Women on Web testimony for the Supreme Court in Brasil

 

Brazil’s Supreme Court holds a two-day public hearing that started on Friday August 3. The court will consider whether Brazil’s restrictive abortion laws are violating constitutional protections. The ADPF case was filed on March 8, 2017 by the Socialism and Freedom Party, together with the Anis-Institute of Bioethics, Human Rights and Gender. Rebecca Gomperts, director of Women on Web was one of the experts invited to present.

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Many Brazilian experts including several doctors, public health experts and the ministry of health and women's rights groups as well as many other international experts presented to the court, such as IWHC, Center for Reproductive Rights, IPAS, Human rights watch, presented data and scientific arguments that show that the criminalization of abortion violates women's constitutional rights. 

 

 

 

 

 

All the testimonies can be seen here https://www.facebook.com/nempresanemmorta/videos/932563110238657/UzpfSTQwNjUwMjE1Mjc1NjA1NjoyMTQzMjYzMjE1NzQ2NTk5/?hc_location=ufi (Dr Gomperts is from 36.28 till 19.40)

 

Some media coverage:

 

Testimony for the Brazilian Supreme Court “Audiência Pública sobre interrupção voluntária da gestação” by Dr. Rebecca Gomperts

 

Your Honour,

Thank you so much for the opportunity to share my expertise as an international medical abortion provider.

The medicines used for a medical abortion, mifepristone and misoprostol, have been on the list of essential medicines of the WHO since 2005 and are available in almost all European countries, USA, Russia, China, Australia and Canada.[1]

The costs for a medical abortion is between 5 and 15 USD depending on the country.

Scientific research by the World Health Organisation has shown that medical abortion can easily be done by women themselves at home without supervision by health professionals. A medical abortion has the same health impact as a spontaneous miscarriage. The risk of an abortion with medicines are similar to the risks of commonly prescribed medicines and over the counter medication such as antibiotics and NSAID’s and is safer than Viagra. [2] [3] An abortion with pills is much safer than childbirth and safer than plastic surgery [4] [5]

For pregnancies of up to 9 weeks (63 days) a medical abortion is done either using the combination of 2 medicines mifepristone and misoprostol or using misoprostol alone. A woman needs 12 tablets of misoprostol to be most effective to cause a safe abortion. [6] [7]

The use of misoprostol outside the health systems in countries where abortion is restricted by law has caused a significant decline in maternal mortality. [8] [9]

 

Misoprostol used to be available in Brazil over the counter but since 1998, misoprostol is listed by the Brazilian Health Regulatory Agency (Anvisa) as a substance subjected to special control (List C1 – Portaria nº 344/1998), which means that it is not possible to freely purchase the medication at pharmacies[10]. This results in a black market for misoprostol tablets with the following consequences:

1-    High prices on the black market so many women can only afford to buy much less than the required 12 misoprostol pills (prices are between 800 and 2000 realis for 4 pills), resulting in women having a higher risk of complications and incomplete abortions.

2-    Many women are being scammed by people selling fake medication. [11]

Just today we received this email from a girl in Brasil: “I am 16 years old and 7 weeks pregnant. I canno have this baby. I bought Cytotec but it was a scam. The medicines were fake and did not work. I do not know anymore what to do.”

 

The sale of fake medication and scams and abuse of vulnerable women is being enforced by the current practice of the Brazilian court system to punish the import of Cytotec/ misoprostol as drug trafficking instead of contraband even when the amount could be for personal use.[12]

 

An analysis of a total of 80 court decisions elaborated by the judges of the 4th Regional

Federal Court in Brazil concerning the import of unregistered medicines, showed that the judges openly argued for the penalty to be increased due to the presence of misoprostol (Cytotec). In all the cases article 273 of the Brazilian criminal code, which is classified as a crime against public health which is listed alongside rape, manslaughter, terrorism and torture, was considered. The minimum penalty for Article 273, which imposes a penalty of 5 to 15 years of detention, is twice as high than premediated murder. It is much higher than the penalty for inducing an abortion which is 1 to 3 years detention. However, when the courts decided in cases that concerned the import of other medicines or fake pills of Cytotec, only the penalty of contraband (minimum detention of 1 year) was applied.

