Between law and reality: how integrating referral services andprimary health care can strengthen care for legal abortion

Abstract

This article analyzes the comprehensiveness of
health care in the context of legal abortion in
Brazil, highlighting challenges and advances in
guaranteeing this right, focusing on Primary Health
Care (PHC) and specialized services, such as the
Center for Comprehensive Care for Victims of Sexual
Assault (NUAVIDAS). It presents how this service
operates and innovative aspects in the care provided to
cases of sexual violence and legal abortion following
violence, such as the adoption of the telehealth model
during the pandemic, which expanded access to safe
abortion. NUAVIDAS still faces challenges due to the
lack of specialized services and weak coordination
with primary care. Despite legal support, barriers
to the implementation of the right to legal abortion
persist, contributing to the maintenance of unsafe
abortions and inequalities in access to reproductive
health. The article proposes strategies for integration
between PHC and specialized services, with the
expansion of telehealth and regulation of care flows
for greater access and effectiveness in care. Although
there has been progress, fully guaranteeing legal
abortion requires a strengthened health system,
consolidated regulations, and evidence-based public
policies, aligned with the principles of the Unified
Health System (SUS), within the framework of sexual
and reproductive rights and reproductive justice.