Kafkaesque

by Belle Waring on January 7, 2012

One hesitates to use the term, because it is so often misused, but it’s genuinely applicable here. Brazil just passed a law requiring every pregnant woman to register with the State. The alleged reason is to improve pre-natal care, but since no such provisions exist in the law it seems an exercise of raw power.

On December 27, while most Brazilians prepared for the New Year by bleaching their whites and gathering flowers to toss into the Atlantic for the goddess Iemanjá, Dilma Rousseff, Brazil’s first female president, was gathering a group a conservative legislators to stealthily assist in drafting and enacting a Ceauşescu-like law requiring all pregnant women to register their pregnancies with the state….
So what is going on? Brazil, the most populous Catholic country in Latin America, finds its politics intrinsically tied to the hierarchy of the Catholic Church. Dilma, who won a last-minute reprieve from the church’s negative onslaught in the 2010 presidential elections once she disavowed any suggested support for abortion, is to a certain extent beholden to that base. Indeed, Dilma’s cabinet includes an unofficial church representative who was responsible for brokering an agreement between the Vatican and Brazil during President Luiz Inácio Lula da Silva’s administration. For years Catholic and evangelical parliamentarians have been trying unsuccessfully to establish a registry for pregnant women, with Dilma’s support they’ve finally succeeded.

The obvious actual intention of the law is to prosecute women who have abortions or induce miscarriages. It’s hard to imagine anything more painful than losing a wanted fetus and then being grilled by the police about it, and possibly sent to jail for up to 3 years. Oh wait, except being forced to carry a fetus to term when you are the victim of a rape but there was no successful rape prosecution. That would be worse. Will the cops walk around stopping pregnant women and checking whether they are registered? If anything this seems likely to worsen access to pre-natal care, as women who are undecided about whether to carry to term at first, but end up staying pregnant, decide to give birth at home to avoid getting in legal trouble for failing to register the pregnancy earlier. Or when teenage girls who are ashamed of their pregnancy don’t want to register, and then won’t go see the doctor for any pre-natal care whatsoever. I hope when Brazil’s congress returns to session they will overturn this law. This is just evil and wrong.

UPDATE: Thanks to Witt in comments below, a link to an English-language article explaining the law in greater detail, by Brazilian women’s health activist and human rights advocate Beatriz Galli. (Additionally, those curious may want to know that the woman’s doctor will be compelled to register her with the government when he knows she’s pregnant, which might well be before she does!) Excerpt:

In fact, PM 557 does not guarantee access to health exams, timely diagnosis, providers trained in obstetric emergency care, or immediate transfers to better facilities. So while the legislation guarantees R$50.00 for transportation, it will not even ensure a pregnant woman will find a vacant bed when she is ready to give birth. And worse yet, it won’t minimize her risk of death during the process….
Last but certainly not least, MP 557 violates all women’s right to privacy by creating compulsory registration to control and monitor her reproductive life. In fact, it places the rights of the fetus over the woman, effectively denying her reproductive autonomy. A woman will now be legally “obligated” to have all the children she conceives and she will be monitored by the State for this purpose.

{ 107 comments }

1

Oliver 01.07.12 at 10:24 am

If the state has the power to demand one register births, it also has the power to demand registrations of conceptions.

2

Martin Bento 01.07.12 at 10:42 am

Jesus H. Christ. I guess the only good side of a law like this is if it triggers enough of a backlash that the agenda and power behind it ends up behind where it started. Does anyone know how much popular opposition there will be to this? Both from a pro-abortion and a general anti-big-brother standpoint? This sounds more Orwellian than Kafkaesque to me. Though the religious should also note its Herodian resonance.

3

Belle Waring 01.07.12 at 10:53 am

Mmmm, yeah, on reflection Orwellian would have been better but I won’t change it now. I wonder if you have to detail the circumstances. “we stayed up late eating popcorn and watching True Blood season one, and then…”

4

Down and Out of Sài Gòn 01.07.12 at 11:08 am

That’s jaw droppingly evil, Belle. Thanks for bringing it to our attention.

Fortunately, the law “Provisional Measure 557 (PM 557)” seems to be provisional, as far as I understand it. Wouldn’t there have to forms to be signed and also a bureaucracy involved in order to count pregnancies? Both wouldn’t exist yet – certainly not so soon after New Years.

I can’t see how they’re going to enforce this law even if Congress gets on board. Bureaucrats would die – as in, get shot by bullets or arrows – if they entered the favelas or Amazonian villages to count pregnant women.

5

Scott Martens 01.07.12 at 12:06 pm

Since the story in 2009 about that nine-year old who got excommunicated after she had a life-threatening pregnancy (caused by being raped by her father) legally terminated, I’ve come to the conclusion that the Catholic hierarchy in Brazil is just evil. The deals they cut with the government – even a leftist government – are always going to be bad news.

I blame JPII for this. He appointed radical conservatives to as many of Brazil’s bishoprics as possible in order to suppress liberation theology, which was pretty firmly rooted in Brazil in the early 80s. It would be hard to imagine the Church in the US or Europe even supporting such a brazenly religiously motivated anti-woman measure. much less proposing it.

6

Sergio Praca 01.07.12 at 12:47 pm

The Slate piece is amazingly uninformed. See BR12′s comment in there: “At first I was alarmed, but I took a look at this vilified piece of law, and I can assure you that in NO WAY AT ALL it does require pregant women to register. Of course, such kind of legislation would be unconstitutional in Brazil, as we don’t have nothing comparable to the Patriot Act or other “Ceausescu-like” law.
The measure is directed to health care services, not to the women. And, of course, its goal is to provide basic health assistance to pregnant women, not to control their bodies.
Another point demanding clarification is that a Provisional Measure must be voted and approved by Congress in 60 days, otherwise it will just cease to exist. “

7

tomslee 01.07.12 at 12:50 pm

I see nothing in the Slate article, or elsewhere with a quick Google, about timeframe for registration. The practical consequences could obviously be much worse the earlier in the pregnancy registration is required: registration at 8 months would have little impact on abortion decisions, for example. Has anyone seen anything about that?

8

Watson Ladd 01.07.12 at 1:02 pm

Of course, one shudders to think of what Brazil would do if they provided heath care to all women for free, and then had the doctors centralize the records.

9

Lynne 01.07.12 at 1:12 pm

Oliver, not so. A birth brings a new citizen into the country. A conception is a private change in a woman’s body.

10

Barry 01.07.12 at 1:22 pm

“I blame JPII for this. He appointed radical conservatives to as many of Brazil’s bishoprics as possible in order to suppress liberation theology, which was pretty firmly rooted in Brazil in the early 80s. It would be hard to imagine the Church in the US or Europe even supporting such a brazenly religiously motivated anti-woman measure. much less proposing it.”

That man’s actions will reverberate down through the 21st century.

11

Belle Waring 01.07.12 at 1:40 pm

Well Watson, if Brazil provided healthcare to all women for free, perinatal deaths among both women and children would be massively reduced, so that would be nice, what with them being actual human beings and everything. If the government collated the records, further recorded who gave birth, and then went looking for everyone who didn’t, demanding medical proof that miscarriage was unintentional, and threatening people with between 1-3 years in jail if they couldn’t show that they had gone to the doctor after the miscarriage, and asking the doctor to judge whether it was “natural”, and further threatening the doctor with significant jail time if they suspected he performed abortions or gave women RU-486, well, then, that would eat a bowl of big fat dicks. Does one shudder?

12

Uncle Kvetch 01.07.12 at 2:15 pm

I’ve come to the conclusion that the Catholic hierarchy in Brazil is just evil.

Scott, if you could point me to a non-evil Catholic hierarchy anywhere in the world I’d be most grateful.

13

Henri Vieuxtemps 01.07.12 at 2:36 pm

…or non-evil non-Catholic hierarchy, for that matter?

14

P O'Neill 01.07.12 at 2:52 pm

I think there’s going to be a good case for decentralized boycotts of the FIFA World Cups in 2014, 2018, and 2022. Heckuva job, Sepp!

15

leederick 01.07.12 at 3:27 pm

“Oliver, not so. A birth brings a new citizen into the country. A conception is a private change in a woman’s body.”

That’s obvious nonsense. Just because someone is born doesn’t mean they are a citizen. Statutory public health registries – including for abortions and stillbirths – are also very common and do a great deal of good.

16

Ben Alpers 01.07.12 at 3:36 pm

Just because someone is born doesn’t mean they are a citizen.

In the US it certainly does.

