The Ministry of Health launched a guide on assistance in abortion cases in which it distorts normative interpretations and, in some cases, is based on moral assessments, without scientific support, to guide clinical conduct.
This Wednesday (15), the Feminist Network of Gynecologists and Obstetricians and the Medical Network for the Right to Decide issued a joint repudiation note requesting revocation of the manual. For them, the document creates barriers to access situations already provided for by law, that is, to save the life of the pregnant woman, if the pregnancy results from rape or in the case of an anencephalic fetus (by decision of the Federal Supreme Court).
In 2020, the Ministry of Health decided to amend another controversial ordinance that contained rules for assisting women seeking abortion in the cases provided for by law, which, for specialists and entities in the health area, were a way of intimidating women who seek the procedure.
wanted by Sheet this Wednesday afternoon (15), the Ministry of Health said that it will hold a public hearing to hear society and experts about the content of the guide.
The medical networks that signed the repudiation note point out at least 14 distortions in the new ministry document, among them, considering “every abortion is a crime, but when situations of exclusion of illegality are proven after a police investigation, it is no longer punished”. (…).
“What does the Ministry of Health mean by that? That all legal abortions will be investigated by the police? Who will be investigated in the case of a therapeutic abortion? [para salvar a vida ou a saúde de uma mulher grávida] The doctor? The woman? And in cases of pregnancy resulting from rape?”, question the entities.
For the medical networks, saying that the police will investigate cases that already have legal support for abortion “is psychic torture of the Brazilian State, in addition to a flagrant breach of the constitutional right to intimacy, privacy and professional secrecy”, in addition to putting at risk women, “because it will distance them from the necessary health care”.
The ministry document also guides health professionals to notify the authorities of rape cases that result in termination of pregnancy. It so happens that there are already ordinances and guidelines that only allow this notification to the police or justice with the consent of the victim.
Otherwise, the conduct may constitute a violation of professional secrecy, in which case professionals incur a crime provided for in article 154 of the Penal Code.
“For the provision of legal abortion to victims of sexual violence, health care should not be conditional on any communication external to the justice system or the police. The role of health professionals is to care, not to investigate, or to initiate any investigation”, say the entities.
The justification is that reporting the crime to the police, without the victim’s consent, can put her in a new risk situation. Studies show that most cases of sexual violence are committed by people close to girls and women.
The document also states that “from a medical point of view, there is no clinical sense in performing an abortion excluding illegality [aborto legal] in pregnancies that exceed 21 weeks and six days”.
As an argument, he cites a case, without any reference, of a baby weighing 212 g who would have survived in Singapore. “So this could be the current weight of fetal viability, after being evaluated by specialists (…)”, says an excerpt from the ministry’s document.
However, in Brazilian law there is no limitation on the gestational age for performing a legal abortion. “Thus, the Ministry of Health cannot limit what it does not restrict there, under penalty of generating an omission of assistance to women and girls”, say the medical networks.
According to the entities, what determines legal abortion is not the gestational age, but being within the hypotheses authorized by Brazilian law. They also recall that there are cases of malformations incompatible with life in which the diagnosis is only possible at more advanced gestational ages, and that this does not prevent access to abortion.
There are parts of the document that, according to the entities, are discriminatory. An example is when the guide says that “experience shows that the possibility of a repeat abortion is greater precisely among women who think they will not be exposed to pregnancy in the following months or years, and, therefore, do not adequately protect themselves”.
“There is no reference to scientific studies or normative bases to support the information that women who have had an abortion do not adequately protect themselves,” the medical networks say.
Another controversial point is about the use of telemedicine for abortion provided for by law. “In order to protect the physical integrity of women and ensure the promotion of life, the Ministry of Health understands that abortion via telehealth is illegal and therefore not recommended”, says the manual.
However, the WHO (World Health Organization) and Figo (International Federation of Gynecology and Obstetrics) endorse safety and recommend the use of telemedicine to ensure access to abortion in the first weeks of pregnancy, when it can be done at home. , with the use of medication. Brazil is the only country in Latin America and one of the only countries in the world to restrict the use of misoprostol to hospitals.
According to WHO and Figo, telemedicine for abortion is safe and adverse events are “extremely rare”. Furthermore, they argue that technology increases access, especially in low- and middle-income countries, meets many women’s preferences for privacy and stigma-free care.
For the entities, it is not possible to understand why the Ministry of Health considers Figo a reference for part of the technical and clinical recommendation for abortion care, but ignores the entirety of the federation’s recommendations.
In the manual, the Ministry of Health also makes recommendations already considered obsolete by the WHO for more than ten years, such as the use of uterine curettage. The WHO guideline is to replace it with manual or electric aspiration or drug treatment.
Chad-98Weaver, a distinguished author at NewsBulletin247, excels in the craft of article writing. With a keen eye for detail and a penchant for storytelling, Chad delivers informative and engaging content that resonates with readers across various subjects. His contributions are a testament to his dedication and expertise in the field of journalism.
