SP City Hall suspended service without irregularity

One of the arguments that the city of São Paulo used to close the legal abortion service at the Vila Nova Cachoeirinha Hospital – the unit that provided the most services in the largest city in the country – was the suspicion that some of the procedures had been irregular, that is, outside the law that allows the termination of pregnancy in cases of sexual violence, fetal anencephaly or risk to the pregnant woman’s life.

Shortly after the suspension, at the end of last year, the Secretary of Health, Luiz Carlos Zamarco, said he was going to order his team to carry out a survey of abortions carried out in the unit, suspecting that something was wrong. And the Department of Health even copied patients’ medical records – which is illegal, as the data is confidential and could only be accessed by the patients themselves or by court order. “The technical team, together with Cremesp [Conselho Regional de Medicina de São Paulo]is authorized to check medical records where irregularities are suspected,” said Zamarco at the time.

However, information obtained by Public Agency via the Access to Information Law (LAI) shows that the secretariat did not register any reports of illegal abortions in Vila Nova Cachoeirinha in recent years. In other words, there was no reason to suspect illegalities in the service to the point of suspending it.

“The Executive Secretariat for Hospital Care of the Municipal Health Secretariat of São Paulo informs that it has not registered a report of illegal abortion at the Vila Nova Cachoeirinha municipal hospital covering the requested period (since 2019)”, says the text sent to the report by the Municipal Access Commission to Information, the body that decides in the last instance on requests for information in municipal management, after the request was denied twice by the Department of Health.

“The absence of complaints makes it clear that there is no reason to close the legal abortion service and demonstrates that Mayor Ricardo Nunes’ decision was ideological and, therefore, illegal. It is worth remembering that the service closed by the mayor mostly served young victims of rape. We will appeal until we get the service back”, said federal deputy Luciene Cavalcante, from PSOL, one of the authors of a popular action asking for the service to be resumed.

In the popular action filed by her and councilor Celso Giannazi (PSOL), the city council appealed twice in court, and won, so that the service remained closed in Vila Nova Cachoeirinha. The decision in favor of the city hall says that the suspension of legal abortion in the unit is not illegal because patients would be referred to other hospitals in the city. The plaintiffs appealed once again, arguing that other hospitals deny care to people in advanced stages of pregnancy. There has been no new decision yet. In the meantime, the service remains closed.

In addition to the alleged irregularities, the city hall also argued that the suspension of the service would be part of a “reorganization” with the aim of carrying out joint operations on the site involving women’s health, such as endometriosis. However, professionals consulted by Public they say that abortion-related care does not harm the performance of other procedures, because the teams would not be the same and the number is relatively low. Vila Nova Cachoeirinha performed an average of nine legal abortions per month in 2023 – the year with the most services in its history.

The hospital is the one that performed the most legal abortions in the city of São Paulo – much more than all the others authorized to perform the procedure in the capital. There were 419 consultations in the last decade. The other four who provide the service, together, handled 190 cases in the same period.

Hospitals refuse to treat people in advanced pregnancy

Only Vila Nova Cachoeirinha terminated pregnancies in girls and women over 20 weeks of gestation. The city hall claims that the Municipal Hospital and Maternity Prof. Mário Degni, Tide Setúbal Municipal Hospital, Dr. Fernando Mauro Pires da Rocha Municipal Hospital (Campo Limpo) and Dr. Cármino Caricchio Municipal Hospital still provide care in cases of advanced pregnancy.

A Public found, with health professionals and entities that work for women’s rights, that this is not happening. In March, we already told the case of a woman who was a victim of sexual violence and was denied her right. She had to leave her state to be treated at a hospital in Salvador, Bahia.

The São Paulo Public Defender’s Office received the case of a woman, victim of sexual violence, who was denied her right at the Hospital do Campo Limpo – one of the units that should provide care in the capital of São Paulo. At 24 weeks of gestation, she was informed that the service could not be performed due to the unit’s lack of preparation. Instead of recommending that she go to another hospital, the team recommended that she go directly to the Public Defender’s Office, because her rights would only be guaranteed if she went to court.

The request was granted and the judge who analyzed the case ordered the abortion to be performed. But, in the meantime, the Federal Council of Medicine (CFM) issued a resolution that prohibits doctors from performing fetal asystole, a method approved by the World Health Organization (WHO) for cases of abortion over 20 weeks, which would be the case her. Then the decision was reversed. An injunction suspended the CFM resolution, but it was overturned last week.

With this back and forth, the woman, who has the constitutional right to terminate her pregnancy as a result of rape, still has an uncertain fate.

Offensive against a constitutional right

This Monday (29), Cremesp voted, unanimously, for the precautionary ban of two doctors from Vila Nova Cachoeirinha. Another case will be analyzed in this Tuesday’s session. The professionals allegedly practiced torture, cruel treatment, negligence, recklessness and murder of fetuses, according to the Folha de S.Paulo.

The cases would have reached the council illegally, through access to patients’ medical records, according to the newspaper. The documents would also have been forwarded to the Public Security Secretariat and the Civil Police, which raises fears that health professionals and patients will be targets of criminal investigations.

The continued suspension of legal abortion services in Vila Nova Cachoeirinha and the persecution of doctors have generated a climate of tension among employees at the unit and others who still perform legal abortions. According to reports heard by Publicthere is an understanding that the city council’s top leadership does not agree with the interruption of advanced pregnancies for moral reasons and that it will make care difficult despite being provided for by law.

The Ricardo Nunes administration even appointed an openly anti-abortion doctor affiliated with PL, Jair Bolsonaro’s party, to be director of the unit, but retreated after the case gained repercussion in the press.

The PSOL feminist bench in the City Council sent a representation to the United Nations (UN), the WHO and the Pan American Health Organization (PAHO) pointing out that the closure of the service in Vila Nova Cachoeirinha, the CFM resolution and others Recent measures represent “an express prohibition on access to legal abortion for girls, women and people with uteruses who are victims of sexual violence”.

The councilors ask that international bodies “intervene and urge Brazil to guarantee unrestricted access to legal abortion for victims of sexual violence, as provided for in national legislation and international human rights treaties ratified by the country”.

We asked the city hall about the points mentioned in this report, but the response sent was protocol. “The Municipal Health Department informs that the Legal Abortion program is available in four municipal hospitals in the capital. They are: Dr. Cármino Caricchio Municipal Hospital (Tatuapé); Municipal Hospital Dr. Fernando Mauro Pires da Rocha (Campo Limpo); Tide Setúbal Municipal Hospital; Municipal Hospital and Maternity Prof. Mário Degni (Jardim Sarah). The service takes place within the safety and quality premises as stipulated by current legislation”, says the note.