17

Belle Waring 01.07.12 at 3:42 pm

Well, in Amurrica someone’s being born does mean they’re a citizen, actually. And the idea of the National Institute of Health keeping track of miscarriages and maternal mortality etc. in an effort to see which states are doing the worst (hi Mississippi!) and improve care is perfectly reasonable. The idea that a woman will miss her period and then march down to be registered as a pregnant person is much different, insidious, unpleasant, being proposed on entirely disingenuous grounds, and all in all sounds much more like Margaret Atwood novel than the work of a humane functioning government that gives two shits about half its citizens. I have to go to bed; please endeavour not to fake incomprehension of obvious facts; it’s so tedious and unproductive. Or talk about George R.R. Martin.

18

leederick 01.07.12 at 3:59 pm

“Well, in Amurrica someone’s being born does mean they’re a citizen, actually.”

I can’t really see the relevance of that. Lynn’s point was that birth registration is legitimate in that it records citizenship. Your point is what? You support birth registration in the US (except for children of diplomats, presumably) but oppose the French doing it? It’s clearly a dumb and bogus justification for registration.

“And the idea of the National Institute of Health keeping track of miscarriages and maternal mortality etc. in an effort to see which states are doing the worst (hi Mississippi!) and improve care is perfectly reasonable… [Brazil] in all sounds much more like Margaret Atwood novel than the work of a humane functioning government that gives two shits about half its citizens. “

That’s great. But if that’s the disagreement then how about all the hyped up carping on about privacy concerns and declaration that registries can’t substantially improve pre-natal health stop.

19

Witt 01.07.12 at 4:32 pm

The difference is that tracking a miscarriage after a person comes to a hospital, or tracking a maternal death, is data collection *after the fact.* Data collection before the fact, in a domain as uniquely* personal and intimate as pregnancy, is a radically different question.

*I actually considered talking about HIV/AIDS registries here, but decided not to because I think pregnancy is so profoundly different from any other phenomenon that we ought not to muddy the waters with analogies.

20

Belle Waring 01.07.12 at 4:32 pm

Gah. This is being proposed on disingenuous grounds, and likening it to records kept by, say, NIH in order to distribute resources better just takes the claim at face value: “we want to improve access to pre-natal care!” Additionally, it is also a horrendous privacy violation. It’s like two flavors of evil ice cream in one! Why should anyone be barred from mentioning both facts? “Hyped-up carping” my lily-white ass. If you were a scared 17-year-old whose parents didn’t know she was pregnant yet and who would be breaking the law by not going to write her name down on a national registry of pregnant persons, I submit you’d feel differently.

21

Rich Puchalsky 01.07.12 at 4:40 pm

The reasons for data collection and privacy supports around data collection matter tremendously. It’s quite possible to imagine two different collections that ostensibly collected the same data, but had completely different and obvious purposes. For instance. Medical databases used to collect health stats so that people can compare how areas are doing are very, very careful not to link things back to personal identity. If you want to know how many miscarriages are going on in each hospital to see whether there are bad hospitals or something, you don’t need to know who had them. Or, if you’re collecting information that does require knowing who someone is, such as because you want to get them pre-natal care, privacy protections are even more important.

22

Sebastian H 01.07.12 at 4:43 pm

It isn’t really Kafkaesque, that would be more of a Catch-22 situation, or something incomprehensible. This is just straight up Big Brother Orwellian invasive citizen monitoring. Unfortunately there doesn’t seem to be a huge privacy push in much of the world (even in Europe there is a ridiculously high level of continuous electronic monitoring).

I do think the more general health care privacy point is being pushed aside too easily here, though. It is absolutely forseeable (in the sense of seeing that it WILL happen, not that it COULD happen) that nationalized medical databases will be used for nefarious ends next time we get something like the AIDS scare in the 1980s.

23

bobbyp 01.07.12 at 4:48 pm

Of course, one shudders to think of what Brazil would do if they provided heath care to all women for free, and then had the doctors centralize the records.

Perfectly reasonable policies, the adoption of which, do not logically require a preggers registry in the slightest. If you outlaw abortions, only criminals will have them. But you knew that already, right?

Oh. And Hitler.

24

leederick 01.07.12 at 5:16 pm

“likening it to records kept by, say, NIH in order to distribute resources better just takes the claim at face value: “we want to improve access to pre-natal care!” Additionally, it is also a horrendous privacy violation. It’s like two flavors of evil ice cream in one! Why should anyone be barred from mentioning both facts?”

You’re welcome to hate on Brazil because of their position on abortion. But if you think bodily matters like conception are inherently private, then people will disagree with you as that logic also undermines registries on AIDS, cancer, birth defects, stillbirth, etc. And if you say registries can’t improve pre-natal care unless there are specific health care provisions in the law, then there’s lots of evidence that public health registries are incredibly valuable in and of themselves and people will point that out. So perhaps you should stick to hating on Brazil because of their position on abortion.

25

Salient 01.07.12 at 5:18 pm

if you’re collecting information that does require knowing who someone is, such as because you want to get them pre-natal care, privacy protections are even more important.

Tangentially extending this, I’m pretty sure wanting to give a subpopulation access to health care does not require determining in advance who they are. Presumably, women who want that access would happily volunteer to sign up for it. If the worry is that non-pregnant women would attempt to receive the care (a worry which makes no sense to me) then one could require a pregnancy test to prove eligibility, which would only be slightly weird and creepy. It would be very weird and creepy and possibly horrible to in any way mandate medical treatments against the woman’s will, and would be definitely horrible to assign jail time to women who did not comply.

26

Rich Puchalsky 01.07.12 at 5:22 pm

“But if you think bodily matters like conception are inherently private, then people will disagree with you as that logic also undermines registries on AIDS, cancer, birth defects, stillbirth, etc. “

This is total bullshit.

Here, via the wonder of Google, is the first birth defect registry found, for the wonderful state of Texas.

“They then abstract relevant information onto a form designed for this purpose. Information is abstracted from medical records on pregnancies with birth defects delivered to residents of Texas and includes birth defect diagnoses; medical tests and procedures; gestational age; delivery information; illnesses, complications, maternal exposures; demographic information. All information is held in strict confidence in accordance with state and federal privacy laws.”

27

Watson Ladd 01.07.12 at 5:29 pm

The point is anything bad you could do with a registry of pregnant women you could do with a registry of pregnant women collected by their doctors. The issue is that rather then a bare cage, we might accept a gilded one. Ultimately only you can protect abortion rights by advancing social change, rather then attempt to restrain government.

28

geo 01.07.12 at 5:36 pm

leederick @22: public health registries are incredibly valuable in and of themselves

Do you mean that the manifest intention of the legislative faction pushing the pregnancy registries — to assist in prosecuting abortions, or intimidate women considering them, rather than to facilitate public pre-natal care — is irrelevant?

29

Bloix 01.07.12 at 5:38 pm

leederick, in the United States, about 10% of all pregnancies terminate in miscarriages – that’s 600,000 miscarriages a year. About 2/3′ds of these take place in the first trimester (which is why many women don’t tell anyone that they’re pregnant until they’ve been pregnant for 3 months) – and a full third take place in the 2nd and 3rd trimesters.

For example, my wife had a miscarriage in the fourth month of her first pregnancy. It was a traumatic event for both of us, and for her it was not merely upsetting but also painful, frightening, and exhausting.

Now, imagine that a few days after coming home from the hospital we’d been visited by an officer of the pregnancy police. Lost a baby in the fourth month? How unusual. And you’re a career woman, you say. You’re awfully old for a first child – you’re sure you wanted to be a mother? Let’s look around your house. Did you have a nursery set up? No? Any peculiar medications in your medicine cabinet? Who is your OB/GYN? We know all about her. We’ll swing by to have a word.

That’s what this is about: criminal investigations and prosecutions. Not improvements in pre-natal care.

30

Rich Puchalsky 01.07.12 at 5:39 pm

Why do I keep feeling the urge to write sock-puppet travesties of opposing arguments? One of these days I should give up on writing this whole “Watson Ladd” thing.

Anyways, just to make up for some of the harm I’ve done, I’ll add — which is of course obvious — that no, the point is not that “anything bad you could do with a registry of pregnant women you could do with a registry of pregnant women collected by their doctors.” The point is that registries of medical information have privacy protections on them. You can’t go into a registry of birth defects, whether collected by doctors or self-reported, and say something like “Hmm, this women was underage. I think I’ll send police off to interview her for possible criminal infractions. Also, I think that her parents should know about this.” It’s really kind of basic, and well-understood in other contexts — such as why police in the U.S. aren’t supposed to turn over illegal immigrants who come to them to report crimes over to immigration enforcement.

