Abortion in Brazil: what do the official data say?

Area of Science:

• Public Health
• Epidemiology
• Reproductive Health

Background:

• Globally, millions of abortions occur annually, with a substantial proportion being unsafe.
• Brazil faces incomplete data on abortion and its complications, relying on public sector health records and death investigations.
• Existing data systems, including SIM, SINASC, and SIH, provide partial insights into abortion-related morbidity and mortality.

Purpose of the Study:

• To describe the situation of abortion in Brazil using available public health data.
• To analyze hospitalization rates and causes related to abortion procedures.
• To identify trends in abortion-related maternal mortality and characterize high-risk populations.

Main Methods:

• Utilized data from Brazil's public health Information Systems: SIM (mortality), SINASC (live births), and SIH (hospitalization).
• Analyzed hospitalizations for abortion-related procedures between 2008-2015.
• Examined maternal deaths attributed to abortion from 2006-2015, considering underreported causes.

Main Results:

• Approximately 200,000 annual hospitalizations for abortion procedures were recorded, with only 1,600 for legal/medical reasons.
• An estimated 770 maternal deaths were directly attributed to abortion between 2006-2015, with a slight reduction over time.
• Deaths from unspecified abortions constituted 56.5%, and a potential 29% increase in mortality figures was estimated by including related mentions.

Conclusions:

• Official data underrepresent the true burden of abortion-related mortality in Brazil.
• Specific demographic groups, including Black and Indigenous women, those with low education, and women outside reproductive age ranges, face higher risks.
• Regional disparities and incomplete cause-of-death reporting complicate accurate assessment and intervention strategies.