Half of pregnant children under 14 do not receive the option of a legal abortion, says research

The medical team said that the date of sexual intercourse did not match the date of possible conception, according to the ultrasound, says Shisleni de Oliveira, project coordinator at Vivas. "It didn't matter."

Women have the right to abortion in three cases in Brazil: when the pregnancy puts their life at risk, if it is the result of rape and if the fetus has congenital malformations. Any sexual relationship with a child under 14 years of age is considered rape of a vulnerable person under the country's legislation.

Still, girls aged 13 or younger who become pregnant do not know their reproductive rights - the right to decide if and when to have children - or have them violated, according to research and experts.

A study by the NGO Plan International, released in July, showed that half of the girls who became pregnant before the age of 14 did not even have the possibility of legal termination of pregnancy offered by the health services that served them.

Carried out with a national organization, the survey interviewed more than 1,500 women aged 19 to 29 in the country at the beginning of the year. Of these, 35% became pregnant in childhood or adolescence.

There is no law that specifies which services must offer legal abortion to those who have the right and how they must do it, despite the provision in the Penal Code, says public defender Tatiana Campos Bias Fortes.

"The number of teenagers who have children alone demonstrates that legal abortion was probably not offered to these girls and families as an option", says the defender, highlighting that not necessarily all children will opt for legal termination of pregnancy.

According to her, there is a lack of information among health professionals and overcoming moral barriers to legal abortion.

Every day, 45 children between the ages of 9 and 14, most of them black, give birth in the country, according to data from the Criança Não é Mãe Observatory collected between 2019 and 2023.

Before pregnancy, these girls have less access to information, points out Plan International. They are 13 percentage points (p.p.) more likely to not receive sexual education than the others and 9 p.p. more likely to be unaware of reproductive rights and where to obtain free contraceptives.

Also according to the study, family dialogue is marked by silence or moral control, while in health services many girls report discrimination and a lack of reception from professionals.

"It is not enough that this child was exposed to situations of sexual violence and that we did not act as a society to prevent this, we failed to respond, we denied rights and imposed a torturous experience on these girls", says Paula Alegria, advisor on Advocacy and Sexual and Reproductive Rights at Plan.

The UN (United Nations) understands how torture it is to force children to go ahead with a pregnancy. Paula says that the lack of sexual education, often stigmatized by conservative sectors, contributes to the cycle of violence against children in the country.

"Sometimes, the right to a legal abortion is even communicated, but in a discouraging way, or it is communicated and it will be up to the protection network to look for health equipment that performs the procedure on child victims of rape, because that is another layer as well", says Paula.

According to the advisor, among the three cases in which abortion is legalized in the country, the greatest resistance is found in the termination of pregnancy in children and adolescents.

Studies by UFPel (Federal University of Pelotas) show that four in ten Brazilian children up to 14 years old who become pregnant after suffering sexual violence are unable to access prenatal care in the period considered ideal by health professionals.

The delay is even more alarming when looking at the proportion that reaches health services after 22 weeks of pregnancy. This occurs with 28.3% of children up to 12 years old - double the proportion observed among adolescents in general.

There are few services for legal termination after 22 weeks. Although the law does not set a limit, the CFM (Federal Council of Medicine) establishes this period.

For Shisleni, who works with Vivas nationally, one of the impediments to abortion is getting the mother to travel with her daughter from Espírito Santo to São Paulo, for example.

According to Shisleni, families who come to Vivas generally receive a referral from a third party who is outside the health system. "Not necessarily who should have indicated it, who was the one who welcomed the UBS, sometimes the Guardianship Council is not even involved in the relationship", he says.

Experts cite the Conanda resolution, vetoed by Congress in June, as a barrier to access to rights.

"Conanda's intention was precisely to ensure that children who were victims of sexual violence were informed and that the health service had a rule. This means that all the stages were delimited, not only the referral for legal abortion, but psychological support, the role of guardianship councils", says Shisleni.

"What was overturned was the entire national structure of a reception service for children victims of sexual violence."

The girl who sought out the project in January was accompanied by the activists to another hospital and managed to receive care. With the guidelines, says the activist, there would be a document to prove misconduct in health services.

The City of São Paulo informs that it provides legal abortion care at the Municipal Hospital Dr. Cármino Caricchio (Tatuapé), Municipal Hospital Dr. Fernando Mauro Pires da Rocha (Campo Limpo), Municipal Hospital Tide Setúbal (São Miguel Paulista), Municipal Hospital and Maternity Prof. Mário Degni (Jardim Sarah) and Vila Nova Cachoeirinha Municipal Hospital and Maternity School.

In the end, says Paula, the cycle of violence breaks out in other data revealed by the study "Marcas do