SAO PAULO (Reuters) - At a dilapidated clinic in a gritty section of Sao Paulo, doctors know that many of the pregnant Bolivian immigrants, shantytown dwellers and prostitutes they treat will go on to seek abortions elsewhere.
Abortion is illegal in Brazil, the world’s biggest Catholic country, and back street abortions are rife, often leading to uterine infections and, in some cases, death.
When Pope Benedict visits here May 9, he will find his authority is being challenged, not just by sexual behavior in Brazil, but also by changing attitudes to abortion.
Brazilians tend to be sexually liberal -- having multiple partners is common, prostitution is legal, and even the president says “nearly everybody likes sex.”
Many ignore the church on birth control and abortion. The government hands out condoms -- also opposed by the Catholic church -- to prevent the spread of AIDS. And doctors blame Catholic leaders for hurting women’s health and weakening the fight against AIDS.
“The church gets in the way,” said Dr. Tania Lago, who runs women’s health programs for Sao Paulo state.
Safe, clandestine clinics cater to rich Brazilians, but poor women induce abortions with an illegal drug called misoprostol, bought in Sao Paulo street markets. Too much can result in a ruptured uterus. Others rely on homemade potions containing peroxide, which causes burns, or improvised devices.
For Dr. Ruth Loreto Sampaio de Oliveira, a gynecologist at the Centro de Saude Escola Barra Funda clinic in Sao Paulo, this is her worst fear.
“We’ve had patients die after resorting to risky abortions,” she said.
Supporters of abortion want President Luiz Inacio Lula da Silva to confront the church on abortion rights and birth control now that he is in his second term and cannot seek re-election.
Polls have shown Brazilians would reject abortion if Lula’s health minister is successful in bringing the debate to a referendum.
But anti-abortion leaders say they are concerned by developments in other Catholic countries: Portugal legalized abortion after a plebiscite in February, and Mexico City legalized abortion in April.
“This year has been worrisome for people who believe life starts at conception,” Luiz Bassuma, head of the anti-abortion caucus in Congress, said in a newspaper column.
Activists believe abortion will eventually be legalized as the church, while powerful, has lost political sway since the end of military rule in 1985 and the emergence of AIDS.
Government policies already clash with church doctrine on family planning, science and AIDS.
The health ministry provides everything from free birth control pills to tubal ligations, and gives abortions in cases of rape or when a mother’s life is in danger. Congress has approved stem cell research on frozen human embryos.
Some states allow gay civil unions. One federal prosecutor wants courts to deem gay marriage a constitutional right.
Moreover, officials hand out millions of free condoms each year to prevent AIDS, many at public schools, angering the church but drawing praise from the United Nations.
“The church lost the battle over AIDS policy,” said Dr. Lago of Sao Paulo state. “Because it’s a disease that kills, politicians were willing to face off with the church.”
Catholics make up 74 percent of Brazil’s 185 million people and their rates of abortion and contraceptive use mirror the broader populace, studies show.
“There’s a huge gap between what Catholics think about reproductive health and the rules the church hierarchy defends,” said Dulce Xavier of Catholics for Free Choice.
On such issues, the church looks increasingly out of touch.
“We cannot agree with condoms because they turn life into a life without responsibility,” Cardinal Geraldo Majella, head of the National Bishops Council, said just before this year’s Carnival celebrations, when the government gave out condoms.
Archbishop Angelo Amato last week called gay marriage evil, abortions terrorism, and their clinics slaughterhouses.
Church teachings on abstinence fall on deaf ears in Brazil, where love motels with names like Desire and Opium line the highways.
“If I told my patients to practice abstinence, everybody would laugh in my face,” said Dr. Marta Campagnoni, who runs family planning classes at the Barra Funda health clinic.