Among the colourful fruit and vegetable stalls in the historic city centre of Rio de Janeiro, customers barter with market vendors. Considered an essential public service, trading has continued throughout the coronavirus pandemic, which has claimed at least 160,000 Brazilian lives since March. One stand, adorned with herbs and alternative medicines, offers something more taboo. Groups of young women form an orderly queue to ask for a remedy to cure their “sore tummy” – a euphemism in Brazil for an unwanted pregnancy.
Mixed with hot water, the chá de canela, or cinnamon tea of abortive herbs, known as emmenagogues, may induce cramps, bleeding and ultimately a miscarriage. They’re most effective before a pregnancy reaches six weeks, one woman at the market explains. The idea of using parsley, mugwort, pennyroyal or black cohosh to manage reproductive health may seem entirely outdated in 2020. But for many of these women, the alternative to self-induced abortion is terrifying.
In almost all circumstances, abortion is a crime in Brazil. This may come as a surprise to those accustomed to the sunnier image projected by the South American country of beach bodies, carnival parades and sexual promiscuity, where the prevailing political mode is liberal conservatism. But Brazil has a long history of secrecy and hypocrisy when it comes to abortion. While the Roman Catholic Church remains influential, evangelical Christianity is also on the rise. Terminations are only legal if the woman’s life is at risk, if she can prove in court she was raped, or if the foetus has anencephaly – a rare condition where part of the brain or skull is missing.
Since the election of Jair Messias Bolsonaro in 2018, abortion in Brazil has carried even more stigma, while safe procedures are harder to access. The political climate has become sufficiently extreme that in August this year, supporters of the president protested outside a hospital where a ten-year-old girl was due to have an abortion. The child had become pregnant after being repeatedly raped by her uncle. The case obviously fulfilled the legal exemptions for abortion, and a court order had granted the child permission to terminate the pregnancy. But the protesters were undeterred, branding hospital staff “killers” and trying to storm the building before being dispersed by police.
A firebrand former army captain, Bolsonaro – whose middle name means “Messiah” in Portuguese – has significant support from Brazil’s evangelical Christians. While he is still an avowed Catholic, he was baptised live on television by a prominent leader of the Pentecostal church in the run-up to his election.
Over the last two decades, Christian evangelism has been gaining influence in Brazil. Estimates suggest that 28 per cent of Brazilians now consider themselves to be evangelical. Some 93 of the 513 lower house representatives in Bolsonaro’s parliament are aligned with evangelical churches – a number that is expected to climb higher in the next round of local elections.
Evangelicals are playing a key role in imposing regressive law changes, including seeking to restrict access to abortion by trying to block legal abortions in the case of rape, reducing funding for paediatric general clinics that attend to mothers and children, and changing the way sex education is taught in schools. Bolsonaro’s son, Eduardo, a prominent member of the Brazilian congress, suggested as part of a televised campaign that if young people wanted to curb unwanted pregnancies, they should abstain from sex.
According to a recent study conducted by the non-profit group Article 19, only 42 public hospitals are currently performing legal abortions, in a country of roughly 210 million people. In 2019, the year Bolsonaro assumed office, it was almost double that. As women are forced to turn to other measures, emergency contraception and cramping pills like misoprostol, better known by the brand name Cytotec, are routinely confiscated by customs authorities.
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Brazil’s extremely restrictive abortion law dates back to 1940. But despite being a criminal offence, punishable by up to three years in prison, it is fairly common for women to seek out illegal abortions, and very rare for them to serve jail time for doing so.
Data from the National Abortion Survey for 2016 showed that roughly half a million women have abortions in Brazil every year. “That’s almost one woman per minute,” pro-choice lawyer Gabriela Rondon calculates. Of these, half needed to go to hospital to finish an incomplete abortion – in other words, 250,000 women were hospitalised after having illegal procedures.
Relatively safe, albeit clandestine, abortions have traditionally been available to those who can afford them. But since Bolsonaro’s election, it’s also becoming harder to access these clandestine clinics or to treat complications that might result from unsafe procedures.
Juliana Reis, a filmmaker and women’s rights advocate, explains that many clinics are closing due to “a culture of denouncing doctors”. If someone reports a doctor for working in this space, they could lose their medical license. The impact of this, Reis says, is that “there are fewer facilities that perform abortions, the price of a procedure goes up, and many more women are entirely excluded from a fairly safe place to turn to.”
Carolina Viera, 29 (not her real name), a public relations employee, paid the equivalent of £800 to a private doctor in São Paulo. This would be prohibitive for most Brazilians who earn, on average, less than £370 per month.
The doctor bungled the procedure, and she needed emergency treatment. But she couldn’t even bring herself to tell her own mother. “They call him a ‘classic’ for this sort of thing because women have been going to that specific gynaecologist for generations,” said Viera. She didn’t want to denounce him as she said he helped dozens of upper-class women in her city every day. She personally knows ten clients he’s seen in the past.
“Taking money out of the ATM in instalments makes you feel dirty,” she said. “I have the right to choose when I want to have a child and there I was, alone, notes in hand. And I’m one of the lucky ones.”
Other women in her circle had been forced to travel to another city, because the nearest respected private clinic where women pay for illegal abortions had closed.
In a country where social injustice and economic inequality are endemic, richer women have a much better chance of finding a qualified person to assist with a clandestine procedure. But as abortion gets harder to access, women are turning to increasingly dangerous methods.
