POPULATION-BRAZIL: More Women Opt for Sterilisation

By Fabiana Frayssinet Reprint | | Print |

Fabiana Frayssinet

RIO DE JANEIRO, Oct 25 1996 (IPS) - At the age of 26, Rosangela de Morais, a mother to four children, decided her family was big eneough.

So she underwent sterilisation surgery which, despite being disallowed under Brazil’s public health system, has increased by more than 40 per cent in the past 10 years. The reason: simple economics.

“With so many children, there just isn’t enough money to raise them properly, and life is difficult,” de Morais said. The family must exist on about 400 dollars a month, mostl;y from her husbands earnings as a shop assistant.

Rosangela used to work as a domestic employee, but her four successive pregnancies prevented her from adding to the family earnings.

Her case differed to that of Brazil’s Sports Minister and former soccer star, Pele, whose wife had to resort to artificial insemination in order to have a child with his new wife, after doctors failing to reverse his vasectomy.

Rosangela is one of millions of Brazilian women who have been sterilized, according to a recent population study conducted by the non-governmental organization Welfare for the Family in Brazil (BEMFAM), with financial support from the U.S.-based demography institute Macro International.

The figures reveal Brazil has the highest rate of sterilization in Latin America and, according to the study, 40 percent of Brazilian women who use contraceptive methods have opted for sterilization, reflecting a 49 percent increase in 10 years.

Despite the publicity surrounding Pele, Brazilian men have also turned to sterilization. While in 1986 only 0.8 percent had undergone vasectomies, in 1995 that percentage was 2.6.

Ria Badiani, who coordinated the study, expressed alarm about the decline in the average age of women opting for sterilization. Ten years ago, it was 31, and today it is 28 and of all sterilized women, 6.4 percent have only two children.

“What concerns me is what is happening to cause Brazilian women to be persuaded to choose sterilisation,” says Badiani. “It is an indication of the lack of access to other methods, a problem of limited availability of methods, and of the difficulties women have in sharing contraceptive responsibility with men.

“It is also an indication of the need to offer better conditions to educate children.”

On the basis of the study, other variables will also been investigated, for example whether women who are sterilized are conscious of the fact that it is in most cases irreversible.

“Many people say that tying your tubes is irreversible, and that you can’t have any more children. But I am happy with the ones I already have,” says Rosangela.

She had the surgery at a private clinic and paid the equivalent of 400 dollars, but according to Badiani, many sterilizations are performed in public hospitals.

“Does the public sector pay for sterilization? Then what happens? What we do know is that women have Caesarian sections and are sterilized at the same time,” explained Badiani.

In January, president Fernando Henrique Cardoso issued a decree authorizing sterilizations throughout the public health system but, four days later, reversed the ruling because the Ministry of Health considered the method to be a form of “mutilation.”

Political sources, however, acknowledged that he may have bowed to pressure from the Roman Catholic Church, which opposes all contraceptive methods that are “not natural.” Some Brazilian politicians subsidize sterilizations in exchange for votes, an allegation which the BEMFAM study will also explore.

“What occurs in Brazil is not family planning, but population control,” warned Lucia Souto, a state representative for Rio de Janeiro, who is also a public health doctor and has criticized sterilization because “it profoundly alters women’s physiology.”

BEMFAM prefers not favor or denounce sterilisation and considers that the government should stimulate contraceptive education, and offer other medical options of birth control.

“What we do have is an absence of policies, of a real definition of public health programs for women – or rather the implementation of those policies – which makes women’s choices very limited,” she said.

“Other methods do not work. I used an IUD (intrauterine device) and I got pregnant; I took contraceptive pills and I got pregnant. I needed to be sure,” said Rosangela, adding that sterilization was recommended to her by her obstetrician.

BEMFAM has criticized the role of doctors involved in reproductive health in Brazil, who prefer methods that are “highly efficient.”