Health experts accuse government of distorting science to justify abortion risk awareness day

In early July, Brazil's government moved to establish a national observance on October 8th dedicated to fetal awareness and abortion risk consciousness. The initiative, championed by Damares Alves, the minister overseeing women, family, and human rights, arrived as a presidential decree signed by Jair Bolsonaro. The stated purpose was straightforward: to disseminate information grounded in scientific evidence about the supposed physical and mental health dangers of pregnancy termination.

But the evidence the government cited tells a different story when examined closely. Four health professionals who work in Brazil's legal abortion services—including gynecologists Helena Paro and Olímpio Barbosa de Moraes Filho, and psychiatrist Thomaz Rafael Gollop—reviewed the studies the ministry had referenced. Their conclusion was unanimous: the research lacked scientific rigor, contained methodological flaws, and contradicted what larger, more carefully designed studies actually showed.

The government's central claim was that women face greater mortality risk from abortion than from carrying a pregnancy to term. To support this, officials cited a 2018 study by Australian physician Gregory Pike, published by the Society for the Protection of Unborn Children, a British organization that identifies itself as the world's oldest pro-life group. Yet data from the U.S. Centers for Disease Control and Prevention painted a starkly different picture. In 2017, the maternal mortality rate in the United States stood at 17.3 deaths per 100,000 live births. Deaths from legal abortion that same year numbered only two—so rare that mortality rates are calculated across five-year periods. Between 2013 and 2017, the rate was 0.44 deaths per 100,000 legal abortions performed. Paro noted that Brazil has never recorded even a single death from its roughly 1,600 legal abortions performed annually since 2008, when systematic counting began. Barbosa de Moraes Filho was direct: abortion is six to eight times safer than childbirth. The actual danger, he emphasized, lies in unsafe abortion—the clandestine procedures that poor and Black women resort to when legal options are unavailable or inaccessible.

The government also cited two studies published only as book chapters, neither peer-reviewed, to warn of physical complications including hemorrhage, infection, uterine injury, infertility, and premature birth in subsequent pregnancies. One chapter was written by Elizabeth Kipman Cerqueira, a coordinator for the "Brazil Without Abortion" movement. Paro dismissed these sources as lacking methodological rigor and riddled with bias. She countered with a 2015 study from the American College of Obstetricians and Gynecologists that tracked nearly 55,000 abortions and found zero deaths. Serious complications occurred in just 0.23 percent of cases—29 incomplete abortions, 39 infections, 35 hemorrhages, and three uterine perforations. Research indicated infection and hemorrhage risks of 0.9 per thousand induced abortions. For comparison, a 2013 analysis published in the Lancet found that maintaining a pregnancy carried infection risks of 8 per thousand and hemorrhage risks of 27 per thousand.

The government's mental health claims rested on two sources: Pike's work and a 2011 meta-analysis by Priscilla Coleman published in the British Journal of Psychiatry, which suggested abortion increased risks of anxiety, depression, substance abuse, and suicide. But Paro identified serious problems. Of the 22 studies Coleman reviewed, 11 were her own. The methodology was opaque—no clear explanation of how anxiety and depression were measured. More rigorous research contradicted these findings. A 2008 task force from the American Psychological Association concluded there was no link between induced abortion and mental health risks. Psychological distress after abortion, the APA found, was tied to pre-existing mental health conditions, not the procedure itself. A 2016 study from the University of California, San Francisco, published in JAMA Psychiatry, followed 1,000 women across 30 legal abortion clinics in 21 states over five years. Those who obtained abortions experienced no greater depression, anxiety, low self-esteem, or life dissatisfaction than those denied the procedure. The only women whose psychological distress increased were those who sought abortion but were turned away because they had exceeded the gestational age limit—and even that distress faded within six months.

Psychologist Daniela Pedroso, who has worked for 23 years with survivors of sexual abuse, raised a deeper concern. The government's campaign risked deterring women from specialized sexual violence services. These clinics do far more than provide abortion access; they affirm women's legal rights and recognize pregnancy from rape as another form of violence. The choice to terminate remains the woman's alone. But when the government frames these services as "abortion clinics" and spreads fear about abortion's dangers, it pushes vulnerable women—particularly poor and Black women—toward unsafe clandestine procedures. The legal services themselves remain restricted to a handful of reference hospitals, making access difficult even for those who know the law permits abortion in cases of rape, fetal abnormality, or threat to the mother's life. Pedroso's warning was stark: government misinformation does not deter abortion; it only makes abortion dangerous.