31

Salient 01.07.12 at 5:42 pm

The point is anything bad you could do with a registry of pregnant women you could do with a registry of pregnant women collected by their doctors.

…ugh, Watson, really? I suppose that would be true if no matter what you mandated that women submit themselves to a doctor’s pregnancy test every month, and the data were centrally collected. But here in the real world, “women who want to abort their current pregnancy” and “women who want prenatal care for their current pregnancy” has a fairly small intersection, and recording a lot of data about the latter does not require one to know anything about the former.

…oh, and also, in the real world, a woman doesn’t go to jail for years if she happens to not see a doctor during her pregnancy.

32

Stephen 01.07.12 at 5:49 pm

Poor old Kafka, the most intense efforts of his imagination long ago outdone by reality.

Actually I think the adjective we need is Ceauşescuvian (Ceauşescuvesque or Ceauşescuian somehow don’t sound quite right).

You do remember the compulsory pregnancy tests during the glorious rule of the Partidul Comunist Român, don’t you?

33

Aulus Gellius 01.07.12 at 6:21 pm

All right, we clearly need a vote here. Which of the following twentieth-century figures* best predicted the law under discussion? You may vote once.

1. Franz Kafka
2. George Orwell
3. Margaret Atwood
4. Joseph Heller
5. Nicolae Ceausescu*
6. Other (further suggestions welcome!)

*Should we limit it to authors? I was going to, but then it seemed a shame after Stephen went to all that trouble to come up with an adjective.

34

leederick 01.07.12 at 6:23 pm

“The point is that registries of medical information have privacy protections on them. You can’t go into a registry of birth defects, whether collected by doctors or self-reported, and say something like “Hmm, this women was underage. I think I’ll send police off to interview her for possible criminal infractions.”

Rich – none of the critics have complained about the the specific details of the legal privacy protections on the registry. I doubt any of the critics even know what the relevant protections are. What they’re saying (Slate, #8 #19, the feminist blogosphere) is that any registration is a violation of privacy.

I can’t see why the Texas registry is at all relevant. It is an active system – i.e. people go out and look for cases and record them. The complaints are about passive systems with statutory reporting – i.e. people being under a duty to make a report. Though if Brazil had gone for an active system, don’t think the same crowd wouldn’t still be outraged.

35

bobbyp 01.07.12 at 6:29 pm

Pope Paul VI

36

lupita 01.07.12 at 6:56 pm

The comment thread on the Slate article was going very nicely (meddling Vatican, oppression of the Brazilian state, Brazilian women do not have our constitutional rights, etc.) until a poster (BR12) from Brazil noted that it was untrue that pregnant women have to register.

By the way, a cursory google search reveals that the provisional measure (meaning it still has to be approved by congress) does not require pregnant women to register. Those who do, however, receive a cash stipend plus pre- and post-natal care.

37

bobbyp 01.07.12 at 7:03 pm

The complaints are about passive systems with statutory reporting..

This is hardly a “passive system”, and nobody is objecting to the collection of data per se .

38

Anderson 01.07.12 at 7:26 pm

As a cross-check, they’d best require men to report ejaculations. But since men are notoriously unreliable and lawbreaking, some kind of meter will have to be worn around the testicles (or implanted there), and the information sent wirelessly to HQ.

39

Salient 01.07.12 at 7:33 pm

a cursory google search reveals

Links, please. The first ten pages or so of google results on my end were either (a) third-hand reports with no primary source links or (b) nonsense completely unrelated to the bill. Tried a variety of search terms, ran it through several search engines, nothing stuck.

40

G. McThornbody 01.07.12 at 7:56 pm

BW once again brings the outraged passion parade! Unfortunately I’m going to add a raindrop or two. BW could be spot-on opining on the law’s intentions, but the slate article is bereft of information or pointers to relevant information.

Slate: “The problem is that it won’t reduce maternal mortality. Notwithstanding the fact that many of its provisions are legally and constitutionally questionable, its requirements are not based on sound public health policy.”

Ok Slate, I’m ready for the facts of… wait what? Were there several policy paragraphs omitted? I expect to see an example of a policy and numbers showing that registration won’t reduce mortality, countering the arguments that it will. I expect to see the many legal and constitutional provisions that are questionable. And by many I mean at least one. One = many, right? A hyperlink to one or many of them would be nice. An example of sound public health policy countering Brazil’s unsound one would perhaps be convincing.

Dear Gillian, it is ok to link to your own organization’s info. Perhaps the google machine can help: http://www.ipas.org/Publications/asset_upload_file640_3027.pdf
I bet there’s plenty more in http://www.ipas.org/Publications/Index.aspx as well.

“The obvious actual intention of the law is to prosecute women who have abortions or induce miscarriages.”

Why bother with time consuming facts when we already know the conclusion. We all know the problem is the catholics who will put you in prison if they can’t steal your babies. Obviously this is prognostication and speculation, and obviously it could come true. There are a lot of “evil” catholics in Brazil, after all.

At this point, I’m going to agree with a general pregnancy registration. First, the government is the primary health care provider in Brazil. As a public policy, you want to make sure you have a healthy citizenry (unless you are a bunch of barbaric heathens.) Since the cost of healthcare for pregnant mothers begins months or longer before the baby is born, registration allows for better cost assessment and better health information. With a public registration, there’s also no excuse not to provide needed healthcare. The government can further subsidize health education, research, policy implementation, treatments, etc with exact numbers to back up these policies. Registration would also force the government to address abortion policies by doing un-catholic things like providing contraception.

Another thing I like about registration is that it mostly eliminates the need for a census. You already know how many people you have, you can track income, health issues, economic mobility and a myriad of other things. This effectively turns family planning into constant data-driven nation planning.

That being said, here’s where I come back to agree with some of BW’s concerns. Although the slate article borders on the hysterical especially in the final paragraphs, I think that the complaints have legitimacy and that such a registration system would be abused. I can say the same of just about any system though. Cheers.

grismcthorn

41

Watson Ladd 01.07.12 at 8:17 pm

Salient, I imagine pregnant women (who don’t want to be) ask for a referral for an abortionist. Or am I wildly off base here?

G. McThornbody, the question is whether the nation will commander the wombs of its women.

42

lupita 01.07.12 at 8:23 pm

The only original source in English (google news) is the Slate article. However, if you google in Portuguese, (“Bolsa gestante”, “grávidas¨, “MP 557″) you will find 67 articles, none of which reveals any outrage whatsoever, either in the article or in the comments thread.

I found only this one article that addresses concerns about the system being used to go after women who have had an abortion and a reply from the Health Minister stating that, among other things, pregnant women are not required to register.

43

phosphorious 01.07.12 at 8:57 pm

Anderson @37 “As a cross-check, they’d best require men to report ejaculations. But since men are notoriously unreliable and lawbreaking, some kind of meter will have to be worn around the testicles (or implanted there), and the information sent wirelessly to HQ.

Which raises the possibility of the funnest denial-of-service attack ever!

44

mollymooly 01.07.12 at 9:12 pm

MEDIDA PROVISÓRIA Nº 557, DE 26 DE DEZEMBRO DE 2011

Art. 7 Compete às Comissões de Cadastro, Vigilância e Acompanhamento das Gestantes e Puérperas de Risco:

II – cadastrar em sistema informatizado os dados de todas as gestantes e puérperas atendidas nos serviços do estabelecimento de saúde;

45

Substance McGravitas 01.07.12 at 9:15 pm

Article 19-J is pretty interesting via Google Translate.

46

P O'Neill 01.07.12 at 9:33 pm

It appears to be just a conditional cash transfer program.

http://www.atribuna.com.br/noticias.asp?idnoticia=130057&idDepartamento=8&idCategoria=0

47

Scott Martens 01.07.12 at 9:45 pm

Lupita, I found several quite outraged in Portuguese language blogs, and one claiming the outrage in the press is overblown and caused by feminist bloggers. (http://tinyurl.com/7cga5v7 – “Desde que foi publicada no Diário Oficial da União na última terça-feira (27), a MP 557 tem causado bastante ruído nas redes. Blogueiras feministas deram início ao bafafá.”)

I don’t know how much trouble it’s caused in the Brazilian press – it’s true the newspaper articles aren’t causing a lot of outrage, but abortion rights have very little public support in Brazil, so that’s not surprising. But it looks like it’s hit feminist blogs in Brazil in a big way. I’m inclined to take Beatriz Galli’s complaints seriously (http://tinyurl.com/85pmvuv), since she’s pretty heavily involved in reproductive rights in Brazil.

48

G. McThornbody 01.07.12 at 9:59 pm

@43 Electronic medical records? Right on.
@45 Incentivising health? Right onner.

