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Cad. Saúde Pública vol.23 n.9 Rio de Janeiro Sep. 2007
Abortion and public health in Brazil
For the first time, a Brazilian Minister of Health has taken a stance in favor of changing the country's legislation on abortion. The recent position by Minister José Gomes Temporão is simple: abortion is a matter of public health. The shift from the moral field to that of public health has led to a redefinition of the terms underlying the Brazilian debate in the last thirty years. A recent search by the University of Brasilia and the State University of Rio de Janeiro retrieved 1,600 printed sources on abortion in Brazil dating from 1987 to 2007, demonstrating how the issue has maintained a constant presence in Brazilian science, with some key characteristics of the debate highlighting the force of the Minister's statement.
There is limited scientific research on the abortion phenomenon in Brazil. A possible explanation for this gap is the context of illegality and immorality surrounding the issue. To identify the women themselves, hear their stories, and care for their physical and psychological needs poses a risk for research participants and researchers: although the two sides may agree to safeguard the data's secrecy or confidentiality, this does not ensure legal protection against police or court inquiries. The context of moral guerrilla warfare surrounding abortion in Brazil places both researchers and research subjects at jeopardy. In various instances around the world, abortion researchers have been ordered to turn their data over to the courts, and several have already been arrested for refusing to comply.
However, there is another way of understanding the abundance of sources but paucity of scientific studies on abortion in Brazil. The debate on abortion represents an arena for confrontation between two previously defined positions: abortion as a serious moral offense and abortion as an exercise of women's reproductive autonomy. Within this clash between incommensurable positions backed by sparse scientific evidence, the reaffirmation that "abortion is a matter of public health" gains great political force and vitality. In fact, although the available evidence is still limited, the existing results support the contention that illegality has serious consequences for women's health, that criminalizing abortion fails to prevent it from happening in practice, and that it perpetuates social inequality. In other words, the scientific side of the Brazilian debate on abortion anticipates the Minister's position.
To seriously tackle the abortion phenomenon as a public health issue means to understand it as a health care issue and not as a moral offense committed by frivolous women. This political redefinition can draw on some consistent trends in bedside surveys with Brazilian women who have undergone abortion, namely that the majority are Catholic, young, poor, and already have children. Interestingly, this description fits not only women who have abortions, but also Brazilian women as a whole. Therefore, understanding abortion as a public health issue in a secular state and pluralist society represents a new argumentative approach, in which the field of public health can provide important evidence for the debate.
University of Brasilia, Brasilia, DF, Brazil.