BRAZIL: Time to Break the Silence on Abortion

It was noon on a regular weekday; a Wednesday in March 2009. After coming home from university, I was having lunch with my brothers and watching the local news on TV. I was not paying much attention to the voice of the commentator until I was struck by a familiar name: Olimpio Moraes Filho—my father.

It took a while for my brothers and I to understand what was going on. My father—a doctor—and his medical team were being publicly excommunicated by the archbishop of our city, Jose Cardoso Sobrinho, for performing an abortion.

But this was not a common case of abortion. A 9-year-old girl from the interior of my state, Pernambuco, had become pregnant with twins after being sexually abused by her stepfather. Carrying on with the pregnancy represented an enormous risk of death to the girl, who was not yet prepared for such transformations in her young body.

Brazilian law considers abortion a crime, but there are exceptional cases in which it is legal for a doctor to perform an abortion. Abortion is legal here if there is no other way to save the pregnant woman’s life or if the pregnancy is the result of rape. Both of these circumstances were present in the 9-year-old girl’s case. Therefore, my father and his medical team were not doing anything illegal.

The archbishop argued, however, that the law of God is superior to the law of men, and that performing an abortion mandated excommunication from the Catholic Church. When asked about the girl’s stepfather who had raped her, the archbishop affirmed that rape was a dreadful sin. But abortion, he said, was even worse.

This led to an astonishing amount of attention from the media and generated wide public debate, not only in my state and in my country, but also internationally. The story was published in the New York Times and led to an apology by the Vatican itself. Reporters from all over the world came to visit our house to get more information about the story.

Brazilians started asking how the archbishop could claim to protect life while presenting a degree of tolerance for the rape of an innocent child. They started questioning the archbishop for condemning doctors who were acting with the support of the law and trying to save the child’s life. The case raised all sorts of questions about theology, morality, the role of religion in politics and law, gender-based violence, criminality in Brazil, among other crucial issues. But first and foremost, the 9-year-old girl’s case finally made people—young and old, progressive and conservative, religious and atheist, male and female—discuss abortion.

A Matter of Social Justice

Taking a position on abortion means dealing with very delicate and often intimate experiences and beliefs. Science currently does not offer a definitive answer to the question of when life begins. We often turn to religion to regulate our conduct, both morally and legally, and to understand complex issues like abortion. This is especially true in my country.

Brazil has legally been a secular state since 1890. This means the state and the Catholic Church have been officially separated for 120 years. In practice, the Catholic religion continues to shape public opinion. According to the national census from 2000, nearly 74% of the country’s population is Catholic. By the latter half of the 20th century, Brazil ranked as the largest Catholic country in the world. This strong influence has been considered harmful by many women’s rights organizations, whose work goes against the Catholic Church’s position on abortion and the use of contraceptives.

Brazil’s women’s rights movement argues that criminalization is ineffective at discouraging women with unwanted pregnancies from having an abortion. “What in fact happens is that the abortion is performed anyways,” says Benita Spinelli, the coordinator of the women’s health sector in my city, Recife. “The difference is that wealthy women can afford a safe abortion in clean clinics—legally or not—whereas poor women, who are the majority of the female population in Brazil, have to perform abortions in places with no adequate medical care, resulting in serious damage to their health.” Research led by the NGO Ipas Brasil, in 2007, in partnership with the Institute of Social Medicine of the University of the State of Rio de Janeiro (UERJ), showed that over a million abortions are performed in Brazil each year. Unsafe abortion is among the top three causes of maternal death in my country.

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The same research showed even more shocking results when statistics are broken down according to race/ethnicity, geographical location, and age. Black women in Brazil are three times more vulnerable to death due to unsafe abortion than the population of white women. Annual rates of unsafe abortion are visibly higher in states from poorer northern and northeastern regions, and abortions become even more dangerous for the adolescent population (between 10-19 years old).

These numbers lead to the consistent conclusion that unsafe abortion disproportionately victimizes less economically privileged social groups. And the statistics show the legacy of racism and social exclusion in Brazil that has lasted since the first Africans were brought here as slaves for Portuguese colonizers. Taking this context into consideration, it becomes clear that the issue of abortion, far from a topic to be kept exclusively in the intimacy of households, is a serious matter of public health and social justice, and deserves the attention of both government and civil society.

Criminalization Is Not the Answer

Proponents of criminalizing abortion in Brazil argue that it is a way of discouraging and repressing the practice. However, the evidence shows that a woman can usually find a way to have an abortion, even if it puts her own life at risk. In 2007 the United Nations Committee on Elimination of Discrimination Against Women (CEDAW) supported this position.

In Brazil, the codes criminalizing abortion punish only the woman. Although the man is involved in making the woman pregnant, if the pregnancy is unwanted or unfeasible and she gets an abortion, her partner is considered innocent. The Brazilian criminal code, which dates back to 1940, assumes a role for women in society that is very different than it is today.