In soviet Brazil, you don’t pay for doctor visit. Doctor visit pays for you!

grismcthorn

49

Uncle Kvetch 01.07.12 at 10:08 pm

Another thing I like about registration is that it mostly eliminates the need for a census. You already know how many people you have

Yes, assuming they all live forever.

50

lupita 01.07.12 at 11:09 pm

Thanks, Scott, for the links. I did not mean to dismiss criticism from Brazilians whose input is needed in designing a system that works towards its stated goals while respecting the dignity and privacy of all those involved. Neither do I take issue with foreigners commenting about places and events they know nothing about – I do it all the time.

Brazil is a country that has elected a labor union leader as president followed by another who was tortured by the military regime, that appoints culture ministers with dreadlocks, that collapsed the WTO talks in Cancún, and that broke the AIDS drug patent. Offhandedly equating Brazil with Ceauşescu and police stopping pregnant woman on the street without googling the facts first seems a bit ignorant and condescending.

I do not think that articles such as the one we are referring to and such comments help develop bonds of solidarity among nations. They are actually quite alienating.

51

Down and Out of Sài Gòn 01.07.12 at 11:48 pm

Since my Portuguese is non-existent, I ran Scott Martens@46′s second link through Google Translate. The result is good enough to get the gist. It sounds like Belle Waring is on the money.

Viomundo – What the MP 557 is for sexual and reproductive rights of women?

Beatriz Galli – At no time, she mentions.

Viomundo – The MP also does not mention abortion. As we will make a map of maternal mortality in Brazil, ignoring one of its main causes in Brazil? Failure to address abortion no longer creates a bias?

Beatriz Galli – Worse than that. The PM wants to create a registry of pregnant women, violating the privacy and confidentiality of information contained in medical records or medical records at a time of worsening political and closing of several illegal abortion clinics across the country.

I would go beyond. Since Brazilian legislation criminalizing the practice of abortion and has been used to close clinics and process hundreds of women, is at least troubling that the State proposes a register of monitoring and surveillance of pregnant women.

Viomundo – whereas there are already policies, laws, ordinances to reduce maternal mortality in Brazil, the MP 557 would be unnecessary, would not it?

Beatriz Galli – completely unnecessary. If the government wanted to address the issue, it would suffice to rescue the CPI report on Maternal Mortality, 2001. Here are all the recommendations in terms of policies and laws needed to reduce it.

52

marcel 01.07.12 at 11:59 pm

Bloix wrote:

in the United States, about 10% of all pregnancies terminate in miscarriages – that’s 600,000 miscarriages a year. About 2/3’ds of these take place in the first trimester (which is why many women don’t tell anyone that they’re pregnant until they’ve been pregnant for 3 months) – and a full third take place in the 2nd and 3rd trimesters.

The figure I’ve seen is that somewhere between 1/3rd and 2/3rds of all conceptions in humans result in miscarriages. Most happen before the woman has any indication that she is pregnant.

This site says that 10%-25% of “clinically recognized” pregnancies end in miscarriage, and this one says that 15%-20% of “known pregnancies” end in miscarriage. According to The March of Dimes,

According to the March of Dimes, as many as 50% of all pregnancies end in miscarriage — most often before a woman misses a menstrual period or even knows she is pregnant. About 15% of recognized pregnancies will end in a miscarriage.

More than 80% of miscarriages occur within the first three months of pregnancy.

According to this site,

When considering this question [How Common is Miscarriage?], it is helpful to ask how often pregnancy occurs on average each cycle. Studies looking at very sensitive pregnancy tests suggest that pregnancy will occur in at least 60% of natural cycles in fertile couples.

The risk of miscarriage decreases as pregnancy progresses. It is possible that as many as 50% of pregnancies miscarry before implantation in the womb occurs. Early after implantation, pregnancy loss rate is about 30% (i.e. this is still before a pregnancy is clinically recognised). After a pregnancy may be clinically recognised (between days 35-50), about 25% will end in miscarriage. The risk of miscarriage decreases dramatically after the 8th week as the weeks go by.

… gives a whole new perspective on the personhood amendments like that recently defeated in Mississippi.

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marcel 01.08.12 at 12:00 am

Hey guys, if anyone is there: I just had a moderately long comment, with several links, go into moderation. Please rescue it.

54

marcel 01.08.12 at 12:19 am

Nevermind about the moderation – I’m going to resubmit it as several comments.

1) Bloix wrote:

in the United States, about 10% of all pregnancies terminate in miscarriages – that’s 600,000 miscarriages a year. About 2/3’ds of these take place in the first trimester (which is why many women don’t tell anyone that they’re pregnant until they’ve been pregnant for 3 months) – and a full third take place in the 2nd and 3rd trimesters.

This site says that 10%-25% of “clinically recognized” pregnancies end in miscarriage.

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marcel 01.08.12 at 12:20 am

(Continued):

This site says that 15%-20% of “known pregnancies” end in miscarriage.

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James Wimberley 01.08.12 at 12:21 am

Articles 6 and 7 requore all hospitals and clinics, public or private, to register all pregnant women. Where is the legal foundation for the Health Minister’s assurances that registration is voluntary? Only if, like the richest slice of Brazilian women, you go to a private specialist not a clinic for care; or if, like the very poorest and most isolated, you don’t get care at all.. Where are the privacy safeguards? It’s reasonable to worry about the potential for abuse, as with the NHS Spine Record.

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marcel 01.08.12 at 12:22 am

(Cont.):

And

According to the March of Dimes, as many as 50% of all pregnancies end in miscarriage—most often before a woman misses a menstrual period or even knows she is pregnant. About 15% of recognized pregnancies will end in a miscarriage.

More than 80% of miscarriages occur within the first three months of pregnancy.

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marcel 01.08.12 at 12:24 am

Oops. Sorry (Been rescued by the time I submitted the last episode).

59

Salient 01.08.12 at 12:28 am

Shoot, didn’t occur to me to search in Portuguese, patently obvious in retrospect. Thanks for the tip, lupita.

Anyhow, if the translations are reasonably accurate and I’m understanding them correctly (corrections appreciated!)–

* the law is mostly redundant with existing ordinances, but introduces two new things — one provides a $50 benefit to new mothers on the registry (shrug, seems harmless enough) and two, criminalizes providing medical services to a pregnant woman without adding her information to the centralized registry (holy crap, wtf, etc).

* the statement “pregnant women don’t have to register” should be filed under ‘technically true, but awfully misleading’ — it is the doctors who provide health services to a pregnant woman who are required to add that woman’s name to the registry. Even if the treatment is for something completely unrelated to pregnancy, say, the flu. Soooo, any pregnant woman who does not wish to subject herself to pregnancy surveillance and tracking will have to avoid seeking medical services entirely for the duration of the pregnancy.

* Women who learn they are pregnant from a medical service provider will have no choice — their name will be added to the registry, possibly even before they receive the information themselves. True, they don’t have to register; they just have to be registered. Distinction, meet without a difference.

* The registry of incidents of maternal death already exists. The law might centralize it and specify agencies which will have access to it; I can’t tell from the translations.

* The registry is to be used for monitoring, surveillance, and tracking purposes. The surveillance explicitly does not end at birth, continuing into the postpartum period (duration unspecified in the law itself).

*I have no idea how to interpret Article 3 section IV. Thoughts?

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G. McThornbody 01.08.12 at 12:31 am

@48 Yes, assuming they all live forever.

It seems that Brazil is aware that people there do not live forever: http://www.loc.gov/lawweb/servlet/lloc_news?disp3_l205402425_text

(Dec. 15, 2010) On December 14, 2010, the Ministry of Justice of Brazil launched a Unified Certificates program designed to provide registrars nationwide with standardized forms to be used for the issuance of birth, marriage, and death certificates. The program is the result of a partnership between the Ministry of Justice and the Human Rights Secretariat of the Presidency and the National Council of Justice.
The new forms will be manufactured and distributed by the Brazilian Bureau of Engraving and Printing (Casa da Moeda do Brasil) and will be issued on security paper which incorporates technical elements that inhibit the counterfeiting of these documents. The model to be implemented also allows more effective control of civil records made in the country. (Press Release, Ministério da Justiça, MJ Assina Convênio para Dar Mais Segurança aos Registros Civis (Dec. 13, 2010)

Good call on my mistaken assumption Uncle. People in Brazil did live forever up until the end of 2010. I was under the impression they might have something mundane like funerals or obituaries to keep track of deaths until Dec. 12.

