Sen. Pia shares how her personal experiences as a mother inspired her series of maternal and child health laws
Speech of Senator Pia S. Cayetano at the inauguration of the Human Milk Bank of the Dr. Jose Fabella Memorial Hospital (February 8, 2023)
Hello, thank you. Please take your seats.
I love talking about breastfeeding. It was one of the most difficult and yet, now most memorable times of my life. Parang marathon lang yan, mahirap habang ginagawa, but forever, you have stories to remember that experience.
So the work that I have done is clearly inspired by my life as a mother, and a breastfeeding mother at that. The reason I always have been saying in local and international forums that we need more women leaders, more elected women leaders, more appointed women leaders, more executive women leaders, is precisely because women have distinct experiences. Iba ang karanasan ng isang babae. Kahit hindi ka naging nanay, iba pa rin ang karanasan ng isang babae. So kapag gumagawa ng desisyon, the most high-level decisions should include the perspective of a woman. I have to start with that statement. Women should always have a voice at the table.
So, today, it’s common for us to see women in the workplace. Especially in a health environment, I don’t know, dominant ba ang women? [asks the audience composed mostly of healthcare professionals and staff] Of course, sa nurses, dominant ang women. How about sa doctors? I know sa graduating, dominant na rin ang women, but I don’t know in the earlier batches. Ngayon lang, yung medical personnel, are there more men or women? Women? Sa Fabella? Women. Okay.
So, very clearly, women are part of the workforce in the healthcare system, in government, part of the workforce. Whether the number is 20 percent, 30 percent, 50 percent, sometimes more, you need women in decision-making positions to make the women who work have a fulfilling life at work and at home.
And I need to emphasize, we don’t do enough to make the workplace favorable for a woman who has obligations at home. And I am referring to women who may be mothers, may be wives, may be caregivers for their older parents, or for all their adopted pamangkins and cousins and lahat ng pinag-aaral nilang mga pamangkin nila at kamag-anak nila. Ganun talaga ang kababaihan worldwide, and especially with the Philippine culture.
So with that in mind, I worked on certain laws based on my experience and the experience of other women. So I want to share my breastfeeding story with you, something I talk about often, every August, for sure yan, during breastfeeding month, and in the early years when I was working on these laws. But most of the laws have been made, I am not aware and I am happy to be educated if may need pa for more laws, pero kung hindi naman, then let us continue to ensure that our laws are implemented well.
READ: Philippines Senator Serves as Breastfeeding Champion, Yale School of Public Health (June 4, 2018)
So, dinatnan ko sa Senate na nandyan na ang Milk Code, which is a law by way of Executive Order but has the force of law, and at the time that I was a new senator, there were still a lot of cases where there were violations. I think, I hope that those are not as much of an issue anymore, yung namimigay ng gatas [formula milk], mukha namang na-[address] na natin yan, ano? And we have been able to promote breastfeeding.
So the first law that I worked on was the Expanded Breastfeeding Law. But before I go there, history, and then I’ll jump back to it. So, I was a breastfeeding mother by choice. I am a lawyer, I was a practicing lawyer when I became pregnant with my first child, and I had decided, please take note walang internet, okay? So hindi madaling maghanap ng information. But I had decided that I will be present in my child’s life despite the fact that I had to work for 8-12 hours a day depending on the workload per day, by way of breastfeeding my child, something that my mom, my wonderful mom, who continues to be a very active grandmother to my kids and her other apos now, something that my mom and the yaya cannot give, which is my breastmilk.
So that was a choice that I made. And it was a difficult choice because breastfeeding is a personal experience. For some people, it comes easy. My best friend who gave birth a few years after me, I gave her all these pep talks, kasi ako hirap na hirap ako, but when she expressed her milk for the very first time, for some reason, she didn’t have access to her baby or she had extra milk, tried to express it, ganun-ganun lang. Puno na ang 4 ounces na bote. Ako, it took months for me to express that kind of milk. So my first few days of life as a breastfeeding mom was so difficult. It was very painful, it was very difficult, it is what it is. And for many mothers, they are not prepared for that kind of difficulty.
