Politics of Women’s Health

With all the travel back and forth between home and Brazil – in addition to traveling for work – I’ve missed a few critical doctors appointments over the past year or so. Remembering that preventative healthcare is actually very important, I started calling a few doctors to set up appointments.

By “I,” of course, I mostly mean Gustavo because a) I’ve learned that Brazil does not have HIPPA laws, and b) while I can communicate with doctors in person, navigating Portuguese on the phone is more of a challenge without body language or being able to read people’s lips. In other words, it’s easier.

Originally, I was looking for a midwife to do a regular well woman exam. In the US, I generally prefer to go to midwives for my usual check-ups since their philosophies tend to be more in line with my own when it comes to women’s bodies. (My undergraduate thesis talks about this in quite some detail.) As we called around, we both quickly learned that midwives don’t provide this type of service in Brazil for legal reasons, so we had to pivot. It was interesting for the both of us, since Gustavo never really had a reason to know this and I’ve never truly navigated a healthcare system in a different country before.

Fortunately, one of the midwives we called recommended another doctor who focuses specifically on natural childbirth, which was more in line with the type of gynecologist I was looking for. We set up an appointment with her and, a few days later, were sitting in her waiting room in Jardim Botânico with its gorgeous view of Lagoa. Her walls were decorated with empowering photos of women and the environment felt so welcoming in a way that I haven’t yet experienced in the US.

When our appointment began, she began by asking me a long list of questions about my health and family history, as per usual. Yet when we got to the part where she asked me if I had ever been pregnant before, it hit me: what if I find out I have an unplanned pregnancy right now?

I’ve been very fortunate in my life so far in that I’ve never faced an unplanned/unwanted pregnancy, but I have worked with and counseled many, many woman who have. I started my career in the non-profit sector, focusing on women’s reproductive health, which meant offering options counseling to pregnant women who were considering both abortions and/or adoption plans. My work with these woman was both an expression of my passion for women’s rights, as well as a deeply formative experience that showed me the depths of inequality in our world and how the politics of inequality plays out on women’s bodies specifically.

It’s strange how things hit you. I never thought twice about my options and choices when going for regular, well-woman care in the United States. On the off-chance I found out I was pregnant, intentionally or not, my doctors could offer me a variety of options, depending on my desires, health, and life situation. Not all of them may agree with it – and yes, they could refuse to provide information on all of my options – but the option is there nonetheless, especially for my social and economic position. It’s a right that I’ve long taken for granted.

In Brazil, abortion is illegal, except in cases of rape or risk to the women’s health. Yet one in four women dies per day due to clandestine abortion procedures. Just because abortion is illegal, that doesn’t mean that people aren’t trying to get them.

To be honest, from a cultural perspective, I still don’t fully understand why this hasn’t changed yet. Because the procedure is illegal, you can go to jail for an abortion attempt, as can any doctor who has helped you, for up to three years. My understanding from talking with friends is that it’s based in the Catholic past of the country. I think, and I don’t have statistical data for this, there’s an element of eugenics as well. In a country with so much poverty, abortion access can seem like a way of prevent “more poor people,” so to speak, rather than actual choice. While I disagree, it’s a fair argument and something we’ve struggled with in the past in the US as well.

As someone who has taken this right for granted, it scared me to be in the doctor’s office in that moment. I knew I wasn’t pregnant, nor was I planning to be in the near future, but it hit me that there wasn’t anything I would be able to do in this situation. Would the doctor be afraid to talk about it? Or would it simply be a “Congratulations!” even when it felt like the congratulations wouldn’t be warranted? What would happen if I even asked about my choices?

To me, it’s a very scary position to be in and a reality for many women throughout the world. Yet I recognize that it’s scares me precisely because I’ve always been aware of the option. I’m not sure how I would feel if that option were never on the table to begin with. And while I struggle to reconcile my personal beliefs with the differences in Brazilian feminism, I’m sure we can all agree that women having agency over our own bodies is one of the central tenants, in any place in the world. Whatever that may mean.

Argentina just passed a law making abortion illegal. Brazil is set to vote on it this year. I’m hopeful, but not optimistic, based on the current political situation. Nevertheless, I hope we don’t have to wait much longer for women in Brazil to be able to practice the choice that I’ve so long taken for granted.

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