It should not be too surprising that in Brazil, the country with the largest number of Roman Catholics (73% of the populace, or about 140 million), abortion is illegal except in cases of rape, when the mother's life is in danger or when the fetus has severe genetic abnormalities. Indeed, the ban on abortion is an immovable plank in the campaign platforms of the two main candidates in Brazil's upcoming presidential election. Yet a recent study revealed that 1 in 5 Brazilian women of child-bearing age has terminated a pregnancy, and statistics by the Health Ministry show that 200,000 women each year are hospitalized because of complications arising from unsafe abortions.
The study has shocked doctors, who were surprised at just how common the illegal procedures are. "I think the big conclusion we draw from this is that the woman who has an abortion is a typical Brazilian woman," says Marcelo Medeiros, the economist and sociologist who coordinated the government-funded study. "She could be your cousin, your mother, your sister or your neighbor. All the evidence shows this is a serious problem and one that is not being debated openly."
Outgoing President Luiz Inácio Lula da Silva, who says he is personally against abortion, is on the record calling for the state to discuss it as a public-health, rather than as a moral, issue. The popular President, however, has done little to foster any wider debate on legalizing the procedure, and his government has not made reducing maternal mortality which is tied to the unsafe abortions one of its health goals. The two leading candidates to replace him in October's presidential election have adopted a similar stance and both say they have no plans to change the current law. Only Marina Silva of Green Party, the outsider in the race, has said she supports a liberalization of current rules surrounding abortion. But even Silva has not said that she is advocating outright legalization.
In fact, Brazil's Congress is discussing tightening legislation rather than relaxing it. A bill in the committee stage proposes criminalizing any act designed to deliberately damage a fetus and prohibiting any statements that promote even legal abortion, a move the New York Citybased Center for Reproductive Rights said "totally disregards women's health and lives." Health professionals say they hope the bill will die with the end of the current legislature and are hopeful next year's new Congress will be more forward-looking.
Birth-control advocates are dismayed that Roman Catholic Church still wields considerable power. Brazil was recently the scene of a controversy involving the excommunication of doctors who performed an abortion on a 9-year-old raped by her stepfather. Bishops last month pointedly told voters to vote for a presidential candidate who is "committed to unconditional respect for life."
And yet if the study's findings are correct, abortion is alarmingly widespread given its illegal status. Although exact figures are impossible to determine, experts believe between 500,000 and 1 million pregnancies are terminated in Brazil each year. Around half of them are induced using a cocktail of drugs and the rest are performed in clandestine clinics. The number of women hospitalized from complications arising from illegal abortions fell by 40,000 between 2003 and last year. However, 200,000 women are still admitted each year, says Adson França, the special assistant to the Health Minister.
França says the federal government offers everything from condoms and contraceptive pills to vasectomies all free in every one of the country's 5,565 municipalities. It has increased the budget for contraceptive measures sevenfold since 2003. But in spite of that, and for all Brazil's undeniable progress in other health-related fields, maternal mortality has remained steady for 15 years, a fact researchers say is intimately linked to a lack of safe abortions. Specialists fear that unless the issue is treated more as a health one than as a moral one, that statistic will not change. "The Health Ministry has said all along that this is a public-health problem," says França. "It should be up to the woman to decide how many children to have."