I would now like to present the research and experience of Women on Web.

Women on Web (www.womenonweb.org ) is a telemedical abortion service that supports women in countries where there are no safe abortion services, to get access to information and safe medical abortion with mifepristone and misoprostol. Its aim is to reduce maternal mortality and improve reproductive health and rights.

Several scientific studies in the outcome of the abortions and the experiences of women using the Women on Web service have proven the telemedical service is very safe, very effective and highly acceptable for women. [13] [14] [15] [16] [17] [18] [19] [20]

This has been confirmed by the WHO which recognized that abortions done with the help of Women on Web are considered safe abortions. [21]

The number of women reaching out to Women on Web show that there is a huge unmet need for safe abortions with medicines in Brazil.

Every year the Women on Web website has 1.2 Million unique visitors from Brasil.

In the past 7 years, Women on Web received more than 55000 help requests from women living in Brazil.          

In 2016 a study showed a dramatic increase in demand for safe abortions in Latin-American countries that issued public health advisories in response the Zika virus. From November 17, 2015 till March 2, 2016 Women on Web received 1210 help requests from women living in Brasil. This was 108% higher than the expected number of help requests at that moment.[22]

In 2017, Women on Web received 9,736 help requests from Brazilian women, averaging approximately 811 help requests per month.

Of the 1713 women who also completed the online consultation, 53% answered that the unplanned pregnancy occurred because of the contraceptive method used has failed; 42% did not use any contraceptive method and 5% were victims of rape. Most Brazilian women needed an abortion because of financial problems (30%). 16% of the consultations were carried out by adolescents between the ages of 11 and 18 years. Today we received this email from Brasil:” I urgently need your help. I am only 3 weeks pregnant. I am 15 years old. And I am vert scared because I cannot buy the medicines.”

Women on Web helped thousands of women living in Brasil. Unfortunately, in January 2013 the Brazilian customs started stopping all the packages containing medical abortions. Now sWomen on Web provides information about travel options to other countries like Portugal and Mexico City and information about the best and safest use of misoprostol.

In 2009, a court case was initiated against a woman in Brazil whose package had been stopped by the customs. The public prosecutor demanded a punishment of 10 to 15 years imprisonment. The woman was finally acquitted in 2011. [23]

In January 2013 a young Portuguese woman, the daughter of a famous Portuguese singer was put in custody after using the abortion pills she obtained through Women on Web. After intervention of the Portuguese government she was released. [24]

The consequences of the lack of access of legal and safe abortion services in Brasil are reflected in the emails the Women on Web helpdesk receives every day from women living in Brazil.

These are:

1-    The lack of access to legal abortion even in cases where the pregnancy is a risk for the woman’s health and life.

2-    Lack of access to legal abortion in case of rape.

3-    Use of very dangerous abortion methods by desperate women caused by lack of access to legal abortion services.

4-    Lack of access to legal abortions when there is a risk of suicide.

5-    Lack of access to real and sufficient misoprostol tablets because of the high costs caused by the restricted access to misoprostol.

6-    Lack of access to right information about the best use of misoprostol.

 

1-    The lack of access to legal abortion even in cases where the pregnancy is a risk for the woman’s health and life.

An email correspondence with girl of 20 year who contacted the Women on Web helpdesk in November 2014 when she is 4-5 weeks pregnant shows that she died unnecessary because she could not access an abortion in Brazil even though she had a serious health condition called hyperemesis gravidarum (HG) which is a pregnancy complication that is characterized by severe nausea, vomiting, weight loss and dehydration.

