- Brazilian obstetrician-gynecologists and abortion: a survey of knowledge, opinions and practices

The majority of OB-GYNs in our study and in the previous Faundes et al. study agreed that abortion should be legal when the pregnancy endangers the life of the woman or is a result of a rape (in those circumstances abortion is permitted under current Brazilian law)[14,15]. However, among those OB-GYNs with previous experience performing abortions, more than half of them had done so in cases of fetal malformation, a circumstance that was not explicitly permitted under current abortion law. Not only do these findings underscore the widespread confusion and misperceptions surrounding abortion law, but they also provide powerful evidence of the fact that abortions are being performed by OB-GYNs even in cases that are technically illegal. This information is particularly valuable to those advocating a liberalization of abortion law to permit legal abortions in cases of fetal malformation. This study also demonstrates the need for training in surgical and medical abortion techniques for Brazilian OB-GYNs. MVA is not as well known as D&C, even though the former is both more effective and less expensive than the latter. Likewise, training on medical abortion is needed to educate physicians on the benefits of using misoprostol in conjunction with mifepristone or methotrexate. Educational efforts, ideally beginning with medical trainees in universities, should focus on introducing these safer, less costly abortion techniques in Brazil. In conclusion, we hope this study can inform educational campaigns for Brazilian OB-GYNs in order to clarify misperceptions of abortion law and increase their technical capacity to provide safe, legal abortions.

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