Using Special Powers, Brazil’s President Passes Law Requiring Compulsory Registration of All Pregnant Women


In the dead of night on December 27, Brazilian President Dilma Rousseff enacted legislation that will require all pregnancies to be registered with the government. Provisionary Measure 557 (PM 557) created the National System of Registration, Vigilance and Monitoring Women’s Care during Pregnancy and Post Childbirth for the Prevention of Maternal Mortality (National Registration System).

She used a provisionary measure—intended only for urgent matters—that allows the president to pass a law without congressional approval. Congress only gets to debate and approve the law once it has been enacted. Rousseff claims that PM 557 will address Brazil’s high rates of maternal mortality by ensuring better access, coverage and quality of maternal health care, notably for high-risk pregnancies. 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.

How does simply monitoring pregnancies reduce maternal mortality? There is no guarantee that care will be available to all pregnant women and no investment in improving health services included in the legislation.

And what’s the benefit to women? PM 557 does authorize the federal government to provide financial support up to R$50.00 (roughly US$27) for registered pregnant women for their transportation to health facilities for pre-natal and delivery care. However, to receive the stipend women must comply with specific conditions set by the state related to pre-natal care. Let’s face it, that paltry sum may not even cover the roundtrip for one appointment depending on where a woman lives.

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.

The biggest problem with maternal mortality in Brazil is not access to health-care services but rather the quality of health care in public health facilities. The majority of preventable maternal deaths actually take place in public hospitals, disproportionately affecting poor women, women who live in rural areas, youth and minorities.
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.

It’s unclear why Rousseff sought to enact this legislation so quickly and with so little opportunity for debate or public opinion. What is clear though is that women’s real interests and health needs are not the focus here—just their uteruses.

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  • maryanna-price

    Gosh, one of these days, women might be granted Personhood status, if it can pass the ballot initiative…

  • drreproepi

    I really fail to understand why registration is bad. Sure, passing laws in the middle of the night is bad, failing to provide adequate care is bad, not taking care of people in need of care is bad, but does this mean that registration is bad? I think that good public health information systems are vital in order to make the case to politicians and others that something should be done. And those systems are horrible in Brazil. If something is not counted it is much easier to ignore.

  • crowepps

    I think the underlying assumptions are that instituting laws by executive degree in the middle of the night, failing to provide adequate care, not taking care of the poor and lousy public health information systems are an indication that the government of Brazil isn’t serious about safeguarding the health of poor women, and that the registration law has less to do with identifying who will get care and more to do with gathering evidence to put women in jail if they have miscarriages that are suspected to be abortions.

    Now that may be because we are leaping to the conclusion that this law is for similar purposes to that in Romania, or that this is at the behest of a Church eager to criminalize being female, and it could be instead a perfectly reasonable reaction to the verdict of guilty of human rights violations announced by the United Nations Committee on the Elimination of Discrimination against Women.

    It’s just really hard to continue to have faith that decisions about women’s issues are being made for the betterment of women’s lives and in a way that will stand up to daylight when they are done furtively at midnight without discussion.  Certainly if I lived in Brazil, I would be very reluctant to get obstetric health care from a physician who felt his primary duty was to gather evidence for the prosecutor instead of to provide health care.
  • lightning

    There is ALWAYS a stigma attached to being put on a list. When that list will be kept by people you don’t know, for end-use PURPOSES that you don’t know, that may well change, during the life of the list, then there is a privacy/citizenship/agency/personal sovereignty issue as well. Yes, medical information systems are important in shaping a response to medical problems. But — due also, to the fact that Brazil is in some ways medically backward — there is also a deep distrust of how the information will be used.

     

    Remember, this is a country in which Cops have been known to go beggar-shooting in the Bario. Would YOU feel safe, putting your name on a government list in such a country?

     

    Think if there were a “rash” of car accidents, and the government said that their “solution” for the problem was a registry for new drivers. NOT a driver-training program, or an experienced-ride-along requirement, but a simple list of new drivers, to be kept in a government office somewhere.

     

    Nothing necessarily bad about that, except WHAT DOES IT DO FOR YOU? Keeping a list does NOT by itself do ANYTHING beneficial at all. To complete the analogy, let’s say that the gov. would pay for sending out the first tow truck, in event of an accident. STILL very little, um, BENEFIT; and certainly no more driver instruction in AVOIDING accidents…

     

    Where pregnancy is concerned, I think I’d like problem AVOIDANCE to be the focus. Better to know about, say, FAS before the fact, than after.