Because Gisele could not obtain enough misoprostol tablets, she had an incomplete abortion that resulted in heavy bleeding. Normally women do not die as a result of an uncomplete abortion but as she was already severely dehydrated because of the Hyperemesis gravidarum her body could not compensate the blood loss. Although she consulted a doctor before she died, he did not make the proper diagnoses and he did not provide her with the appropriate after care which would have been emptying her womb or giving extra misoprostol and treating the dehydration. Gisele’s death could easily have been prevented if she would have had access to a safe and legal abortion and proper aftercare in Brasil. [25] 

2-    Lack of access to legal abortion in case of rape.

Although women who have been raped are entitled to have access to legal abortions in Brazil.[26] The help requests for rape cases show that in reality this is often not possible. [27] [28]

“I was raped by someone close to my family and if I tell you what happened two children will suffer. I talked only to you and my husband, who is supporting me, I took the test for sexually transmitted diseases and gave non-reagent. The hospitals in my city ask for proof and expert report. Unfortunately”

 

3-    Use of very dangerous abortion methods by desperate women.

Many of the emails describe the desperate measures women are taking when they do not have access to safe and legal abortion services. These include the use of knives and needles to puncture their wombs.[29]

For example: “she is aware of the safe medications she can take but the question really is money. She is unemployed and the father does not participate. She is willing to abort anyway, even thought to ask for someone to stuck a knife in her belly”

Today we received this email:” I am one month pregnant and I am desperate because I do not have the money to buy the medicines. I have already tried tea, cinnamon, antibiotics, enalopril but it did not work. I think I will kill myself”

 

4-    Lack of access to legal abortions when there is a risk of suicide.

Even in countries where abortion is legally restricted, the risk of suicide is considered a threat to the women’s (mental) health and life and a legal ground to access abortions in the case abortion is allowed for health risks as in Brasil. Our emails show that many women are suicidal as a result of the unwanted pregnancies but cannot access legal abortions in Brasil.[30]

“I'm not in a good moment of my life, Sometimes I think of suicide, so it would be better”

 

Conclusion:
The women that are seeking to terminate a pregnancy in Brazil and don't have access to a safe method to do so are not at this Court today. But they write to me every day, and their stories are very real. Their suffering and lack of options comes across in every single email that we get. And now, given the current restrictive legislation in Brazil, neither our organization, nor the Brazilian health system, has the ability to help or protect them from the risks of an unsafe abortion.

Just today we received 34 emails from Brasilian women in need of help. Not dogma’s but compassion, respect and trust will do justice to these women.

Our data show that the restriction of access to legal abortion services in Brasil severely harms women’s health and live. Women in Brasil are dying because of a lack of access to sufficient quality medication to do a safe abortion and the lack of access to proper after care.

The current policy of the government to restrict access to misoprostol and even punishing the import of misoprostol for drug trafficking with up to 10 years imprisonment, causes a lack of access to reliable and affordable misoprostol which are considered as essential drug by the WHO .

The lack of access to safe and legal abortion services and reliable affordable sources of misoprostol, drives women to resort to very dangerous methods such as the use of needles and knives.

Even in cases where abortion is legal Brasil, in case of rape or risk to the woman’s health and life for example in cases of threat of suicide or hyperemesis gravidarum, women cannot access abortion services.

 

 

[1] http://www.who.int/medicines/publications/essentialmedicines/en/

[2] WHO, Safe abortion: technical and policy guidance for health systems , 2 ND

Ed., 2012. Available in:

http://apps.who.int/iris/bitstream/10665/70914/1/9789241548434_eng.pdf . Last access on 9/14/2017.

