By Jen Ross
Sunday, May 15, 2005
Brazil is moving to address the problem of illegal abortion, the country's fourth leading cause of maternal death. In March the government eased abortions for rape victims and in April it formed a committee to review all its abortion policies.
SAO PAULO, Brazil (WOMENSENEWS)--Marta won't give her last name for fear of legal recriminations.
Her ex-husband, she says, has already threatened to report her to the police.
Her offense: Undergoing an illegal abortion at the age of 26 after her husband--from whom she was separating--raped and impregnated her.
"We always used condoms, but that time, with the violence, I was so distraught, in such disgust because I didn't want to, that I didn't even realize he had penetrated me without a condom," she says. "When I found out I was pregnant, I knew I couldn't have another child from a marriage that was ending."
Although most abortion is illegal in Brazil, exceptions are made for cases of rape or where a mother's life is in danger.
But since Brazil does not recognize marital rape, Marta couldn't seek a legal abortion.
So like many women in Brazil and throughout Latin America, she decided to seek an illegal abortion.
But Marta had just gone back to school at the time and had no money for the $600 it would cost to get an abortion done in a private clinic, a widespread practice according to Catholics for a Free Choice (Catolicas Pelo Direito de Decidir).
Friends told her about Cytotec, a pill for treating ulcers, that is widely used in Brazil, Colombia and the Dominican Republic (where abortions are also illegal) to induce miscarriages. The medication is taken orally and works to dilate the cervix, according to All Women's of New York, an organization of private physicians that offer abortion services. In Brazil, Cytotec was banned a few years ago, but is still available on the black market for about $40.
Marta found a pharmacy that sold Cytotec under the table. It worked, but she bled for 40 days afterwards. She says she avoided seeking medical help for fear she'd be denounced.
An estimated 5,000 women die, and 800,000 are hospitalized every year as a result of clandestine abortions across the region, according to the International Planned Parenthood Federation.
A large portion of these cases occur in Brazil, where illegal abortions are the fourth cause of maternal deaths.
A 2004 study by Brasilia-based government health statistics provider DataSus found that 238,000 women are hospitalized per year in public hospitals alone for complications due to illegal abortions at a cost of about $10 billion. The total toll and cost is assumed to be much worse because private hospitals weren't counted.
In April, the leftist government of President Luiz Inacio Lula da Silva established a tripartite commission, composed of six members of the government, six members of the legislature and six members of civil society. The commission has been criticized for including several pro-choice groups and women's health activists. The working group will spend three months analyzing the existing abortion legislation. Their recommendations will be packaged in a bill before Congress, which could come as early as July.
"The idea is to open up the decision at a societal level," says Maria Jose de Oliveira Araujo, technical coordinator for the Women's Health Division of the Ministry of Health "Because punishing women obviously hasn't resolved the problem of women getting clandestine abortions."
Many women's rights activists applaud the moves taking place under President da Silva, who is widely known simply as Lula. "I think President Lula himself is very sensitive to the issue," says Ana Fatima Macedo Galati, a health counselor with the Sao Paulo-based Feminist Collective for Health and Sexuality (Coletivo Feminista Sexualidade e Saude). "Of course, it doesn't only depend on him. But I think we have a chance."
In the meantime, the government has also eased abortion policy in the case of rape.
On March 28, Brazil's ministry of health issued a directive that removes the requirement for a raped woman seeking an abortion to present a police incident report.
The 1940 law that permits abortion for rape said nothing about requiring an incident report, says the Health Ministry's Araujo. The requirement of a police report, she says, evolved during the late 1990s, in response to fears within the medical community, which wanted protection from lawsuits in cases where it was later found that the women hadn't actually been raped, making the abortion providers open to criminal prosecution.
Many women's health advocates say that onerous requirement led to only 160 legal abortions in 2004. Meanwhile, they say, about 1 million illegal abortions are performed each year in Brazil, a country with a population of 185 million.
"Women who've been raped don't always want to report the aggressor," says Dulce Xavier, a coordinator with the Brazilian branch of Catholics for a Free Choice, based in Sao Paulo.
Noting that around 70 percent of the aggressors in sexual violence cases are known to the victim--an ex-husband or a father--Xavier says women often feel either threatened or obligated to the aggressor, inhibiting them from initiating criminal proceedings. "That's why we feminist organizations have long been asking doctors to simply respect women's word."
Xavier says women often use primitive methods for inducing abortions, such as inserting objects in their uterus or taking poison. Many who take these extreme measures are too poor to arrange anything safer, she says.
"Here in Brazil, women sometimes ingest a poison used to kill rats . . . It's a dramatic situation and the women who die as a result of clandestine abortions in Brazil are mainly young, black and poor. Women with money can pay to have an abortion in a private clinic."
The government's move to eliminate the incident report has sparked a backlash.
Earlier this month, the president of Brazil's House of Representatives, Severino Cavalcanti, railed against the Health Ministry's directive for rape cases, suggesting they will open a Pandora's Box for false cases.
"The Ministry of Health is not requiring any kind of proof that a woman was actually a rape victim," he said adding that women could claim that they don't "recognize" the rapist if they were making a "false declaration." Araujo says the Federal Council of Medicine, the national regulatory body for physicians, based in Brasilia, has advised its doctors to ignore the directive and continue asking for an incident report. Ministry of Health, she says, is trying to create a legal proviso that will protect doctors who perform abortions on women later found not to have been raped.
Marta, for her part, doubts that policies on abortion are about to undergo any major change.
"I think the Lula government is at least making a positive step because before no one even discussed the issue," Marta says. "But I think there's still a long way to go before we reach a place where women are given the freedom to choose. I have no hope that we'll gain that right anytime soon."
Jen Ross is a Chilean-based freelance journalist who delves into social issues affecting women across the continent.
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