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Life-threatening Abortions: A Frequent Practice in Brazil

This analysis was prepared by COHA Research Associate John Garcia
July 2, 2010

It should come as no surprise that a country whose population is 74% Roman Catholic bans abortion. In Brazil, the prohibition of abortion dates back to 1940. Today, the procedure can only be legally practiced if medical complications threaten a woman’s life, or when a pregnancy results from incest or rape. Due to this law, women who do not meet one of these conditions and who desire to have an abortion must routinely go through precarious and unlawful means, such as taking a drug cocktail or going to an unlicensed clinic. Unsafe abortions occur with such great frequency that the government’s critics insist that the law places millions of women at serious risk yearly. They demanded that the authorities show some responsibility and protect the health of women by legalizing abortion. Standing in the way of change is the Roman Catholic Church’s dogma, which dominates public opinion. As an institution, the Church itself stands opposed to the decriminalization of abortion, and uses the threat of excommunication as a means to frighten those in government who hope for progress.

A Dangerous Status Quo

A recent national survey conducted by the University of Brasília shows that one out of five women under the age of forty has had an abortion. The Health Ministry reports that approximately 1,000,000 illegal abortions are performed a year, and an estimated 200,000 women annually must seek hospital attention due to complications arising from these illicit abortions. The problem may be even more serious than the study indicates because it does not take into account the large number of abortions performed at private clinics. An International Planned Parenthood Federation investigation carried out in Brazil found that over 5,000 women die, and at least 800,000 women must be hospitalized after undergoing these illegal procedures every year. Roughly half of the illegal abortions are induced by prescription-related drugs, while the other half are performed in clandestine, often unsanitary clinics.

The University of Brasília’s survey defied preconceived notions regarding the sort of woman who gets an illegal abortion. It revealed that single adolescents and older women are not the only ones commonly seeking illicit abortions. The team leader of the study, anthropologist Debora Diniz from the university’s Bioethics, Human Rights and Gender Department, has noted that research indicates most women who obtain abortions are married, church-going, have children, but have received minimal education. This study showed that the problem of life-threatening abortions affects women from all walks of life, but that poorer women put their lives at much greater risk than wealthier women.

More affluent women are more likely to survive an abortion because they have the money to access safer clinics. On the other hand, Citizens’ Human Rights Advocacy, a non-governmental organization, conducted a study that found Brazilian women who suffer complications or die from botched abortions are poor, black, and uneducated. Gleyde Selma da Hora, the organization’s executive director, explains the reasons why poor women get abortions: “Poor women who undergo abortions already have an average of three children and maintain that they are unable to guarantee a decent life for an additional child; others claim they cannot count on their partners to share the responsibility; and there are also some who say that the condom ripped and the pregnancy was unwanted.” On a day-to-day basis, Brazilian law currently fails to protect women who seek an abortion under acceptable conditions as a result of the unremitting hostility of the Church.

The government study supports the university’s finding that a woman who decides to have an abortion comes from any socioeconomic class. Marcelo Medeiros, the economist and sociologist who coordinated the government-funded study, concluded that in Brazil a woman who seeks an abortion is, “A typical Brazilian woman. She could be your cousin, your mother, your sister or your neighbor.” Despite the common notion that only poor, uneducated women get abortions, these studies prove that women of varying race, economic class, and marital status all seek abortions.

Roman Catholic Church’s Control

The Roman Catholic Church puts tremendous pressure on Brazil’s government to continue to proscribe abortion. Brazil has the highest number of Roman Catholics in the entire world with over 140,000,000 claiming the faith. The Roman Catholic Church stands fiercely opposed to abortion and contraception. Bishops frequently remind people that the use and promotion of contraceptives constitute an excommunicable offense. In 2008, Brazil’s Catholic Archbishop José Cardoso Sobrinho condemned the distribution of the morning-after pill in the city of Recife during the Carnaval festival, and warned that those who use the pill are subject to excommunication. Abortion is also an excommunicable offense, not only for the woman, but for anyone involved in carrying out her decision, such as parents and doctors.

The Church’s use of excommunication induces great fear in doctors and politicians alike. The most egregious case of the Catholic Church’s use of excommunication in response to an abortion occurred in 2009 when a nine-year-old girl was raped by her stepfather and impregnated with twins. Doctors recommended an abortion because her uterus was too small to carry one infant, let alone two. Archbishop José Cardoso Sobrinho excommunicated the girl’s mother as well as the doctor who performed the abortion, citing its illegality according to Church law. The doctor defended his decision by saying that he performed a legal abortion because the girl had been raped and was facing a life-threatening pregnancy.

On his way to Brazil, as part of his tour of Catholic nations, Pope Benedict XVI spoke to reporters aboard his plane, supporting the excommunication of politicians who in any way legalize abortion. During the Pope’s visit to Brazil, he emphasized that the Church places the right to life above all else. In his first address to the Brazilian people, he told them of his belief that life must be valued and respected “from conception to its natural decline.” His public appearances over the course of his five-day visit emphasized the Church’s strong line against abortion. In an overwhelmingly Catholic country, it is no surprise that Brazilian politicians are afraid to break from the Church’s adamancy on the subject.