[3] https://www.nap.edu/read/24950/chapter/4#69, Page 69

[4] https://www.nap.edu/read/24950/chapter/1

[5] http://www.who.int/reproductivehealth/publications/unsafe_abortion/abortion-task-shifting/en/

[6] Efficacy of two intervals and two routes of administration of misoprostol for termination of early pregnancy: a randomised controlled equivalence trial.

von Hertzen H, Piaggio G, Huong NT, Arustamyan K, Cabezas E, Gomez M, Khomassuridze A, Shah R, Mittal S, Nair R, Erdenetungalag R, Huong TM, Vy ND, Phuong NT, Tuyet HT, Peregoudov A; WHO Research Group on Postovulatory Methods of Fertility Regulation. Lancet. 2007 Jun 9;369(9577):1938-46.

[7] Lancet. 2017 Nov 25;390(10110):2372-2381. doi: 10.1016/S0140-6736(17)31794-4. Epub 2017 Sep 27.

Global, regional, and subregional classification of abortions by safety, 2010-14: estimates from a Bayesian hierarchical model.Ganatra B1, Gerdts C2, Rossier C3, Johnson BR Jr4, Tunçalp Ö4, Assifi A4, Sedgh G5, Singh S5, Bankole A5, Popinchalk A5, Bearak J5, Kang Z6, Alkema L6.

 

[8] Efficacy of two intervals and two routes of administration of misoprostol for termination of early pregnancy: a randomised controlled equivalence trial.

von Hertzen H, Piaggio G, Huong NT, Arustamyan K, Cabezas E, Gomez M, Khomassuridze A, Shah R, Mittal S, Nair R, Erdenetungalag R, Huong TM, Vy ND, Phuong NT, Tuyet HT, Peregoudov A; WHO Research Group on Postovulatory Methods of Fertility Regulation. Lancet. 2007 Jun 9;369(9577):1938-46.

[9] Lancet. 2017 Nov 25;390(10110):2372-2381. doi: 10.1016/S0140-6736(17)31794-4. Epub 2017 Sep 27.

Global, regional, and subregional classification of abortions by safety, 2010-14: estimates from a Bayesian hierarchical model.

Ganatra B1, Gerdts C2, Rossier C3, Johnson BR Jr4, Tunçalp Ö4, Assifi A4, Sedgh G5, Singh S5, Bankole A5, Popinchalk A5, Bearak J5, Kang Z6, Alkema L6.

[10] Portaria 344/1998: < http://www.anvisa.gov.br/hotsite/talidomida/legis/Portaria_344_98.pdf

[11] “Minha última menstruação foi 15/06. Estou na correria pois foi meu 3° golpe.

Como vocês podem me ajudar?”

[12] http://idg.receita.fazenda.gov.br/orientacao/aduaneira/viagens-internacionais/guia-do-viajante/guia-do-viajante-versao-ingles/questions-answers

[13] Gomperts R, et al. Regional differences in surgical intervention following medical termination of pregnancy provided by telemedicine.

Acta Obstet Gynecol Scand 2012;91:226–31.

[14] Menezes, G, Aquino, EML. Pesquisa sobre o aborto no Brasil: avanços e desafi os para o campo da saúde coletiva [Research on abortion I Brazil: gaps and challenges for the public health field]. Cad. Saúd Pública, 2009;25(2):193–204. (http://www.scielo.br/scielo.php?script=

sci_arttext&pid=S0102-311X2009001400002 accessed on November 19 th, 2012).

[15] Experiences of women living in Hungary seeking a medical abortion online, Les K, Gomperts R, Gemzell-Danielsson K., Eur J Contracept Reprod Health Care. 2017 Oct;22(5):360-362. doi: 10.1080/13625187.2017.1397112. Epub 2017 Nov 22.

[16] Self reported outcomes and adverse events after medical abortion through online telemedicine: population based study in the Republic of Ireland and Northern Ireland., Aiken ARA, Digol I, Trussell J, Gomperts R., BMJ. 2017 May 16;357:j2011. doi: 10.1136/bmj.j2011.

[17] Regional differences in surgical intervention following medical termination of pregnancy provided by telemedicine., Gomperts R, Petow SA, Jelinska K, Steen L, Gemzell-Danielsson K, Kleiverda G, Acta Obstet Gynecol Scand. 2012 Feb;91(2):226-31. doi: 10.1111/j.1600-0412.2011.01285.x. Epub 2011 Oct 17.

