WOMENS HEALTH AND THE PRIVATIZATION OF FERTILITY-CONTROL IN BRAZIL

In Brazil, privatization of the public sphere and neglect of public he alth is part of a conservative modernization strategy that is dominate d by elite groups. The politics of human reproduction, consistent with this pattern, have left women dependent on the private sector for acc ess to the means of fertility control, in spite of the existence of a conceptually-advanced public programme for comprehensive health care f or women-a programme which expressed the demands of, and is widely sup ported by, the women's movement. While both the rate of contraceptive use and the types of methods used (oral contraceptives and surgical st erilization) are modern, the privatization of fertility control has re sulted in a complete separation between fertility control and health c are for poor women, who are the vast majority. Evidence indicates that many, perhaps most, women accumulate the health effects of totally un controlled and incorrect use of oral contraceptives, including unwante d pregnancies and illegal abortions, in the end resorting to clandesti ne surgical sterilization, which is usually performed through unnecess ary caesarean section, Data on reproductive morbidity and mortality, h owever, are virtually non-existent. International women's reproductive rights networks and alternative services for women have advocated gre ater empowerment for women, in terms of improved standards of self-car e and increased power in the use of health services. As a result, a ge nder approach to reproductive health care is now being proposed for go vernment programmes. The Brazilian case serves as an example of the li mits faced by such programmes when adopted in a wider context of unfav orable political conditions.