Despite the high risk for women, hospital supports “distance abortion”

The practice of tele-abortion for women victims of rape continues to be endorsed by the Hospital de Clínicas of the Federal University of Uberlândia (UFU) – an institution that prepared a manual defending the use of telemedicine to promote abortions during the Covid-19 pandemic. However, the law that authorizes and regulates telehealth does not establish abortion as one of the modalities of care that can be practiced at a distance. The Ministry of Health also published, in 2021, a note stating that the procedure cannot be done by telemedicine.

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Public bodies also changed their position on the subject. At the time of publication of the teleabortion booklet, the Federal Public Prosecutor’s Office (MPF) and the Federal Public Defender’s Office (DPU) requested action against the document that encourages abortion at home, without the presence of a doctor. Despite the change in understanding of some public bodies, tele-abortion has not ceased to be dangerous. Experts heard by People’s Gazette state that there are risks to the pregnant woman’s health and possible complications in the procedure performed at home.

The note from the Ministry of Health stated that “abortion is a plexus of actions from various specialties, including a clinical procedure that is not authorized to be carried out by Telemedicine and that must – obligatorily – be accompanied in person by a doctor at the hospital environment”. This is because the hospital will have devices and resources to safeguard the woman from possible complications, “which, by the way – and, unfortunately – are very common in these cases”.

Doctor from USP Hélio Angotti Neto, physician and author of several books in the field of philosophy of medicine and bioethics, points out that like all technology, telemedicine can be used for good or for evil. “It is not feasible [o teleaborto]but there are several transformations and ideological pressures taking place”, he comments.

He explains that the telehealth law can open loopholes to facilitate abortion at a distance, even more so with the current political scenario and the regression of pro-life guidelines. Recently, Lula announced that Brazil is no longer part of the international agreement of the Geneva Consensus, in defense of life from conception, and the Minister of Health, Nísia Trindade, revoked the ordinance that required doctors to notify police authorities in cases of abortion resulting from rape.

The teleabortion procedure is performed with misoprostol, a drug used in hospitals to cause the death or expulsion of the fetus. Although abortion advocates claim that its use is simple and risk-free, the substance is dangerous and aggressive. Pregnant women who use this drug at home, without observation by the health team, may experience complications such as infections, hemorrhages, uterine rupture, thrombosis, infarction, seizures, liver disorders and septic or hypovolemic shock.

There are also cases in which the abortion does not take place even after using the drug. In these situations, the baby can be born with orthopedic malformations, according to obstetrician Jacyr Leal. “Scientific works show a malformation that is conventionally called Moebius Syndrome”, he says.

Incoherence of the pro-abortion movement

Retired professor at the Institute of Biology at the University of Brasília (UnB) and president of the National Citizenship Movement for Life in Brazil Without Abortion, Lenise Garcia, highlights the inconsistency of the pro-abortion movement, which, while defending the legalization of the procedure under the justification of increased safety for women, it also militates in favor of tele-abortion.

“In some countries, they have facilitated access to misoprostol, but the manufacturers themselves indicate that this drug should only be used in the presence of a doctor and with the possibility of medical resources, in case there is bleeding. It is a very big risk to perform an abortion without being in a place that has care if necessary, ”he says.

The official package leaflet for misoprostol contains several contraindications, such as having had a previous cesarean section; cerebrovascular disease; coronary disease and uterine scarring. For Lenise, if tele-abortion is released in the future, loopholes will be opened for the procedure to be performed in other cases that are currently punishable. Today, abortion is not punished in three cases: rape, anencephaly and risk to the mother’s life. “It is evident that if tele-abortion is allowed, it becomes difficult to discern the cases in which the legislation punishes or does not punish”.

In the view of Angotti Neto, telehealth must be an agenda conducted with responsibility, scientific and ethical foundations. Otherwise, there may be complications for procedures other than abortion. “Technology used responsibly enhances medical follow-up. But if not used responsibly, it can promote inappropriate follow-up.”

Other side

Asked about its position regarding the fact that the abortion procedure is not a modality established by the telemedicine law, the Hospital de Clínicas of the Federal University of Uberlândia has not yet responded. The Federal Council of Medicine also did not return to People’s Gazette.