MJ assina convênio para dar mais segurança aos registros civis. That headline obviously shows how deficient the civil registry was before death was invented.

grismcthorn

61

Witt 01.08.12 at 2:03 am

62

Belle Waring 01.08.12 at 2:18 am

“Ceauşescu-like law” was suggested in the Slate quote in the original post (far be it from me to suggest anyone read the OP). It is probably the most accurate, with Orwellian second. Kafkaesque–I submit that the existence of a mysterious, far-off bureaucracy that will make totally opaque decisions that will then be enacted on your own flesh-and-blood person is sufficient to make something Kafka-esque. Additionally, there is a Catch-22 aspect–going to the doctor to find out whether you’re pregnant or not will result in your already being put on the registry, such that a law claiming to want to widen access to pre-natal care may have the effect of causing women of child-bearing age to avoid going to the hospital at all, even for other illnesses, in case they should turn out to be pregnant, since they don’t plan to have a baby at that time. So, maybe not the most felicitous, but it would seem unfair to crowdsource a new title and then pretend to have been cleverer all along, so here we are.

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Belle Waring 01.08.12 at 2:34 am

I don’t think this thread really turned out very well for McThornbody.
“At this point, I’m going to agree with a general pregnancy registration. First, the government is the primary health care provider in Brazil. As a public policy, you want to make sure you have a healthy citizenry (unless you are a bunch of barbaric heathens [or committed to the well-known, deeply held reproductive health policies espoused by the Catholic Church--ed].) Since the cost of healthcare for pregnant mothers begins months or longer before the baby is born, registration allows for better cost assessment and better health information. With a public registration, there’s also no excuse not to provide needed healthcare. The government can further subsidize health education, research, policy implementation, treatments, etc with exact numbers to back up these policies. Registration would also force the government to address abortion policies by doing un-catholic things like providing contraception. Also, because I am anti-abortion and imagine that dressing this controlling measure up in fancied concerns for the health of Brazil’s most vulnerable citizenry will obscure it somehow. Additionally, I’d like to pretend that powerful Catholic interests in Brazil will be “forced” by the bare existence of this intrusive list to approve of state-provided contraception [?!?--ed].
Fixed that. The death certificate thing is just sad; it would be more merciful to pass over it in silence.

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G. Mcthornbody 01.08.12 at 3:20 am

I don’t mind the eds BW. You remind me a little of the people who are constantly insisting “get the government out of my healthcare!” but from the other side of the ideological spectrum. Let me present 2 short plays indicative what seems to be our feelings about the subject. The accuracy of both is really the debate.

grisMcFuture act 1.
Doc: You’re pregnant. We’ll get the registration done for you and give you advice about your pregnancy.
Poor girl: But I don’t want the baby because [insert reason].
Doc: That’s ok. We have pills for that. You’ll be fine.

WaringMcFuture act 1.
Doc: You’re pregnant. We’ll get the registration done for you and give you advice about your pregnancy.
Poor girl: But I don’t want the baby because [insert reason].
Doc: In that case, you’ll be chained up in the basement and forced to have a child against your will and to the detriment of your own health. You’ll also suffer the stinging catholic stigma reserved for the worst of sinners. Off to the maternity dungeon with you! We have your papers are always watching to see what you do with your uterus!

I prefer my future, but just because you’re paranoid doesn’t mean the catholics aren’t out to get you I suppose.

grismcthorn

65

Daniel 01.08.12 at 3:31 am

Amurrica? Is that the same place as Amerika?

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Martin Bento 01.08.12 at 4:17 am

Minus your chidish sarcasm, the future you attribute to Belle is what will occur once the law is in place. Belle’s future will, therefore, be real; the only question is how long it will last. Your future, on the other, hand, is a bit of pure speculation, with no causal link indicated between the law you are defending and the outcome you are invoking. Nor does your required outcome need such a law, and it is not at all clear that it is helped by one. If abortion and abortion pills are legal, the main restrictions to access are costs, and if the government wishes to subsidize those, it can do so much more effectively and efficiently without all this hoo-haa about registration. It’s like saying let the drug gangs take over Mexico, because no one will actually tolerate government by drug gang, and the backlash will have to be some more liberal democratic regime. Such a backlash with such an effect is highly uncertain, and the effect does not require so dubious a gambit. Meanwhile, the misery caused by turning the nation over to the Zetas is perfectly clear and quite certain.

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Down and Out of Sài Gòn 01.08.12 at 4:32 am

I’m going to have to go with Ceauşescuvian. It’s such a lovely adjective, and comes with added cedilla. Sadly, on another subject:

BW once again brings the outraged passion parade!

McThornbody@40: I wish you had started your post with “Belle Waring is impassioned” instead. Apart from being shorter, my alternative is technically correct while imputing dignity. Moreover, it doesn’t contain clashing images. [1]

Best of all, “Belle Waring is impassioned”, unlike your earlier version, doesn’t imply that “getting emotional” over something is the wrong thing to do or unhealthy. In my experience, getting passionate is often the right thing to do, while deliberately trying to stay “cool” or “detached” is often the mark of poseurs, hacks or sophomores. “Keeping your head” is always good, but it’s a particularly male delusion that intellect should oppose emotions. Shouldn’t they work in tandem?

I should add that “BW once again brings the outraged passion parade” has a stench of patronising misogynistic ridicule that makes me despise on sight. Posts starting with such sentences automatically become “TW; DR”. [2] But that’s just me.

[1 Will there be fascist octopii at this outraged passion parade, and do they sing their swan song at the end? Naah, they get thrown into the melting pot afterwards, the poor buggers.]

[2 Too wanky, didn't read.]

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Belle Waring 01.08.12 at 4:47 am

mcthornbody: you are aware of this, right?

A Roman Catholic archbishop says the abortion of twins carried by a 9-year-old girl who allegedly was raped by her stepfather means excommunication for the girl’s mother and her doctors.

Despite the nature of the case, the church had to hold its line against abortion, Archbishop Jose Cardoso Sobrinho said in an interview aired Thursday by Globo television.

“The law of God is higher than any human laws,” he said. “When a human law — that is, a law enacted by human legislators — is against the law of God, that law has no value. The adults who approved, who carried out this abortion have incurred excommunication.”

Not my favorite news source, but easiest to find for the moment. The official position of the Brazilian Catholic Church was that the NINE YEAR OLD should have carried the TWINS to term and delivered via caesarean.

69

Belle Waring 01.08.12 at 4:53 am

Down and Out of Sài Gòn: he managed to avoid using the word calling me hysterical, wisely saving that for the Slate article I relied on. Baby steps.

70

faustusnotes 01.08.12 at 5:19 am

That Slate article doesn’t tell us anything about the content of the law at all. It has a whole paragraph screed about the Roman Catholic church’s influence on the state, but nothing about the law. Then BR12 turns up in comments to point out that the first paragraph contains a huge stereotype (that stuff about the goddess) and some facts about the law.

The second to last paragraph contains a description of 3 ways in which the law violates a woman’s human rights, but actually 2 of the 3 are unrelated to the law, but are related to the continuing illegality of abortion in Brazil. Kane appears to be deliberately conflating the two. Even the first of the woman’s rights that are violated (the right to privacy) is a furphy: every patient in Brazil’s medical system no doubt has their detailed information recorded and used in all sorts of ways they haven’t consented to all the time. It’s fundamentally dishonest to describe medical data registers as a violation of a patient’s right to privacy: subsequent information presented in this comment thread may justify this claim, but there’s nothing in the Slate article to support it. Does Kane speak or read Portuguese? Why doesn’t she back up her claims with anything resembling actual information?

Kane observes that

The majority of preventable maternal deaths actually take place in public hospitals.

as if this is a bad thing. Well gee, things must be terrible in the UK, Australia and Japan too. I think Kane is probably aware that one of the central planks of a modern strategy to reduce maternal mortality is ready access to hospital for women at risk of serious complications in childbirth. If most preventable deaths in Brazil are happening in public hospitals, it’s a sign that their strategy for reducing maternal mortality is working, which the stats suggest is the case. So why does she make this out like it’s reflective of a quality issue in public hospitals?

From the Slate article, it’s impossible to even tell whether the register acts as a database of pregnancy data or just an anonymous notification system. More information would be nice.

And while we’re at it, let’s bear in mind that every woman who attends ante-natal care in the UK NHS gets her pregnancy “registered” with the central data set and anyone who pays a couple of hundred pounds and jumps through the right data protection hoops can get the detailed data on every single one of her ante-natal visits, her birth, and her child’s subsequent medical records. In the nordic countries the same thing applies, only they would probably be able to be linked to her and her child’s school achievement records. Abortion data is in there too. Perhaps Kane should write an article on that?

