them in poverty.

“A problem we saw [was] that women did not have access to basic information about their bodies and their health and they didn’t understand what contraception was,” says Amina Evangelista Swanepoel, the founding executive director of Roots of Health.

Unplanned pregnancies, she points out, aren’t just a “young people” problem. “A majority of Filipina women, even those who are married and are older, have more children than they wanted.”

“We want women to be empowered, we want girls to stay in school, we want all pregnancies to be wanted and planned.” Amina Evangelista Swanepoel, founding executive director of Roots of Health

To date, Roots of Health has educated over 20,000 youths in schools, and provided 18,000 women and teen girls with contraceptives.

As a clinic assistant and CHA, Annabelle reaches out to women to help them understand how they can take steps to plan their pregnancies.

“In the past, some of the women would just depend on what their husbands say. I tell them I explain to my husband and that’s how he understands our situation,” she says. “They are not the ones who get pregnant. We should also think of ourselves and our families’ welfare.”

As she works to empower other women in her community, Annabelle hopes to do the same for her daughter.

“I want to teach my daughter about what it is to be a woman, and that she should plan everything, including her future family.”