Stratified (In)Access: How Abortion Criminalization Constitutes Markets and Risks in Brazil

In this paper, I explore how Brazil’s abortion laws, alongside related health and drug regulations, produce a fragmented and unequal system of (in)access. Rather than creating a legal void, criminalization organizes abortion provision through uneven channels, where safety, cost, and legal risk often depend on one’s class, race, and geographic location. I trace the legal and regulatory shifts, from the 1940 Penal Code and its limited exceptions, to evolving drug policies and current constitutional debates, and examine how these turning points affect access by influencing wait times, costs, medical outcomes, and exposure to criminal prosecution. Access to abortion tends to follow three overlapping routes. First, there are formal legal exceptions, such as those for cases of rape, risk to life, or foetal anencephaly. These are tightly managed in the public health system through clinical protocols and bureaucratic hurdles that not everyone can navigate. Second, many turn to pharmaceutical options, often relying on restricted medications like misoprostol and mifepristone, with access shaped by informal market intermediaries, online sources, and inconsistent enforcement, in an environment that is marked by secrecy, risk of harassment and violence, and lack of information. Third, those with financial means may travel, within Brazil or abroad, for care that is quicker, more discreet, and medically supervised. Legal ambiguity and periodic crackdowns increase the risks for abortion seekers and providers alike, with these risks often passed on as added costs, particularly burdening low-income and marginalized groups. At the same time, documentation requirements and restrictive criteria create informal markets for proof and permissions within the system of legal exceptions. Still, activist networks, digital platforms, and telemedicine have begun to reshape the landscape, offering new forms of support and resistance. I conclude by considering how decriminalization, changes in drug policy, and stronger guarantees within the public health system could expand access and reduce the inequalities currently baked into the law.