I don’t know the particulars of the Brazilian law, but I don’t know that it’s worth getting up in arms over it on the basis of this article, which reads like a classic paranoid screed on medical data registration, rather than anything even vaguely informative about maternal and infant health and women’s rights in Brazil.

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Rich Puchalsky 01.08.12 at 5:54 am

“It’s fundamentally dishonest to describe medical data registers as a violation of a patient’s right to privacy”

As I’ve tried to write in this thread repeatedly: every reputable medical data register in any of the industrialized democracies has privacy protections that go along with it. No one, except the people trying to straw-man the original article, has said that medical data registers are a violation of rights to privacy. On the contrary, the existence of medical data registers is a *support* of the basic idea that this information is generally regarded as private — because in every reputable medical data register, it is.

The question is then “Does the proposed Brazilian system have privacy protections built into it?” I don’t know the answer to that. I do know that the passive vs active data collection has nothing to do with the issue.

And if it’s really as easy as fautusnotes @79 says it is to get this information out of the UK NHS, then they have a problem too. I don’t know what “jumps through the right data hoops” means, though; typically in the U.S., you can get individual data if your research project is approved by a review board that agrees that your research can’t be done without it, and you yourself then have to promise to protect the data.

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Belle Waring 01.08.12 at 6:04 am

faustusnotes: read the linked piece in the update.

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faustusnotes 01.08.12 at 6:16 am

Belle, my criticism was aimed only at the Slate article, not as a defense or otherwise of the law itself (about which I know nothing).

Rich, if only the data hoops were as simple as a review board … I don’t think anyone needs to fear that the NHS is loose in its controls over data.

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faustusnotes 01.08.12 at 6:30 am

But having said that, the additional article only gives one bit of additional information (that names need to be provided) and asks a whole bunch of questions that from a public health point of view are fairly nonsensical. e.g.:

- How does simply monitoring pregnancies reduce maternal mortality?

I wonder. How does simply monitoring operations reduce mortality? How does simply monitoring HIV, TB or other notifiable diseases reduce mortality? This is a fairly basic question that I would have thought in the modern age adults wouldn’t be asking.

- And what’s the benefit to women?

Well, it comes with money. That’s a benefit to women, I’d have thought. Everything else in the paragraph that starts with that question is irrelevant to the law, just as the previous question about monitoring was irrelevant.

The additional article doesn’t tell us anything more about the registry than the previous one. Will the police be able to use it to track abortions? Will the registry be required to notify police when a pregnancy stops? Are births recorded in this registry? Is it linked to any other data sources? How does the registry work to enable the state to “track these pregnancies, from prenatal to postpartum care, presumably to evaluate and monitor health care provided”?

And given abortion is already illegal in Brazil, do any potential criminal justice procedures stemming from this law actually counter-balance the possible public health benefits of tracking pregnancies (if it even allows anyone to do this)?

There are companies in the UK that offer Primary Care Trusts the ability to monitor, in real time, all services provided by GPs and/or hospitals, to check whether they’re giving adequate referrals or treatment, and to identify people at high risk of readmission to hospital. This includes referrals to abortions, treatment for illicit drug use, under-age pregnancies, HIV treatments – anything that the PCT asks for in the monitoring system. In comparison, registering a pregnancy is probably pretty tame.

Reading these extremely vague articles, I think this may be a case of attacking a quite useful law as a tactic in a battle against a nasty law. If the law reduces infant and maternal mortality then this may be counter-productive. On the basis of the information available to us monoglots, my judgment is that it’s impossible to tell what the law even does, let alone whether it is of net benefit or harm to Brazilian women.

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Down and Out of Sài Gòn 01.08.12 at 6:49 am

I don’t think anyone needs to fear that the NHS is loose in its controls over data.

Mr. or Ms. faustusnotes: you haven’t been keeping up with the news. If negligence isn’t bad enough for you, David Cameron promises lots of malfeasance in the future.

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Belle Waring 01.08.12 at 7:05 am

“If the law reduces infant and maternal mortality then this may be counter-productive.”
Indeed. If my aunt had balls she’d be my uncle. But did you read my post about why the likeliest outcome is the reverse? It is difficult to imagine a world in which “your doctor will report you to the government so they know you’re pregnant and can keep track of what you do” doesn’t have a chilling effect.

77

Meredith 01.08.12 at 7:07 am

Baby born. Deposit coin in temple of Juno Lucina, please (though not required, this deposit will help the state keep track of population, for purposes good, for purposes not so good, at all). Ah, the wisdom of the ancients!
Until born, this is not a baby. It is a fetus, an embryo, an unimplanted-in-uteran-wall couple of cells. A thank god I/We’re not pregnant! or, Lord be praised! I/We are pregnant! Or a, god, no — but thanks for the choice, god (sometimes heartfelt thanks, sometimes ironic or Jacob-angry “thanks a lot, you incredibly difficult god, and boy do I have a bone to pick with you”) and, from that realm of choice, I/we will take care of this, one way or the other.
Maybe this specific story is a tempest in a teapot. Still, I simply do not believe that any state’s health services or society’s medical researchers need to keep track of all of this celebration or soul-searching in order to provide better medical care to women. I just don’t.

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G. McThornbody 01.08.12 at 7:27 am

Good evening again BW. I have seen the news article you mentioned. I agree with you that the official position of the church is wrong on a lot of things, but the Fox article doesn’t support your position that the future of reproductive rights in Brazil will be a catholic hell. The girl did in fact get an abortion, and the criminal stepfathers are in jail. The catholics can bloviate all they want, but in your example healthcare and the criminal justice system prevailed while all the catholics got to do was excommunicate a few people. I would expect the family and doctors to give up the religion anyway if that’s the way they are treated.

From the article slate gave us, I’m not willing to make the jump from pregnancy registration directly to infringement of privacy and reproductive rights without any other evidence. I also agreed with you that such concerns were legitimate because there is the distinct possibility of abuse.

Still, there is a lot of insistence that the future will be horrible. Some replies were certain of it and I even got a comment edited when I suggested that this pregnancy registration might not be the doom you predict. I did label the slate paragraph beginning with “What PM 557 does…” as hysterical because it strikes me as argumentum ad metum. I’m sticking to that description.

The outraged passion parade referred to the line of comments that BW brought with her OP. The parade consisted of saying how catholics are evil, the pope sucks, who best predicted this dystopian awful future for women’s rights, bashing registries in the name of privacy, etc. My only two drops to rain on the parade were asking for better information from slate and entertaining the idea that such a move might not be all that detrimental. The responses put those 2 drops on the scale of a storm. http://www.youtube.com/watch?v=Wp76ly2_NoI. Except in your case the Brazilian world will end when pregnancies are registered. Think of the rainstorm that would occur if a lesbian couple registered a pregnancy!

It was only 2 raindrops BW. Just 2. And an extra raindrop from @70.

grismcthorn

79

Belle Waring 01.08.12 at 8:09 am

Don’t piss on my leg and tell me it’s raining, friend.

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Bruce Baugh 01.08.12 at 10:32 am

Belle, the Keep It Brief fairies would like you to have this bundle of FOADs and DIAFs, and they said you’d know how to dispense them to worthy parties in this thread.

Seriously, though, this is just ghastly appalling stuff, and watching some commenters try to turn themselves into ever more thoroughly misogynistic emotionally dead assholes isn’t very inspiring.

81

Kyle 01.08.12 at 12:49 pm

Horrible as the law is, it isn’t Kafkaesque. It’s pretty straightforward.

82

Manoel Galdino 01.08.12 at 1:25 pm

I didn’t read all comments, but as a Brazilian, a few remarks:

re #4: Provisional measure it’s like an executive order in US (I’m not so sure if the comparison is ok, since I don’t know exactly how an executive order works). In any case, it has legal effect from the day it is enacted by the president and the Congress has 90 days to vote for it or against it. If the congress doesn’t vote in 90 days, no other law can be enacted until a vote on it is casted.

Here is a link, in Portuguese, that I think is very good. http://revistaforum.com.br/idelberavelar/2012/01/04/cadastro-de-gestantes-e-bolsa-chocadeira-por-cynthia-semiramis-e-idelber-avelar/

One of the authors of the piece (Idelber Avelar) is a professor at the US, maybe he could write a piece in English to the readers of the Crooked Timber.