So that is something that I continue to talk about. It’s like giving birth. My first baby, I had 22 hours of labor. May taong ganun, may taong one hour, di ba? It’s all different. But I like to prepare women for the potential difficulty kasi so women say they were not prepared on how hard it would be. So it was hard, but I had made the decision that I would be breastfeeding. So I struggled. I really struggled. I struggled on and one of my first breakdowns, meltdowns, was when we got home a few days after and I was going to start learning how to express my milk, yung binili kong pump, nasaksak sa maling, 110 volts yun, nasaksak sa 120, so sumabog. My next obstacle was when I went back to work two months later, and this has nothing to do with breastfeeding, well it does, but kwento ko na rin. Not only did I not lose the weight that everybody said I would dahil athletic daw ako, again it’s a personal journey, bumalik akong hindi pa rin ako bumalik sa dating size ko. So it’s something I had to deal with, but eventually I did with good nutrition and I exercised, but I didn’t at that time. And my first day back at work was very difficult. Nagka-fever ako kasi hindi ko ma-express yung milk ko because my baby was used to breastfeeding 24/7.
So my mom brought my baby to work. Hindi naman every day, but she did it for the first few days to help me out. And then, yung milk ko, ini-store ko yun sa office refrigerator, tapos pag-uwi ko, amoy ulam yung aking gatas. So I decided after that, dadalhin ko na lang ang sarili kong cooler. So inuuwi ko ang cooler ko. And what actually worked for me, because nga nasira ang pump ko, hindi naman ako bumili agad ng bago, was a manual pump. So, for those who still remember a regular telephone, uso pa naman telephone sa offices niyo, no? Okay. So, I would be on meetings with my clients, magda-dial akong ganyan, tapos hawak ko with one hand yung pump ko na naka-pull siyang ganun para ang pressure niya, nag-eextract siya ng milk tapos naka-speaker ako. Ganun ang buhay ko noon, wala pang cellphone noon.
So this went on through my first pregnancy, my first baby. My second baby was born shortly after my grandfather passed away in the US. So I actually flew to the US without an electrical pump, yung manual ko na pump, expressing myself… expressing my milk every 2-3 hours in the airplane, pag-land ko, bumili na ako ng electrical pump. And that changed my life somehow. And yung pump na yan, napasa-pasa na yan sa ibang tao. Nakarating ba sa yo yun, Claire? Claire, on the spot. Napunta ba sa yo yung pump na yun o iba pa? Niregaluhan kita? Okay. So yan na ang gift of choice ko sa mga mahal ko sa buhay katulad ng long-time personal assistant kong si Claire who was breastfeeding for many, many years, which is something I am proud of, kasi sa office ko, lahat ng nagbuntis at nagka-baby, we have encouraged them – not pressured them, take note – to breastfeed.
So, that was my journey with my first two kids. But my third child was actually one of those children born with a congenital anomaly. He had Trisomy 13. So, when he was born, he was born with a cleft lip and palate, which on its own already makes it difficult to suck, and I consulted a pediatric dentist who gave him a…what do you call it? Obturator? Tama ba? And he had that. But because my son had Trisomy 13, which included developmental delays, hindi lang ang cleft lip and palate niya, that was not the only reason that prevented him from sucking properly. So eventually, he had to be fed through a tube, and so I ended up expressing my milk and giving it to him through a tube.
So again, our experiences are different. If he was my first child, siguro hindi ako magkakaroon ng patience, determination to do that kasi ang hirap na nga ng first na pinagdaanan ko, di ba? What more kung ganun. So again, the experience is different. I am not saying na ako, kaya ko, kayo hindi niyo kaya. It’s not that. I am just sharing that there are different experiences for everyone.
