The relation between opinion and behavior related to abortion among Brazilian professionals for whom religion is very important, is different than among all other groups

Objective: To verify whether professionals for whom religion is very important have the same behavior when confronted with an unwanted pregnancy than those who do not give great relevance to religion. Method: Secondary analysis of the data collected in four different surveys among gynecologists-obstetricians, judges and legal prosecutors. Results: Among respondents who do not give great relevance to religion, the percentage who help their partners to abort or aborted their own unwanted pregnancy was always lower than the percentage in favor of more liberal laws. The opposite was observed among respondents for whom religion is very important; the percentage of them who help their partners to terminate an unwanted pregnancy or aborted their own unwanted pregnancy was always higher (in a single case the same) than the percentage who expressed a liberal opinion on the abortion law, in all the four surveys. Conclusion: Professionals who give great relevance to religion are in practice more liberal on abortion than the opinion they give in the abstract, which is the opposite of the behavior of those who do not give great relevance to religion. *Correspondence to: Anibal Faundes, Rua Vital Brasil 200, P.O. Box 6181 Cidade Universitária, 13.084-971 Campinas, State of São Paulo, Brazil, Tel. +55 19 3289 2856, Fax. +55 19 3289 2440, E-mail: afaundes@uol.com.br


Introduction
It is well known that religion and religiosity are among the most important factors associated to the opinion and behavior of people in relation to abortion [1][2][3].
Brazil is a country where the abortion law is quite restrictive as in most of Latin America and Sub-Saharan Africa. It is allowed only to protect women's life and in case of rape [4]. More recently the Supreme Court determined that pregnancy can also be legally terminated in case the fetus was anencephalic [5].
Along the years we have carried out a number of surveys on opinion and behavior related to abortion among different professional group in Brazil, and consistently, we have found that the importance the respondent give to religion is the factor identified as the strongest determinant of their opinion on abortion [6].
We notice, however, that while the difference in opinion between those for whom religion is very important in their life and those for whom religion is not important or do not profess a religion, is very large, a difference or two or three folds. In comparison, the difference in behavior was not equally large. That general observation led us to analyze in more detail, whether there was a real difference in opinion and behavior according to the importance given to religion, particularly when the problem of deciding to terminate or not a pregnancy affects the respondent herself or their partners, when the respondents were males.

Subjects and method
This is a secondary analysis of data collected in four different cross-section surveys carried out by the Center for Research in Human Reproduction of Campinas, (Cemicamp). Two of these surveys were carried out two years apart among obstetricians and gynecologists affiliated to the Brazilian Federation of Obstetrics and Gynecology Societies (FEBRASGO). One among judges affiliated to "Associação dos Magistrados Brasileiros" (Brazilian Judges Association) and the last among legal prosecutors associated to 29 states' associations of these professionals.
In all cases a self-administered questionnaire was sent with the normal correspondence sent by the corresponding associations. It included a letter that explained the purpose of the study and the requested their collaboration by answering the questionnaire A presealed envelop to be used to return the questionnaire was also attached. The percentage of response was of 30.2% for the fi rst and of 22.4% second surveys among obstetricians and gynecologists, of 14% for the survey among judges and of 20% among legal prosecutors.
We used the data related to the same questions included in the four surveys, related to the respondents opinion on the Brazilian abortion law, where five answers were offered: 1) the law should allow abortion in any circumstance; 2) the circumstances in which abortion is allowed should be increased; 3) the law should remain the same; 4) the circumstances in which abortion is allowed should be reduced and; 5) the law should not permit abortion in any circumstance. Those who answer any of the two first alternatives were classified as being in favor of a less restrictive abortion law.
In another section of the questionnaire we asked if the respondent's partner (if male or herself if female) had ever had an absolutely unwanted pregnancy, and if they had terminated that pregnancy. The males who responded positively to these two questions were classified as helping their partners to abort, and the female who gave the same answer were classified as having a voluntary abortion.
All the original studies were carried out had been submitted to the Ethical review board of the University of Campinas and had been approved.

