The struggle to reduce the risks and harms related to abortion: the experience of accompanying women and health professionals in Primary Health Care

• Grant number: 24/18715-0
• Support Opportunities: Scholarships in Brazil - Doctorate (Direct)
• Start date: May 01, 2025
• End date: November 30, 2026
• Field of knowledge: Health Sciences - Collective Health - Public Health
• Principal Investigator: Ana Flávia Pires Lucas D'Oliveira
• Grantee: Nathália Machado Cardoso
• Host Institution: Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brazil

Abstract

Unsafe abortion is a public health problem caused by the restrictions imposed by criminal law. Brazil is one of the countries with the strictest legislation regarding access to abortion, which is only allowed in cases where the life of the pregnant person is at risk, fetal anencephaly and pregnancy resulting from rape. Countries with restrictive laws face the challenge of dealing with unsafe clandestine abortions, which are responsible for high morbidity and mortality in the pregnancy-puerperium cycle. Faced with the state's negligence in dealing with the necessary technical rigor, initiatives have emerged both inside and outside the health services to deal with the issue. Two of these are the subject of this study: health professionals who work from a perspective of harm reduction for unsafe abortions and feminist activists who welcome and help pregnant women undergoing abortions. Once two of these groups of interest have been identified, the study seeks to understand the potential and challenges related to the dimension of care in both practices, exploring the everyday and caring elements that emerge from the interactions. This is a qualitative study based on semi-structured interviews with primary care professionals and accompanying activists in the city of São Paulo. In addition, we will analyze documents that guide the practices of both groups. We will try to understand the pillars that surround these actions and develop a critical reflection on the obstacles and potentialities related to them, based on the theoretical frameworks of gender, reproductive justice, risk and harm reduction and primary care. The proposed study aims to fill a scientific gap about the specificities and challenges related to the comprehensive care of people going through unforeseen pregnancies, contribute to the social decriminalization of the issue and raise greater understanding about the importance of harm reduction actions associated with unsafe abortions in Brazil.

Scientific publications

(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)

NATHÁLIA MACHADO CARDOSO; LUIZA MAGALHÃES CADIOLI; MARIANA PÉRCIA NAMÉ DE SOUZA FRANCO; ELISABETH MELONI VIEIRA; ANA FLÁVIA PIRES LUCAS DOLIVEIRA. Práticas médicas de redução de danos relacionados ao aborto inseguro na atenção primária à saúde na cidade de São Paulo, Brasil: contextos e barreiras para efetivação. Cadernos de Saúde Pública, v. 41, n. 4, 2025-04-25. (24/18715-0)