So I was able to do that for my son with the support of course of the medical staff. My son lived and died in Makati Medical City. So yun ang breastfeeding experience ko with my son. It was so nice to hear the presentation that here in Fabella, you will be able to have the mother stay for their baby for as long as the baby is still in the hospital. So that was my experience with my son because he was never strong enough, we had a plan to bring him home, but the nature of his illness was that he always had respiratory infections. So gagaling, magkakasakit, gagaling, magkakasakit. He never was able to leave the hospital. But of course, I had a plan. So in the meantime, nung hindi pa siya makaalis, I ended up… first, I did a parang day-to-day stay, yung arawan na condominium, and then after that, nag-rent pa talaga ako ng condominium across Makati Med to be near him, kasi I had to breastfeed my son. And of course, given his situation, I’d rather be closer.
Kaya naiintindihan ko talaga yan. And I don’t think it’s easy to explain to others when you think of expenses kasi parang, ‘ba’t kailangan yan, di ba?’ But ako, I know from experience na kailangan yun. And yung mga ‘classmates’ – I call them classmates – classmates ng anak ko, most of whom were preterm, mukha silang kuting when they are born, but they happily grew up to be healthy enough to go home. And my son looked like the most healthy, but he never was healthy enough to go home. So that’s the situation. And yun nga. I think, I actually don’t know, I suppose yung mga nanay na yun, umuuwi ano? But they were there often, so that’s interesting enough na I think they had support from the local government to allow them to be there, because they were there as often as me. So I am very happy to hear that.
So anyway, siguro ang breastfeeding experience ko pa lang, ano na, parang sakop na halos lahat, may long-distance breastfeeding story ako, and the truth is, na-affect ang supply ko because when I went with my mom to pay respects to her father, my grandfather [in the US], syempre I was gone from my baby for more than a week. Eh parang two months pa lang siya nun. So medyo hindi ko na-recover ang talagang same supply. But I continued to breastfeed both those kids, my two girls, for a year. Yung son ko, less kasi he died before he turned one.
READ: Who is Gabriel?
And then after that, I had the pleasure of being able to also share my breastmilk, not after that but during that period, I was able to share pa my breastmilk with friends who had preterm babies. And I am happy that fast forward, my sisters-in-law, si Fille, si Mabbi, they also both breastfed their babies, binigyan ko rin sila ng pump. Excited ako that they also enjoyed and had that breastfeeding journey with all of their kids. And sa pagkakaalam ko, they also were able to donate their milk at some point to babies in need.
So there are a lot of babies in need in different circumstances, katulad nga ng nabanggit niyo. It could simply be preterm, it could be nga may sakit, it could be for some reason, the mom is not able for whatever reason, or nalayo sa mother. So there’s always that need. And I am proud to say that the city of Taguig, where my sister-in-law is mayor… actually it was my brother, Lino, who was the mayor at that time, Batangas? [After Taal volcano’s eruption in 2020], that was just two years ago, di ba? So through our Taguig City Milk Bank, nakapagbigay din kami, nakapag-donate din kami ng 50 liters, can you imagine? 50 liters of breastmilk sa mga mothers who were breastfeeding [in evacuation centers after the Taal volcano eruption].
So can you imagine if all of us can do our part during those times? There will not be this conflict anymore: hirap na hirap ako magpaliwanag sa mga well-meaning people na gusto mag-donate ng delatang gatas, na hindi makakabuti. But from our end, we need to step up also the availability of breastmilk para wala nang debate on the availability of the better milk for the infants.
Now back to the lawmaking. As I said, after the Magna Carta of Women, which is really the starting point of empowering women, the next law that I worked on was the Rooming-In Law, which ended up to be an amendment to the late, then still alive, Sen. Edgardo Angara’s Rooming-In Act. So in-expand ko yun kasi meron nang rooming in, which is great, di ba? Now, it’s a thing. It is what it is. Dati ano yan, hindi yan common. Hindi yan heard of. So, for those of you who’ve been around like me, it’s so nice to see what we have been able to accomplish. And it wasn’t always easy. So, after that, we had the Expanded Breastfeeding Act. So now, when you go to the malls, and in fairness, some of those malls had their own initiative, hindi naman nila inantay maging batas, nauna sila. But interestingly, I’ve been in distant terminals… of boats in the provinces, not in main cities, and I am so pleasantly surprised that there are breastfeeding rooms all over now. So the goal is really, we make it easier for women to breastfeed, for women to give their kids the nourishment that they want to give.