In addition, the criminalization of abortion creates a threatening atmosphere that makes many women present symptoms of anxiety, depression, and insomnia once they have made the choice to end the pregnancy. Leila Adesse, one of the founders of Ipas Brasil, affirms that the penalization and stigmatization women in such a situation does not minimize the problem. “Instead of being discriminated against and put in jail, these women need psychological support, medical care and a more efficient coverage of contraceptive methods,” she says.

Towards Solutions

The most efficient way to reduce the rates of unsafe abortions is, of course, to reduce the rates of unwanted pregnancies. For that to happen, women have to be able to negotiate with their partners and engage in family planning. This demands a level field among men and women. We need to create an environment in our country in which women have a voice.

As a matter of public health and human rights, the reduction of unsafe abortions also demands a proactive attitude from the government. The situation requires public policies promoting education on sexual and reproductive health, reproductive rights, and contraceptive methods. In addition, it is necessary to make condoms and other contraceptive options widely available to the population. These programs should prioritize people living in at-risk communities, and they must involve men as well as women. Gender equality cannot be built by women alone.

But even in countries where these policies are put in place effectively, they are not enough to entirely solve the problem of unwanted pregnancy and unsafe abortion. Therefore, we should legalize abortion in the first trimester of pregnancy, as is the case in most countries in Europe. This would remove barriers to women’s health in our country, especially for those women who are socially excluded.

It won’t be easy to get there. The fact is abortion is a contentious topic. It deals with the most serious issue of all—life. One day I caught myself talking to my grandmother about abortion. From this unlikely dialogue between a strongly Catholic 70-year-old woman and an agnostic 17-year-old girl, we did not reach any definitive conclusions, but we realized that we both had our reasons, which were legitimate and made sense, however different our beliefs were.

One can be against the legalization of abortion in order to protect life and one can also be in favor of the legalization of abortion for the exact same reason. The difference, in many cases, lies in whose life you are considering the most important. And to consider some lives more important than others is undoubtedly problematic.

Despite all these doubts, there is one thing I am certain about: unsafe abortion is a reality in Brazil. And thus, no matter how controversial this subject is, debate should not be avoided, but encouraged.

After my father was excommunicated, he told me that he was glad this had happened because it fostered debate. He added, “I just hope all this debate will be constructive.”

Comment on this Editorial

Comments

Hello, I have stumbled on a nery important information that I would like to introduce in my community health education for reproductive health rights.It has been hard I can say trying to break the thoughts. Thank you for that Thais

Lucia Buyanza Nurse-Midwife Clinical Instructor

Dear midwife.

Abortion is a controversial issue in our country because of the religious influences as well as you said.

Life is the most important gift in the world and especially a child, and that children as young as 9 years suddenly because of a religious culture comes to life at risk, I'm thinking:

Christ was only love, love is not abuse, does not violate, the other does not take away the right to choose life.

This child had no choice and was submitted to the power of an abuser and with the endorsement of religious power.

The doctor is trained to save lives the religious spirit, but what is the appropriate body without a spirit to nourish the fruit of a rape, wanted terrorists in the days of a young man?

God never excommunicate the right to be a girl child, and as a child he would not support that it had to put their physical and emotional health in a shallow grave.

As for his father and the team, the act ensured the law and medicine softened the future already marked this child giving you the chance to stay alive without the responsibility of bearing children without maturity and desire to have them.

Right to be children; Congratulations matter.

Kisses

Quoting the writer:

"One can be against the legalization of abortion in order to protect life and one can also be in favor of the legalization of abortion for the exact same reason. The difference, in many cases, lies in whose life you are considering the most important. And to consider some lives more important than others is undoubtedly problematic."

...undoubtedly problematic.

Protecting life is the bottom line. I consider the innocent life as the one with the greater protection. The unseen but felt innocent child has the greater right. I only believe abortion is moral when it is to save the mother’s life. Otherwise you are taking the life of the innocent child.

Sex is a powerful thing. But we must learn to engage with full responsibility of the consequences. This is where marriage is important. Marriage is a place of bonding and commitments of important responsibilities are made to each other. A disciplined man and woman will wait until marriage to engage in physical love. Selfish people engage in sex before marriage. Then to just kill and discard their mistake is an act of murder and should be punished accordingly. In this day and time we have DNA testing and both mother and father should be prosecuted. Life is very important and especially the innocent. We all make mistakes and act foolish, but a responsible person learns from those mistakes.

In the case of this 9 year old girl, she should have been closely watched up until it was just absolutely assured she would have died. Then the baby should be taken to save her life. Who knows, her body may have developed rapidly. If the child was taken then the stepfather should have not only been accused of rape but murder also.