Last, but not least, let’s see how much we Brazilians can protest against this. But I’m skeptical that we can force congress to reject the law.

best regards,
Manoel

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Belle Waring 01.08.12 at 1:26 pm

Thanks, Keep It Brief fairies! I need those! “[W]atching some commenters try to turn themselves into ever more thoroughly misogynistic emotionally dead assholes isn’t very inspiring.” The thing I don’t get it, where’s their nickel in it? I mean, why not just pass over the post thinking, “silly Belle, getting all het up about some law in Brazil that, 1. while it appears Orwellian and awful, 2. ??? 3. is in all likelihood a good-faith effort to reduce maternal mortality.” Why the need to correct me in a supercilious way? On the one hand, this is the internet, which often appears to be a vast wasteland populated only by assholes; on the other hand, that’s rather a weak excuse for those who bother to comment at CT, it isn’t fucking reddit; on the gripping hand, where’s the harm in thinking I might know what I’m talking about or have identified a real problem? How have these men managed to get themselves all the way to 2012 and still be so viscerally threatened by feminism that they have to say something about it to shut them down? Bah, fuck it, arguing about sexism on CT comment boards is a useless enterprise when I could be tackling more productive tasks, such as watching CSI:NY reruns.

You know who’s hot? Detective Don Flack, that’s who (played by Eddie Cahill. I feel his hottness is shown to severe disadvantage on his imdb page and am drafting a letter to his agent about same. Google search is much better in this regard). He also appears to be, literally, the only homicide detective in the entire city of New York. Realism is not Mr. Bruckheimer’s strong suit, but he knows how to hire hot people, bless his little heart.

84

Belle Waring 01.08.12 at 1:30 pm

Thank you Manoel, it would be wonderful to have more informed Brazilians fill us in on this law. I’m saddened to hear that you think congress won’t reject it. I had a vague idea that the left parties were in the majority, but perhaps they are no more likely to support abortion rights/women’s sexual autonomy than members of right-wing parties. And thanks for the link.

85

Stephen 01.08.12 at 1:32 pm

Belle Waring @62.
Now you mention it, I did read the OP. As far as I can see, it does not contain the word “Ceauşescuvian” which I suggested as a parallel to Kafkaesque or Orwellian; that being (@32) my main point.

I’m afraid I may have irritated Belle through a peculiarity of standard English grammar. Obviously you (singular, Belle) do know all about Ceauşescu’s ghastly policies. But it is not obvious that all of you (plural, readers of this thread) are equally knowledgeable. I suppose if I had written “Youse do remember” or “Y’all do remember” it would have been clear that I did not mean to impute ignorance to Belle; but that would have looked more than a little strange.

86

Belle Waring 01.08.12 at 1:50 pm

Naw, we’re good. Excellent neologism. If I have cause to write about the subject again I will use it.

87

dbk 01.08.12 at 2:25 pm

I suggest that everyone commenting henceforth on this thread read (in full) the link to Beatriz Galli’s piece on RH Reality Check (e.g. G. McThornbody), as well as her CV, links kindly provided as noted by Belle’s update in Witt@61, and then come back and propose to the CT commentariat that the Occam’s razor explanation offered in the OP doesn’t obtain. Legislation relating to women’s reproductive rights/health isn’t normally passed in secret (as this was, on Dec. 27).

Now I’m going to go back to watching CSI:NY reruns, or possibly have a go at GRRM, who as we all know is really, really fond of women.

Belle: do not despair, you are not alone.

88

faustusnotes 01.08.12 at 2:30 pm

Belle, your post about how the law will have the opposite effect to reducing maternal mortality depends on this assumption:

The obvious actual intention of the law is to prosecute women who have abortions or induce miscarriages.

but you haven’t presented any evidence from your limited sources that this is even possible, let alone that it will happen. Are the people running the registry able to even identify “lost” pregnancies? Are they required to report them? Who to? If they do report them, will the police be able to investigate them adequately? What is the state of Brazilian law as regards police access to medical records? We need to know all these things before we can judge whether this will have any effect on the ability of police to prosecute abortion.

In this instance a good comparator is HIV notifications. In Australia and the UK they don’t discourage people from getting HIV testing even though most people who get a test don’t even know that HIV is notifiable, let alone whether it is done anonymously. So it’s unlikely that a similar law about pregnancies will be much of a deterrent to attending ante-natal care. It might serve as a deterrent to those seeking abortion – but since abortion is illegal in Brazil, do we know that people who think they might need an abortion were ever seeking medical care?

The Slate article is a classic piece of hack journalism. Until we get some detailed analysis by a Brazilian with some understanding of the public health and politics of childbirth in Brazil, it’s worse than useless. Sadly no one here reads Portuguese, so the whole thing ends up looking like another example of liberal Americans sticking their noses in where they don’t fit.

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Uncle Kvetch 01.08.12 at 2:49 pm

“[W]atching some commenters try to turn themselves into ever more thoroughly misogynistic emotionally dead assholes isn’t very inspiring.” The thing I don’t get it, where’s their nickel in it?

Solidarity, of course. First the feminists came for the Archbishops, and I said nothing, because I was not an Archbishop…

90

Belle Waring 01.08.12 at 2:57 pm

“[D]o we know that people who think they might need an abortion were ever seeking medical care?”
Yes, actually, we do know this, to a moral certainty. Because Brazil is a large country with a relatively young population, a large number of women are likely to a pregnant at any given time. Some of those will intend to terminate their pregnancies illegally. Some of that subset will get sick. Then they will have to choose between seeking medical care for their non-pregnancy related illness and being reported to the government, or staying away from the doctor altogether. Do you really want to claim that the number of women choosing option 2 will be zero?
“[L]iberal Americans sticking their noses in where they don’t fit.”
You may be interested to learn that what I have in fact done is posted on a blog. Not, say, started a firebombing protest campaign against this law in Brazil. Nope, I wrote a post on a blog, and then further compounded the injury by commenting on the post. I must say, though, that Brazil’s natural resistance to liberal Americans must be quite weak indeed if this can affect it in any way. If I were them I would be at pains to shore up the thing immediately, in case further blog posts and comments on blogs were to destroy the nation entirely.

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Sebastian H 01.08.12 at 5:10 pm

““[L]iberal Americans sticking their noses in where they don’t fit.”
You may be interested to learn that what I have in fact done is posted on a blog. Not, say, started a firebombing protest campaign against this law in Brazil. “

All George F Will ever does is write articles. All Rush Limbaugh does is talk on the radio. Come on.

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Sebastian H 01.08.12 at 5:26 pm

Hmmm brevity probably makes that sound sharper than I mean. It isn’t wrong to comment on the bad policy of another country. But you shouldn’t pretend that commentary is intended to be just hot air. You can exhibit cultural imperialism without using acutal firebombs.

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lupita 01.08.12 at 6:58 pm

If the law reduces infant and maternal mortality then this may be counter-productive.

I have another take on this. Maternal mortality is very high is Brazil (260/100,000 as compared to, say, 31 in Chile and 130 in Ecuador). Given that abortion is currently criminalized, the only way to make progress in lowering the mortality rate is by providing more and better care for women with risky pregnancies and, in general, to all pregnant women.

The other important aspect of this law concerns data: its systematization, analysis, and subsequent recommendations by health authorities. There is only one possible outcome: abortion will rise from being the fourth cause of maternal death to maybe second or first. This is when all the work done to decriminalize abortion may come to fruition. I say this because the number of abortions performed annually and its high death toll was a significant part of the debate to decriminalize abortion in Mexico City. On the other hand, arguments based on the right to privacy (my body/uterus/ ovaries, are mine) and at what point exactly is a living being considered a person, ultimately proved to be more divisive than helpful.

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Vance Maverick 01.08.12 at 7:36 pm

Even granting you’re right, Lupita, more deaths now is a terrible price to pay for the hope of fewer deaths in the future.

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lupita 01.08.12 at 7:58 pm

Vance, I meant the deaths caused by unsafe abortions would go up as a proportion of maternal mortality, not in absolute terms. Maternal mortality would go down if indeed this law provides what it states.

I know that using deaths as part of a political strategy is odious, however, when clandestine abortion becomes the number one cause of maternal death, due to other causes going down, and a society counts with official and updated statistics plus the support of health authorities, this may prove to be the opening needed to decriminalize abortion. At least in Mexico City it played out this way.

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Jawbone 01.08.12 at 9:43 pm

Let’s not understimate the responsibility of Candomble in this fiasco–not all Brazilians are Catholic.

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piglet 01.08.12 at 9:48 pm

leederrick 18

I assume someone has pointed this out already but if not -
here’s the crucial distinction: are public health data collected anonymously to aid the authorities improve health policy or are they collected personally so that the state gets to know medical details about individual citizens that should be none of it’s business?

Correct me if I am wrong but my understanding is that “National Institute of Health keeping track of miscarriages and maternal mortality etc.” fall into the first category. The Brazilian birth registry would perhaps be unobjectionable if the data collection were anonymous.

