Brazilian women risk life, liberty in having to seek backstreet abortions

RIO DE JANEIRO — When 40-year-old Micheline Alves decided to have an abortion six weeks into her pregnancy, she had many mixed emotions. But guilt was not among them.

The mother of two from an affluent neighborhood in São Paulo knew her decision was illegal in Brazil, and yet she believed it was the right choice for her. Moreover, she had faith in the doctor she trusted to carry out the procedure.

“I think it’s difficult to do something clandestine, but I don’t think I should go to prison. I don’t think I should be punished by law,” she said. “I think it’s totally a moral judgment. There are philosophical questions as to whether you should do this or not.”

Abortion remains illegal in Brazil except in cases of rape, danger to the life of the mother or brain deformity. However, as many as 1 million women risk their health — and their freedom — by ending pregnancies illegally in the country every year.

When they do so, it is often in unsafe underground clinics that frequently result in hospitalization and, for some, a prison term. While the number of women who face legal consequences for having abortions is thought to be small, those who do are often reported to the police by the hospitals they visit when abortions go wrong.

A survey of arrests found 33 women were reported to police last year, including 15 in Rio de Janeiro and 12 in São Paulo. At least seven of those in São Paulo were reported by doctors. Abortion-rights campaigners argue doctors reporting women who have abortions undermines trust in the public health service, putting women at even greater risk.

One such case recently hit the local press. When Jessica (not her real name) became pregnant for the second time at 19, she was already a mother to a 4-year-old boy, newspaper Folha de São Paulo reported. Just a child herself when she had him, she dropped out of school and relied on her parents to help her raise her child in Brazil’s biggest metropolis.

But when she discovered she was expecting another baby, despite taking a birth control pill, like many young, poor and desperate women in Brazil, she wanted a termination. “I don’t have a fixed salary. I am just paid for what I do in the salon,” Jessica, a hairdresser’s assistant, told the newspaper. “I also didn’t want to put more on my parents’ shoulders.”

After saving 300 reals ($94) to buy misoprostol — a stomach ulcer drug also used for medical abortions — to end her pregnancy in its the fourth month, Jessica began hemorrhaging and needed to go to the hospital.

The medic who saved her life then called the police.

“It is unacceptable,” said Débora Diniz, a co-author of the 2010 National Abortion Survey in Brazil. “The basic premise for any medical assistance is confidentiality between the doctor and patient. This breach is made when the doctor leaves behind his role as a doctor to assume a police role, and this ends up putting public health at risk.”

Diniz said that half the women who have abortions require hospital treatment and that the only solution would be to decriminalize terminations to stop women from turning to clandestine clinics or even staying at home. “Women’s lives and health are priority items when negotiating agreements,” she added. “But they are the most lacking. In Brazil, we have many people who negotiate morality in the name of rights.”

While Brazil maintains its conservative stance on abortion — with 65 percent of its population supporting current restrictions — neighboring Uruguay legalized abortion in 2012. A year after the legislation was implemented, government figures showed a decrease in abortions there compared with the year before.

From 1995 to 2002, there were an estimated 33,000 illegal terminations per year in the country. In the 12 months after legalization, there were 6,676 abortions. With a rate of 9 abortions per 1,000 women ages 15 to 44, abortion rates in Uruguay fell below those of many European countries.

Leonel Briozzo, a subsecretary for Uruguay's public health ministry, said the figures showed abortion was safe, accessible and infrequent. “It is a law that aims to protect women and reduce the number of abortions, and we are succeeding,” he said. “It is an infrequent practice because in Uruguay, there are all the conditions and security for a woman to have confidence in the health system for them to have an abortion in a legal manner.”

The Latin American and Caribbean Committee for the Defense of Women’s Rights (CLADEM) said countries like Brazil were behind the rest of the world on women’s rights. Research showed 95 percent of abortions carried out in the wider region were unsafe.

“Currently, we are seeing the legislative advance of Uruguay, a Latin American country, in this regard,” said Ana Paula Sciammarella, coordinator for CLADEM in Brazil. “Compared to European countries, we find that there is a delay in providing access [to] safe and legal abortion in Latin America.”

The extent to which women are risking their lives under Brazil’s abortion law came under the spotlight last year when the mutilated and charred body of Jandyra Magdalena dos Santos Cruz, 27, was found in a burned-out car after she died during a clandestine procedure in Rio de Janeiro.

Weeks later, housewife Elizangela Barbosa also died during a bungled illegal abortion.

But anti-abortion activists insist decriminalization is not the answer to the dangers women face. Luciana Lopes, a Rio gynecologist and coordinator for the anti-abortion group Brazil Without Abortion, said, “The decriminalization of abortion is not a healthy solution for anyone. My proposal is that family planning should be the core of discussion about when, how many, if and with whom women can choose to have children. This is truly the discussion about empowerment and valuing the life of women. In short, we should be discussing prevention and not proposing damage or medicalization of the female body.”

While the doctor who reported Jessica to the police is expected to be struck off for breaching patient confidentiality, Jessica and her family have had to pay a $1,000-real bond while she awaits judgment.

Police say that whatever the penalty, she will have a criminal record for the rest of her life.