[18] Experiences and characteristics of women seeking and completing at-home medical termination of pregnancy through online telemedicine in Ireland and Northern Ireland: a population-based analysis, Aiken A, Gomperts R, Trussell J.BJOG. 2017 Jul;124(8):1208-1215. doi: 10.1111/1471-0528.14401. Epub 2016 Oct 17.

[19] Using telemedicine for termination of pregnancy with mifepristone and misoprostol in settings where there is no access to safe services, Gomperts RJ, Jelinska K, Davies S, Gemzell-Danielsson K, Kleiverda G., BJOG. 2008 Aug;115(9):1171-5; discussion 1175-8. doi: 10.1111/j.1471-0528.2008.01787.x. Epub 2008 Jul 10.

[20] Gomperts R, van der Vleuten K, Jelinska K, da Costa CV, Gemzell-Danielsson K, Kleiverda G. Provision of medical abortion using telemedicine in Brazil. Contraception 2014 Feb; 89 (2): 129-33

[21] https://www.theguardian.com/world/2017/sep/27/almost-half-of-all-abortions-performed-worldwide-are-unsafe-reveals-who

[22] http://www.nejm.org/doi/full/10.1056/NEJMc1605389

[23] https://www.conjur.com.br/dl/0014385-3420084036181.pdf

[24] https://www.jn.pt/seguranca/interior/adelaide-ferreira-arrisca-quatro-anos-de-prisao-por-suspeita-de-encobrir-aborto-3011724.html

[25] 21 Nov, 2014

Ola tenho 20 anos e sou fo Brasil.. Descobri que estou gravida de 5 semanas porem não tenho a menor condição financeira r psicológica de ter a criança. Sou apenas eu minha mae aqui em casa e ela esta de cama.. Preciso trabalhar para ajudar nas despesas de casa e não tenho condições de ter  filho. Preciso muito da ajuda de vocês,as que qualquer coisa no mundo.. Não tenho dinheiro e não tenho como recorrer a uma opção aqui pois as que já recorri eram falsos compridos de cytotec. PPR favor eu imploro, me ajudem! (Hello, I'm 20 years old and I'm Brazilian. I've discovered that I'm pregnant for 5 weeks, but I do not have the least financial psychological condition to have the child. I'm just with my mother here at home and she's in bed. I need to work to help with expenses at home and I'm not able to have children. I need a lot of help from you guys, anything in the world. I do not have any money and I can not use an option here because the ones I already used were fake long cytotec. PPR please, I beg you, help me!)

26 Nov, 2014

“…….Dizem que co efeito colateral o misoprostol pode vir a causar enjôos e vomito, no caso, eu já estou sentindo MUITOS enjôos devido o fato de eu estar gestante... Isso pode vir a fazer com que eu tenha maiores chances de ter enjôos e vômitos apos o uso da medicação? So pelo fato de eu passar mal com a gravidez em duas semanas eu perdi 5 kg. ("….. They say that misoprostol side effect is likely to cause nausea and vomiting, in case, I'm already feeling MUCH sickness due the fact that I was pregnant ... Will this make me have more nausea and vomiting after the use of this medication? Only because of the fact that I get sick with pregnancy in two weeks I lost 5 kg. ")

29-Nov, 2014

…”so que já faz mais de uma semana que nada para no meu estomago desde agua ate alimentos concretos... Agora a única coisa que resolveu parar foi laranja, to chupando a laranja e é a única coisa que diminui a anciã e para no estomago... To muito muito fraca já, não levanto porque sinto tonturas e fraqueza.. Posso continuar ingerindo laranja?! Vou iniciar o processo abortivo hoje as 20:00 horas no horário do Brasil.. Sera que vai interferir?! ( so it's been over a week that nothing stops in my stomach, no water or concrete food ... Now the only thing that i could eat was orange, sucking the orange is the only thing that reduces the nausea ... much too weak already, can not get up because I feel dizzy and weak .. I can keep on drinking orange ?! I'll start the abortion process today at 20:00 Brazil time ..Will that interfere ?!")

