Legal abortion services in Brazil--a national study

This article presents the results of a mixed methods study of 68 legal abortion services in Brazil. The services were analyzed in two stages. The first stage was a census, in which all the institutions were sent an electronic questionnaire about the organization of the legal abortion services. The second stage was conducted in a sample of 5 reference services, one for each region of the country. In this stage, a form was used to collect data about the women and the abortions in the medical records, and 82 interviews with health professionals were conducted. Thirty-seven of the services informed they performed legal abortions, and the services were inactive in 7 states. Police reports, forensic reports, and court orders were required by 14%, 8% and 8% of the services, respectively. Women who underwent abortions were predominantly aged 15-29, single and Catholic. Most abortions were performed until 14 weeks in the case of rape-related pregnancy, by means of manual vacuum aspiration. According to the health professionals, the main difficulties faced in the services are the low availability of physicians to perform abortions and the insufficient training of the staff. The data reveal a discrepancy between the legal provision and the reality of the services. The implementation of more services and the strengthening of the existing services available are necessary.