And then the ending of that story is, the Maternity Leave Law. Kasi, I was always conscious of the fact that when I had to go back to work in 60 days [under the old maternity leave law], parang talagang it’s not enough because you’ll still leave your baby very frail, like your baby can’t even hold up their head. So me as a mom, in the years before we passed that, I was really thinking na, syempre, one step at a time, inasmuch as gusto ko mang sabihin na 180 days [maternity leave benefit], the employers naman cannot afford to give 180 days. So sabi ko, ano ba yung minimum? Tingin ko yung minimum [is when] a baby can hold up their head. They look and feel, and they are much stronger. And that’s why the goal was roughly 100 days. Sabi n’yo, ang-weird, 105? Kasi nagkatawaran pa yan. Ganyan in lawmaking. Yung 120 at 100 [proposals from the Senate and House] hinanapan ng gitna. Hindi naman gitnang gitna. Pero ayan, 105, sana 110 na lang, ano? 105 days. So yun ang history nun kaya naging 105.
And take note, ang pinaglaban ko dun, is that it’s a paid leave. Because aanhin ng karamihan ng working mothers ang leave tapos wala naman silang kinikita? We have to be cognizant of the fact na hindi marami ang kayang mabuhay na walang pumapasok na income, di ba? And that’s why we worked very closely, mahaba na diskusyon yun, honestly, [there was a] debate with the Department of Finance kasi ayaw din nila ma-burden ang employers. Pero sabi din naman natin, babalik naman [sa trabaho] na mas maligaya, mas masipag ang mga nanay na maiiwan nila ang mga anak nilang malulusog. Plus the fact that SSS and GSIS naman ang nagbabayad nun, hindi naman employers. So marami ring misunderstanding on who’s paying for what. So it is, again, what it is now. And we’re very happy for that because it allows women to bring home the income when they are doing their other job, which is taking care of their newborn baby.
READ: Pia hails signing of the Expanded Maternity Leave Law (February 21, 2019)
So I think I can end that story now. I am just so happy that we have this event to continue the breastfeeding story all over the country. We all know, and we continue to support Fabella as the leader in maternal care. Dagdag ko na din dyan ang reproductive health journey. Kasama yan sa lahat ng diskusyon ko. Congress recently approved, and we now have an Education Commission, wherein inaaral namin lahat ng problema sa education. And would you believe na, when we were asked [at the EDCOM strategic workshop], we had a workshop where we wrote down on a piece of paper kung ano ang mga obstacles on the delivery of education. Sinama ko talaga ang reproductive health, kasi others will say, quality of teaching, classroom…pero babalik ako sa reproductive health. We cannot – and I am sure those in Fabella and public health personnel see it every day – have more Filipinos than we are capable of taking care of. So kapag andyan na, alagaan natin 101 percent. Pero kapag wala pa, pangaralan naman natin ang mga magbubuntis na planuhin naman nila ang pamilya nila na they can be responsible. Kaya nga ang buong pangalan ng RH is responsible parenthood [Responsible Parethood and Reproductive Health Act] di ba? Parang hindi naman tayo responsible as a nation if we cannot prepare the future parents to also be responsible parents.
So on that note, ang haba ng kwento ko, pero I feel it was very important to share this para kahit ako, when I recount some of these things, nai-inspire din ako na there’s more pa that we can do. And si Dra. Vivian [Eustaquio] over there, has had countless of seminars all over the country when we go out and meet different barangays and LGUs. Ang priority topic namin is always maternal care, and that includes breastfeeding. So ginagawa namin yan and I’m sure ginagawa n’yo din kasi kulang na kulang pa rin. We still have so much to do, but this is a great step in the right direction. Thank you, everyone. I am pleased to be a part of this. Thank you! #
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