Sending Mixed Signals

Brazilian authorities are sending mixed messages to their citizens as to whether the abortion statute will be changed. The government has taken some efforts to remedy the situation by striving to decrease the number of illegal abortions. The health ministry offers free contraceptives—from condoms to contraceptive pills to vasectomies—in all of Brazil’s 5,565 municipalities. Since 2003, the government has increased its spending on contraceptives sevenfold. The health ministry also makes morning after pills available at metro stations in the country’s most populous state, São Paulo. In April 2007, Health Minister José Gomes Temporão declared that illegal abortions are a “public-health problem,” and has called for a public forum in which to discuss its legalization. Dr. Adson França, special assistant to Health Minister Temporão, asserts that women should be allowed to decide how many children to have. By offering free contraceptives, the government is attempting to reduce the number of unwanted pregnancies. This program is proving to be ineffective as the number of illicit abortions remains steady at 1,000,000 per year.

Along with the Health Ministry’s ineffective track record thus far, Brazil’s legislature has been sending mixed signals to Brazilians on the issue of abortion. On the one hand, it appeared that congress was moving towards decriminalizing abortion. For seventeen years, the Brazilian legislature debated the loosening of restrictions on abortions. In 2008, however, Brazil’s lower legislative house, the Chamber of Deputies, tabled two bills decriminalizing abortion by an impressive 30-4 vote, ending all hopes possessed by pro-choice advocates. The vote came after Eduardo Cunha, the head of the Constitution, Justice, and Citizenship Committee, rejected the legislation. Cunha said, “The right to life constitutes the supreme value of the Constitution, because all other rights are derived from it.” He also noted that not even a constitutional amendment can abolish the right to life.

Furthermore, Brazil’s Congress is now proposing even more burdensome restrictions on abortion. It is working on a draft bill that grants unconditional protection for the unborn. The draft bill intends to criminalize any statement that promotes abortion, as well as any act that intentionally causes death to or harms the fetus, including the freezing, manipulation or the use of it as material for scientific experimentation. This law would make potential criminals of women who have miscarriages, as well as, those people who dare utter a word in favor of comprehensive reproductive healthcare. All information so far indicates that the prohibition of abortion is not working and should be repealed, not strengthened. Many Brazilian health professionals hope Congress does not pass this legislation and that future legislators will be more liberal.

The million of illegal abortions every year is an indication that Brazil’s current ban on abortion puts millions of women in grave danger, and government efforts to limit unwanted abortions amount to nothing at all. President Luiz Inácio Lula da Silva, who is personally pro-life, is publicly calling for the topic to be discussed as a public-health issue rather than a moral one. Lula, perfectly aware of the excommunication controversy surrounding the nine-year-old, has said, “In this case, the medical profession was more right than the Church,” and, “As a Christian and a Catholic I deeply regret that a bishop of the Catholic Church has such a conservative attitude.” But despite President Lula’s rather strong words against the Church, during the first seven years of his administration, he has done little to encourage a public discussion about the issue of legalizing abortion. However, in December of last year, Lula sent a proposal to Congress requesting bills on several human rights initiatives, including the decriminalization of abortion. This proposal has been lambasted by pro-lifers in the Congress, the Catholic Church, and the National Congress of Brazilian Bishops.

Lula’s sudden call for action on the issue of decriminalization may be due to the fact that 2010 will not be an election year for him because Brazil’s constitution limits presidents to two terms. One of the stated goals of Lula’s presidency was to reduce the maternal mortality rate because the fourth leading cause of maternal premature deaths is unsafe abortions. The fact that maternal mortality has remained relatively constant for Lula’s presidency indicates that he is failing to achieve this goal as a result of his indecisive policies. Considering Brazil’s economic status and sterling accomplishments in other health-related fields, the country’s alarming maternal mortality rates can be classified as unreasonably high. Lula is attempting to get Congress to initiate a series of liberal reforms, including the legalization of abortion, to improve his legacy as a progressive leader.

Debate for Change

Despite the life-threatening nature of abortion, a majority of Brazilians do not seem to want a substantial change. According to a 2007 survey by Datafolha, 65% of Brazilians believe the current law on abortions should remain unchanged. Only 10% believe that they should be decriminalized outright, and 16% believe the law should be modified to include other categories where abortion should be allowed. While Congress debates tightening regulations on abortions, one study has shown that almost no one wants to tighten restrictions.

Most public health officials favor decriminalizing abortion. President Lula, Health Minister Temporão, among others, believe abortion is a public health issue and not a moral one. In fact, Minister Temporão has said, “From the public health standpoint, I am in favour of legalization.” The Health Ministry tried to make things easier for women by instructing doctors to perform abortions in the case of rape without a police report. However, many doctors still require one because they fear adverse legal repercussions. The Health Ministry is working on changing the law so that women do not need a police report for an abortion.

Conclusion

Of all the BRIC countries (Brazil, Russia, India, and China), Brazil is the only one where abortion remains illegal. Furthermore, Brazil aspires to be a developed nation, and no developed country has such restrictive laws on abortion, with the exception of Ireland. If Brazil wants the international community to take it seriously as a developed nation, then it will have to change its prudential attitudes regarding abortion. The Brazilian Church’s current stance places millions of women in danger and unnecessarily forces them to risk their lives as a result of back alley abortions. However, the draconic grip of the Roman Catholic Church makes changing abortion legislation all but impossible. A very large percentage of Brazilian intellectuals would argue that Lula’s position on abortion is opportunistic and does him little credit because he failed to change policy and did not stand up to the Church. Brazil has already defied the Church by distributing free contraceptives because politicians acknowledge abstinence will not work. As Lula himself said, “Sex is something almost everybody likes.” The writing is on the wall is clear: it is a time for action, not just for words.

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