05 Dec, 2014

Oii.. Deixa eu te falar. Eu fiz um aborto esse final de semana... Não to tendo sangramento forte nem nada.. Mas ru continuo com a sensação de que vai sair uma bola de dentro de mim, ontem saiu um coágulo mas hoje parece que ainda tem mais pra sair.. Não sinto cólica forte so as vezes e não tive febre nem nada.. O que sera?!;x já fui no medico ele so apertou por cima mesmo a região do útero e falo que tava tudo normal. ("hi .. Let me speak. I had an abortion this weekend ... not heavy bleeding or anything .. But i still have the feeling that there's a ball in me, yesterday lost a big tissue but today it seems that there's more to come out .. I do not feel strong cramps, just sometimes, and had no fever or anything .. What is going on?! i've been to the doctor, he squeezed over the same region of the uterus and said that everything was normal.")

20 Jan, 17:28, 2015

“Sou mae da gisele. Ela faleceu devido ha hemorragia causada pelo procedimento. Fez Assim como foi instruído mas não deu certo

Não respondi vocês porque so agora consegui as senhas dela. Esta muito difícil ficar sem minha filha. “

(I'm gisele's mother. She passed away due to hemorrhage caused by the procedure. She did as she was instructed but did not work

I did not answer you because I just got her passwords now. It's very difficult to be without my daughter.)

[26] Ciênc. saúde coletiva vol.22 no.5 Rio de Janeiro May 2017

http://dx.doi.org/10.1590/1413-81232017225.33272016  Women’s protection public policies: evaluation of health care for victims of sexual violence

http://www.scielo.br/scielo.php?pid=S1413-81232017002501501&script=sci_arttext&tlng=en

[27] MADEIRO, AP, DINIZ, D. Legal abortion services in Brazil - a national study. http://www.scielo.br/pdf/csc/v21n2/en_1413-8123-csc-21-02-0563.pdf

[28]

“Fui estuprada e estou com muita vergonha de procurar um centro médico e nem tenho provas disso, pq aconteceu a 2 meses, mas não vou conseguir ter o nenem” (I was raped and I am very ashamed to seek a medical center and I have no proof of this, because happened 2 months, but I will not be able to have the baby.)

“Oi, Eu não fiz ocorrência porque fui estuprada por alguém próximo da família e se eu contar o que ocorreu duas crianças irão sofrer. Eu conversei somente com vcs e meu esposo do qual esta me apoiando fiz o exame pra ver as doenças sexualmente transmissíveis e deu não reagente. Os hospitais da minha cidade pedem boletim de ocorrência e laudo pericial. Infelizmente.” (Hi, I did not do it because I was raped by someone close to my family and if I tell you what happened two children will suffer. I talked only to you and my husband, who is supporting me, I took the test for sexually transmitted diseases and gave non-reagent. The hospitals in my city ask for a bulletin of occurrence and expert report. Unfortunately.")

“Fui estuprada numa festa. Estou grávida de 3 semanas. Quero interromper .Não sei que eh o Pai. Quero ajuda” (I was raped at a party I'm 3 weeks pregnant I want to interrupt I do not know, what's up? I need help")

“Um familiar (prefiro nao mensionar o nome) foi estuprada pelo padastro, e com exames, descobrimos que ela esta gravida. Porém amigo, ela não é qq pessoa. E conhecida em certas partes na midia e na internet.. não queremos que ninguem saiba. Por favor, vi seu site, e acredito que possa ajudar nisso. Ela esta de 3 semanas, e parece ser gemiuns.