Herbs, needles inserted into the uterus and deliberately falling down staircases are common alternative methods for the less well off. Last year, Brazilian customs seized over 26,000 abortion pills coming into the country, compared with about 9,000 confiscated in 2014.
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In early 2020, roughly two-thirds of all public hospital beds were taken up by women who had complications resulting from an unsafe abortion, according to health ministry data complied by NUDEM. But given that abortion is a crime, women who arrive at the emergency room in these circumstances can find it difficult to access treatment, as medical staff fear official repercussions.
One woman, a 30-year-old from São Paulo, described nurses refusing to attend to her in January of this year, after a complication resulting from an illegal abortion at a health clinic. “I was sent away from the hospital, crying in pain,” she said. “I could’ve bled to death at home had I not sought help from a friend who arranged for another private gynaecologist to see me.”
Mariana lives in an upmarket neighbourhood of Rio de Janeiro and has a seven-year-old daughter. She miscarried last year. When she arrived at her local private hospital the senior doctor refused to operate to remove the foetus and told her to wait it out at home. She bled for 40 days. “It was the most traumatic experience of my life,” she said.
She suspected the nurses were fearful of having their license stripped for facilitating what may have been an abortion. Had they assumed she had deliberately induced a miscarriage? “Maternity is romanticised in Brazil,” she said. “A lot of shame is brought to women who cannot conceive a child or who are not in the right circumstances to bring one into the world.”
Her case shows that the stigma around abortion doesn’t only affect women with unwanted pregnancies. The word for miscarriage in Portuguese directly places blame on any woman who is unfortunate enough to lose a child – it is called aborto espontâneo or spontaneous abortion. This is a long-running issue around miscarriage, but in recent years doctors have become even more reticent – given the increasingly inflammatory discussion around abortion since Bolsonaro’s rise to power.
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Given this climate of fear, what hope is there for change? Of the 20 countries in Latin America, only Cuba and Uruguay have legalised abortion for women in early pregnancy. This is difficult to replicate outside these smaller, more progressive nations, because of the role of religion in society and politics.
But there is a new ray of hope in the region: Argentina. Activists there have built a broad women’s rights movement that has drawn enthusiastic support from across the political spectrum. In November, the new president Alberto Fernández put forward a legalisation bill, which is set to be debated in parliament next week. It is the ninth time that such a bill has been introduced and it has reignited fierce debate. Activists are hopeful that, with Fernández as an ally, this time the bill can be pushed through. Since May, hundreds of thousands have taken to social media to stage personal demonstrations against gender violence and in support of abortion rights, with a rallying cry of “No somos invisibles,” or “We are not invisible.” Now both sides are on the streets, in Buenos Aries and elsewhere.
In Brazil, however, the political climate is much tougher, with little space for discussion. In this context, Brazilian activists and campaigners are still trying to find ways of working around regressive legislative norms.
Filmmaker Juliana Reis is one of these campaigners. She set up Milhas Pela Vida das Mulheres or Miles for Women’s Lives, in September 2019. The organisation helps fund Brazilian women to travel to get abortions elsewhere in the region, in places where the law is more lenient. “It’s by no means a solution, but it’s a start,” she said.
The fact that relatively few abortion cases are taken to a higher court, and prison sentences are rare, demonstrates the degree to which Brazilian society and the judiciary understand and accept the need for the procedure. When I spoke to Dr Livia Guimarães, a prominent women’s rights lawyer who works for the Brazilian Society of Public Law, she highlighted 30 important abortion cases brought against women that had been taken all the way to the top court in São Paulo state. Five of those cases were closed on grounds of insufficient evidence and some of the victims were compensated on moral grounds. Cases being dismissed in this way echo a trend in Argentina that began a little over half a decade ago. Could this be the stirrings of progressive change in Brazil, too? At present, case numbers are small, “but not a single woman should be held responsible for an abortion,” Guimarães said.
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Much more needs to be done, particularly now that the Covid-19 pandemic has exacerbated the precariousness of reproductive health services in Brazil.
There seems to be some disagreement in parliament as to how this issue should be managed. On 1 June 2020, the Brazilian health ministry published a technical note as part of a regular public advice bulletin. It highlighted the difficulties women and girls may encounter during the coronavirus outbreak when accessing sexual and reproductive health services. Two days later, President Bolsonaro tweeted angrily about the note, distorting its contents by saying that the ministry under his watch did not support “any proposal to legalise abortion” (the note had made no such proposal). Two of the three public servants who were signatories were subsequently sacked.
Funding is also drying up. Local authorities have reportedly suspended some reproductive assistance considered “not urgent”, including providing contraception, as the virus takes hold. This regression is a lamentable reminder of the approach the current administration is taking towards women’s rights.
But back in São Paulo there’s an appetite for change. Bolsonaro has come under increasing scrutiny for his handling of the pandemic, and for failing to protect hundreds of thousands of lives, including those of mothers and children. The shocking case of the ten-year-old rape survivor went viral, sparking a series of lively, open debates online about the current state of abortion laws.
Having experienced her own trauma in seeking an illegal abortion, Carolina Viera was deeply moved by the girl’s case. “I still burst into tears when I watch videos of the protesters trying to stop that little girl getting help,” Viera said. But she is grateful that the story is opening people’s eyes to the inadequate state of reproductive rights in the country: “Brazil’s laws are putting millions of women at risk.”
This article is from the New Humanist winter 2020 edition. Subscribe today.
