Reproductive health and rights, and public policies in Brazil: revisiting challenges during covid-19 pandemics

ABSTRACT

We revisit the debates on reproductive health and rights (RHR) and public policies in Brazil, with focus on contraception, abortion and maternity care. These were part of a broader political agenda for re-democratisation, and for health sector reform, with the creation of the Women’s Integral Health Program (PAISM) in 1983, and of the Universal Health System (SUS) in 1988. The momentum created by ICPD in Cairo (1994) was essential to institutionalise the language of RHR. Not without resistance and organised activism, recent years of right-wing governments brought a disinvestment in most public policies for women’s rights. Some components of the RHR agenda are more mainstreamed, such as fertility regulation, especially hormonal and long term-methods. The limited legal rights to abortion are poorly institutionalised and constantly threatened. Maternal care tends to be highly medicalised and frequently abusive. The covid-19 pandemic accelerated social and public health disruption. The article addresses notions such as reproductive justice and institutional violence, present in the early days of women’s health movement, in order to highlight important premises that were diluted in the debate on reproductive rights and autonomy. The historical analysis of how these concepts evolved locally and globally can allow a better understanding of present challenges.

KEYWORDS:

• Reproductive rights
• reproductive health
• social movements
• public policies
• COVID-19

Acknowledgements

We thank Sonia Correa and Mirian Ventura for the invaluable comments and suggestions for the preliminary version of this paper.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1 For example, access to the method is extended to the male population; tubal ligation ceases to be a marketing agreement between doctors and patients and becomes a guaranteed right, since certain conditions are met: to be at least 25 years old or to have two live children at the time of sterilisation, and to have a minimum period of 60 days between the manifestation of the will and the surgery (Brasil, 1996).

2 A bill (PLS 107/2018) has been in progress in the Federal Senate since 2018, which seeks to facilitate the access of women and men to sterilisation procedures, allowing sterilisation in the postpartum or immediate post-abortion period, and ending the spouse's need for sterilisation consent for both women and men. https://www25.senado.leg.br/web/atividade/materias/-/materia/132552.

3 The first legal abortion service in the country was created in 1989, in the municipality of São Paulo, when the city was governed by a female mayor (Luiza Erundina of the Workers' Party – PT) and with strong support from a feminist staff and member of her government.

4 The PL 478/2007 continues to await an opinion from the Chamber of Deputies' Committee on Women's Rights. The current rapporteur, Emanuel Pinheiro Neto, is a young deputy who until recently considered becoming a priest.

5 Technical Note 16/2020: ‘Access to sexual health and reproductive health in the context of the COVID pandemic’, published on June 1, 2020 by the Ministry of Health.

6 Tobar, Frederic. Webnario # 15 The impact of COVID-19 on access to contraceptive methods. On: August 5, 2020. https://www.youtube.com/watch?v=jBaKGJHyqL8&t=1683s.

7 https://www1.folha.uol.com.br/equilibrioesaude/2020/07/caso-unico-brasil-passa-de-200-mortes-de-gravidas-e-puerperas-por-covid-19.shtml.

8 Another example is the Feminist Network of Feminist ObGyn, whose members are part of several of the initiatives, helping to disseminate women’s rights among their peers in this grim scenario.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.