Entre em contato o mais rapido que der. obrigado.” (A relative (I prefer not to mention the name) was raped by the stepfather, and with examinations, we found that she was pregnant. But friend, she is not that person. It is known in certain parts of the media and on the internet. We do not want anyone to know. Please, I've seen your site, and I believe you can help with that. She is 3 weeks old, and seems to be gemiuns. Contact us as soon as you can. thank you.")

“por favor estou desesperada,fui estuprada e gostaria de saber,como eu faço para adiquirir medicamentos,,a minha ultima menstruaçao faz 30 dias,………..tenho vergonha tambem de ir ate a policia,,,me retornem ,por favor ,urgente” (Please I'm desperate, I was raped and I would like to know, how do I get medicaments, my last menstruation is 30 days, ......... .. I'm too ashamed to go to the police ,,, come back, please ,urgent)

“……Tenho 25 anos e sou casada a 4 anos com um homem que me fez desisitir de tudo na vida. Minha familia é muito religiosa e não aceita separação embora saibam o que passo. Desde então eu vinha aguentando tudo até que decidi me separar. quando decidimos nos casar ele não deixou mais que eu trabalhasse e estudasse poisdeveria cuidar dele e da casa. Como não tenho renda e nem apoio da familiaa caso saia da casa dele comecei a procurar emprego porque assim com alguma renda eu teria como morar em outro lugar. A partir da minha decisão ele se tornou bastante agressivo ao ponto de forçar relações sexuais, me bater e me trancar em casa. De uma dessas relações forçadas resultou na minha gravidez .” (I am 25 years old and I am married 4 years with a man who made me give up everything in life. My family is very religious and does not accept separation although they know what happens. Since then I've been holding on until I've decided to separate. when we decided to get married he did not let me work and study anymore, because I should take care of him and the house. As I have no income and no support from the family, if I left his house I started looking for a job because, with some income, I would have to live somewhere else. From my decision he became quite aggressive to the point of forcing sex, hitting me and locking me at home. One of these forced relationships resulted in my pregnancy.)

[29] “……ela está ciente dos remédios seguros que ela pode tomar mas a questão realmente é o dinheiro. Ela é desempregada e o pai não participa. Ela está disposta a abortar de qualquer maneira, até cogitou pedir para alguém enfiar uma faca na barriga dela.” (……she is aware of the safe medications she can take but the question really is money. She is unemployed and the father does not participate. She is willing to abort anyway, even thought to ask for someone to stuck a knife in her belly)

“Preciso de ajudar... estou desesperada, tentei perfurar o utero com uma agulha, não sei se deu certo ainda nãoc sangrei.... por favor estou desempregada.... não sei mais o que fazer.... tomei um chá que me fez vomita bastante... preciso de alguem que possa me ajudar..por favor” ("I need help ... I'm desperate, I tried to pierce the uterus with a needle, I do not know if it worked out yet I did not bleed.... please I'm unemployed .... I do not know what else to do .... I had a tea that made me vomit a lot ... I need someone who can help me .. please ")

[30]

“Estou com 9 semanas e estou desesperada. Já pensei até em me matar. Por favor me ajudem. por favor me ajudem, eu n aguento mais, penso em me matar("I'm 9 weeks pregnant and I'm desperate. I even thought about killing myself. Please help me. Please help me, I can not take any more, I think of killing myself)

“……não estou em um momento bom da minha vida , as vezes penso em suicídio, que assim seria melhor , mais não sei mesmo oque fazer , estou perdida e sinto que muita gente está me julgando e isso me Mata por dentro. Acho que não seria legal eu falar que fuiestuprada, até porque já aconteceu isso comigo e sei como não é legal , eu realmente não sei oque fazer.” (I'm not in a good moment of my life, Sometimes I think of suicide, so it would be better, but I do not really know what to do, I'm lost and I feel that a lot of people are judging me and it kills me inside. I think it would not be nice for me to say that I went even because this has happened to me and I know it's not cool, I really do not know what to do.)