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piglet 01.08.12 at 10:15 pm

From the Galli article:

“Both public and private health providers must report all pregnancies—providing women’s names—with the National Registration System so the state can then track these pregnancies, from prenatal to postpartum care, presumably to evaluate and monitor health care provided.”

Clearly, this registry is not anonymous. Now it is possible to argue that this kind of registry could help improve maternal health by providing valuable data that would be analyzed scientifically to better understand the causes of maternal mortality, for example. An anonymous registry wouldn’t be as valuable because it wouldn’t allow to track individual cases. If that was the purpose, the registry should be organized in semi-anonymous form so that individual case studies can be tracked but the individual cannot easily be identified. There is always a risk of data abuse in such a system but at least all state of the art data protection measures should be employed.

In general, even when data collection is employed for a legitimate scientific purpose, there is always a tension between the right to privacy and the interest in data completeness. A good example is DNA databases like the one in Iceland which was conceived as a universal database but was found to violate privacy rights. All scientific data collection protocols now require informed consent. Compulsory data collection might be beneficial for scientific progress but it is now deemed unacceptable and rightly so.

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piglet 01.08.12 at 10:24 pm

And of course, when the state for whatever reason institutes a registry with huge privacy implications, it must be subject to a full democratic debate. That this is being circumvented in Brazil is certainly a huge red flag.

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Britta 01.08.12 at 10:51 pm

Actually, what this law reminds me most of is China’s One-Child Policy, circa late 80s-early 90s, when village women had to record their periods with the Family Planning Cadre. Missed periods were usually followed up with mandatory gynecological exams, and occasionally, forced abortions. Of course, China’s law has the opposite intent to Brazil’s law but apparently a similar MO. Chinese women don’t reflect very fondly upon this policy, and I’d imagine they’re much more willing to put up with intrusive state intervention into daily life than Brazilian women are.

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Vance Maverick 01.09.12 at 12:03 am

Thanks, Lupita, I get your point now — and I agree that good statistics, if anonymously gathered, should be a real gain from anyone’s point of view.

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faustusnotes 01.09.12 at 2:38 am

Not entirely Vance. Statistics gathered anonymously aren’t much use if they can’t be linked to death and demographic data. In the absence of a trusted central clearinghouse and a single centralized identifier, they need to be collected with identifying data so that e.g. pregnancy data can be linked to hospital usage statistics and death statistics. I’m willing to be that Brazil doesn’t have such a central register, so if they want to use this law for its stated purpose (tracking maternal mortality) they’re going to need to be able to link the data on the registration to other data – hospital usage and death records.

Belle, your arguments still rest on the unproven assertion that this law is going to be used to monitor and prosecute abortion. Is the data actually going to be passed to the police? In real time? Most of these kinds of databases tend to be cleaned, compiled and released in annual batches, often a year after the data was collected. This means the police would have to sift through tens of thousands of “lost” pregnancies and work out which ones might have been abortions, then traipse across the country tracing down the alleged aborters. Do you think that’s the purpose of this law? Also, are you aware that public health organizations routinely find ways to provide health services related to illegal activity without notifying the police – often under the very nose of the authorities? You’re assuming without evidence that the Brazilian health services can’t do this.

Also Belle, when I wrote “US Liberals” I meant Gillian Kane, not you.

Does anyone on this website know anything about the relevant laws on police access to medical databases? Or even who is managing this database? From a public health point of view this law seems a perfectly reasonable method to assist the state in pursuing one of its health goals. These kinds of systems are set up all the time and are considered an important part of a functioning modern system. But there’s a strong (particularly in the UK and US) push back happening from a paranoid section of the left who have barcode fantasies. The reality couldn’t be further from the conspiracy theories.

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Belle Waring 01.09.12 at 3:31 am

I don’t know exactly why I’m bothering to say this. faustusnotes, if what the government were proposing was merely an adjunct to patchy, existing medical databases, that applied only to woemen and contained only the datapoint pregnant/not-pregnant (oh, whoops, that’s kind of a red flag, isn’t it?), which would be subject to the same stringent privacy rules as other Brazilian medical databases (since neither of us knows the current state of Brazilian medical privacy law let’s call it a draw, shall we?), then it doesn’t seem likely that they would pass it essentially in secret in the middle of the night, does it? Why bother when so uncontroversial a measure could be adopted at the start of the next congressional session with a voice vote? Secondly, why are Brazilian feminists outraged about the law? Because they are, as a group, so dense as to be unable to conceive of how accurate anonymized data collection might help direct resources to pregnant women? Or perhaps for some other reason? Fuck it, I’m Audi 5000.

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bandeirante 21st century 01.09.12 at 2:53 pm

Oky doky!

I don´t normally comment news on the net, for pure lazyness, but the whole article and the subsequent debate here is so biased ( a boycott against Brazil???) that I was simply forced to.
Before getting to the center of the question, some clarifications.
Only 55% of the Brazilian are actual churchgoers ( catholics, protestants, African – Brazilian sincretic religions, jews, etc).
The other 45%, like me, are either non- believers, or simply, like me, too lazy to care.

So, yep, the church does have a say in Brazilian life, maybe more that in the US, but, the nearly naked beauties of Carnaval, the dental flosses on the beaches and the friendly approach to sincretic religions ( my neighbor is a Hallellujah kind of church goer that is best frind with a Candomble womam, that is very nice, the typical Brazilian Pragmatism), will say that Brazilian don´t buy the heavy, farsesque, dark catholic speech that much.

Yep, abortion is illegal in Brazil. It will end up being legal, as more people get education and old mentalities of rural Brazil ( we are 80% urban now, were 80% rural 50 years ago) wane. The main concern of the law ( I read it, and as most laws, the text is boring and dubious, not to say dumb), is to provide prenatal care for pregnant women, in many senses it is redundant, for in many places, the health system already has a pretty good database on each patient/ citizen. Is it intrusive? Of course. All databases are.
The question is : will it be used for the benefit of the people or for some darky conservative mean to control women´s bodies and deny them the right to chose?

Not that fast!

Brazil is a developing country, with so much to do that spending money to develop a police to control pregnancies ( in a country with some 60 million women on reproductive age) sound simply ridiculous.

The real cause of concern in the case of this law is that it does come to work soon, the money will help poor people in rural areas and poor neighborhoods.
The funny thing is that the debate here in Brazil against this law, is led by conservatives who believe that we should not be funding health for poor people, as it is a socialist policy, and the usual rabid right and left yellers. Those who think that every sperm is sacred ( oh! Monthy Python, how is miss it!) and those who believe that we should provide abortion classes in the kinder ( ok, maybe not the kinder, to 3rd graders).

I think that in the end, the law is a good thing. It will help people who need it. It will cost me on taxes, but, OK. A bit of solidarity in a country where 11 people rae still on the verge of starvation, is a good thing.

Just to clarify, I´m not a catholic, never was, and not a protestant either.
i don´t like the current gov´t, nor any gov´t as I really distrust all concepts of governance per se. But, c´mon , leaving the morale positions for a second, these guys are really trying to create something right for the welfare ( yes, welfare) of those who need most: the poor women of Brazil, that have lower wages, less education , less reproductive rights, and that with the ridiculuos stipend of $50 will be rewarded for doing the right thing ( going to a doc, and not a ” parteira”- midwife). That is only that.

The article on Slate is sensationalist, ignorant of the Brazilian reality and simply evil, in the sense that it spreads confusion, and plays on the side of the most conservative forces of my country on a travesti of a liberal speech.

A good day for y´all ( couldn´t resist the neologism myself)!

The

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bandeirante 21st century 01.09.12 at 3:02 pm

Oh! I forgot to say.
1- Abortions are legal in Brazil in case of rape, risk for the life of the mother and malformation. There are several law projects and propositions to make other abortion reasons legal.
2- the catholic priest who excomunicated a 9 year old girl is from one the least developed region in Brazil, and his position had such a bad repercussion in Brazil… he stood his ground, but the girl ended up having the abortion. Don´t judge Brazil by a region just like we can´t judge the US by looking at Fresh Kills, NY.

3- The law has a lot of interpretations, as any text can have. but the meaning is obviously, even for a dweeb like me, not aimed at controlling pregnancies, but to make the easier.

Até mais!

3- Brazil is a developing country.

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Tim Wilkinson 01.09.12 at 3:03 pm

faustusnotes: please explain what you have in mind when you refer so contemptuously to ‘conspiracy theories’ (emanating from a ‘paranoid’ section of the left, no less)?

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Sebastian 01.09.12 at 4:39 pm

Bandeirante your comment is about to be completely ignored.

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