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New Brazilian law requires compulsory registration of all pregnant women

Date: 24 January 2012
Source: RH Reality Check and A Paper Bird

In the dead of night on December 27, while parliament was closed, Brazilian President Dilma Rousseff enacted a "provisional measure" that, if approved by the parliament within two months, will require all pregnancies to be registered, under women's names, with the government. Provisional Measure 557 (PM 557, translated here for the RHM website) creates a National System of Registration, Vigilance and Monitoring of Women's Care during Pregnancy and Post Childbirth for the Prevention of Maternal Mortality.

The President claims that PM 557 will address Brazil's high rates of maternal mortality by ensuring better access, coverage and quality of maternal health care, notably for high-risk pregnancies.

However, activists are extremely concerned about the anti-abortion implications of PM557. The decree gives the fetus rights with the same status as the pregnant woman for the first time in Brazil. Abortion is legal only in the case of rape, severe genetic abnormalities, or danger to the woman's life, yet it is estimated that one in five Brazilian women will have an abortion in her lifetime. The Health Ministry estimates that 200,000 women are hospitalised each year as a result of unsafe induced abortion. By placing the woman's name in a national registry, a woman may be treated as legally 'obligated' to have every child she conceives.

Anti-abortion politicians are pushing for further laws and will be greatly heartened by this measure. For example, the Chamber of Deputies is currently considering a bill to pay women who become pregnant due to rape and do not have an abortion a minimum wage until the child reaches 18 years of age, what activists are calling a "rape pension".

PM557 is unlikely to reduce maternal mortality, despite that being its stated aim. Although pregnancies will be monitored, there is no guarantee that maternity care will be available to all pregnant women and no funding is mandated to improve maternity services. The bill does say the federal government will provide financial support of about US$27 for registered pregnant women to pay for transportation to health facilities for antenatal and delivery care. However, women must comply with specific conditions set by the state to receive the stipend and access to antenatal tests, timely diagnosis of complications, skilled attendance at delivery, emergency obstetric care, or referrals for specialist care if needed are also not mentioned. Maternal morbidity and mortality in Brazil are primarily related to unsafe abortion and the poor quality of obstetric care in some public health facilities, mainly affecting the poorest women.

Activists compare this measure to similar surveillance of pregnant women which had pronatalist, anti-abortion intention under Ceausescu's dictatorship in Romania in the 1980s.

The measure has to be submitted for approval to the parliament within two months.

Brazilian women's groups and NGOs are considering the implications and deciding how to respond to this surprise event.