Legal Abortions in Brazil’s Specialized Hospitals Rise in Pandemic, Exposing Sexual Violence

RIO DE JANEIRO, BRAZIL – In addition to triggering a global health crisis, the novel coronavirus pandemic has deepened gender-based violence in many parts of the world. In Brazil, social isolation imposed by quarantine has resulted in a 40 percent increase in cases of violence against women, according to the Brazilian Forum of Public Safety.

The figure also includes a higher number of cases of sexual violence, which is reflected in the health service records that attend to victims of this crime and perform the interruption of pregnancy provided for by law- that is, in cases of rape, risk of maternal death, or anencephalic fetus.

The Pérola Byington Hospital, in São Paulo, highly respected for this type of care, performed 275 legal abortion procedures in the first semester this year. In 2019, 190 procedures were performed in the same period, out of a total of 377 last year, according to the São Paulo State Health Department.

At the Clínicas Hospital of the Federal University of Uberlândia (UFU), in Minas Gerais, in addition to an increase in legal abortion procedures, there were also more rape victims seeking medical centers with advanced pregnancies.

“Violence against women has increased and the severity of the cases is greater, we are taking more cases of more advanced pregnancies because the girls and women think that the services are not working because of the quarantine,” says Dr. Helena Paro, head of the sexual violence service at the UFU Hospital.

Throughout the year 2019, 19 abortions were performed in accordance with the law. The first six months of 2020 have already seen 24 procedures. “We estimate an increase of almost 100 percent in relation to last year by the end of 2020, which is related to the pandemic,” adds Dr. Paro.

On the other hand, between March and May 2020, there was a 50.5 percent reduction in rape and rape of the vulnerable with female victims compared to the same period in 2019, according to the Brazilian Forum of Public Safety.

However, the officials who prepare the report explain that the figure “does not point to a reduction in rape, but rather that the victims are unable to reach the police to report the crime.”

According to Daniela Pedroso, a psychologist with 23 years of experience in attending sexual violence victims and legal abortion and member of the Abortion Studies Group (GEA), only ten percent of victims seek immediate help after a sexual assault.

“With a 40 percent increase in domestic violence, children, in particular, are even more exposed to sexual violence. And with no school, which is a place of protection. The very case of the girl from Espírito Santo proves that the pregnancy lasted precisely during this quarantine period,” says the psychologist, referring to the case of the ten-year-old child who was submitted to an abortion after being raped by her 33-year-old uncle in the city of São Mateus.

“The poor knowledge about their own bodies, the difficulty in perceiving the risk of a pregnancy, in addition to the threats suffered, leads these children to perceive pregnancy late,” explains Pedroso.

At the Pearl Byington Hospital, 45 percent of sexual violence services refer to child victims, up to the age of 11. Between January and June this year, the unit performed 1,600 consultations, 728 of them with children up to that age.

Over the same period last year, there were 1,954 consultations, 855 of them to children victims. “In all the services, the majority of victims are adolescents who have been raped, children are the minority, but when they come, they reach us with a more advanced pregnancy”.

“First because they do not know their own bodies, what pregnancy is,” says Helena Paro. In the five specialized units of the São Paulo municipal hospital system, 402 legal abortions were performed in 2019, compared to 201 in the first six months of this year, according to the Municipal Health Secretary.

Given the health crisis, these victims face yet another challenge: limited access to the centers that perform the legal pregnancy termination. Of the 76 hospitals registered with the Ministry of Health offering the procedure, only 42 continued to attend in the first semester this year; seventeen reported having suspended the service specifically because of the pandemic.

In addition, last Friday, the Ministry published an ordinance that complicates assistance by SUS (National Health Service) to rape victims, requiring the medical team to notify the police about the sexual assault suffered by the woman and entrusting the health professional with the collection of potential evidence of the crime of rape, such as fragments of the fetus or embryo.

The new rules also require the signature of a liability waiver by the woman, in which she acknowledges that she is exposed to risks such as bleeding, infections, and even death, among others, when performing the procedure. The victim must also have the opportunity to see the fetus through an ultrasound, and she must also tell the doctors details of the rape, pointing out the criminal’s features.

Stolen Childhood

In the four years of the Federal University of Uberlândia hospital service, the youngest victim of sexual violence who came in pregnant was 11 years old, with 17 weeks gestation.

– Do you know how a woman gets pregnant? asked Dr. Helena Paro to the child.

– No, because I will only learn this at school next year.

“Sometimes the girls we attend have not even menstruated yet and they are already victims of sexual violence. Then, when it is time for the first menstruation to occur, it no longer will, because they are already pregnant,” the doctor laments. Every hour, four Brazilian girls up to 13 years of age are raped, according to the Brazilian Yearbook of Public Safety. Most of the victims are up to five years old.

Ninety percent of these cases of violence occur at home, and 72 percent of witnesses do not report it. “One of the main problems is that the vast majority of girls and women who become pregnant due to rape do not know that they have the right to a safe abortion, with a specialized team, provided by law since 1940,″ continues the doctor.

Although the 11-year-old child was the youngest victim to undergo legal abortion in Uberlândia, she was not the only one in this age group attended by the Clínicas Hospital of the city of Minas Gerais. The doctor says that the majority of children attended are in their teens, 13 or 14 years old, wishing to undergo the procedure, but because of the influence of relatives, they eventually give up.

“We can only respect her and, as she continues to be a victim of sexual violence with a risky pregnancy, we conduct the whole prenatal care for this child. Two years later, many of these children suffer from serious mental disorders due to this stolen childhood.”

The doctor believes that the responsibility for the promotion of women’s rights, including access to legal and safe abortion, is not only the obligation of the Ministry of Health but also of the Education portfolio, which should include sexual and reproductive rights in sexual education classes in schools. But Helena Paro does not like to perform abortions. And, as she herself says, no woman likes to be submitted to this procedure.

“We wish no woman would have to make that choice. But every time I discharge a patient who has had a legal abortion, I feel like I saved a life because they themselves say they began living again. To be pro-life is to give life back to those women who had their lives stolen by sexual violence,” she concludes.

Source: El País