Characteristics of the subjects
The distribution of the participants in the four surveys is shown in table 1.
Close to one fourth of the participants declared religion was very important for them, except prosecutors among whom, less than 20% belonged to that category. Between 10 and 15% of participants declare to have no religion.

Difference between opinion and behavior according to importance given to religion
The d ata from t he f our s urveys s how that t he g reater t he importance the respondents gave to religion, the lower the percentage of respondents who have a liberal opinion on abortion law, who help their partners to have an abortion or who terminated their pregnancy themselves. The difference according to importance given to religion was of between 40 and 50 percentage points for opinion on abortion law, and of between 15 and 20 percentage points (with one single exception) on behavior when confronted with unwanted pregnancies.
Comparing the percentage of respondents in favor of more liberal law with the percentage who terminated an eventually unwanted pregnancy, the pattern was different among respondents for whom religion was very important and all other groups ( Table 2).
The percentage of respondents for whom religion is very important who had a liberal opinion of the law was always lower than the percentage who help their partners to terminate an unwanted pregnancy, in all the four surveys. The percentage who aborted their own unwanted pregnancy had a similar behavior, with one minimal exception where there was no difference between the two percentages: in the second survey among obstetricians and gynecologist, 62.5% were in favor of more liberal laws and 62.6 % aborted their unwanted pregnancies (Table 2).
That was different among all the other groups formed by respondents who gave little or no importance to religion or did not professed any religion. In the case of these three groups of respondents, the percentage who expressed a liberal opinion with reference to the abortion law was always higher than the percentage who terminated an unwanted pregnancy in themselves or in their partners ( Table 2).

Discussion
The results of this analysis show that the professionals who declare that religion is very important in their lives had a behavior that is different than the usual pattern.
The usual observation in most studies is that the proportion of people who give an opinion in favor of abortion is much higher than the proportion willing to act according to that opinion [7]. This is what we observed among the respondents analyzed in this study, who give little or not importance to religion, as well as among those without religion. In all the four surveys analyzed, the percentage of respondents who aborted an unwanted pregnancy was much lower that the proportion who expressed to be in favor of a more liberal abortion law. The opposite was observed among the respondents in the four surveys, who declare that religion was very important in their lives. The percentage that aborted an unwanted pregnancy was higher than the percentage who were in favor of more liberal abortion law.
We did not find any publication on this subject exploring the behavior of people who expressed that religion was a key element on their lives, which leave us without a reference to compare our results.
The professional submitted to these four survey were highly educated people aware of the problem of unsafe abortion in Brazil, and consequently, it was not very surprising that between 40 and 50% of those for whom religion was very important were in favor of more liberal abortion laws, although those percentage were significantly l ower t hat among the other groups for whom religion was not that important. What has not been described, to the best of our knowledge, is that in this group of individuals who give great relevance to their religion the percentage who abort when confronted with an unwanted pregnancy, is much higher that the percentage who express an opinion in favor of more liberal abortion laws.
We have no reasons to doubt of the sincerity of those who were in favor of keeping the law restrictive or of making it more restrictive, but who terminated an unwanted pregnancy. We know that the dilemma of abortion is understood differently according t o the proximity o f the problem to us [8]. It is easy to be oppose to abortion as long as it doesn't affect us directly, neither to any body close to us, and if our religion prohibit abortion, we express our opinion in favor of keeping or expanding restrictive laws, in the belief that a restrictive law will reduce its number. Because our samples were constituted by usually well-informed professionals, the percentage in favor of less restrictive laws is much higher than expected, but still significantly l ower t han among those who do not give great importance to religion.
The new information derived from this analysis is that we have to consider the stated opinion on abortion of people for whom religion is very important, with care, because that opinion can change considerably when the issue of an unwanted pregnancy affects directly to them or their partner. Asking simply of the opinion on abortion in abstract may give a distorted vision of the reality.

Conclusion
Professionals who give great relevance to religion are in practice more liberal on abortion than the opinion they give in the abstract, which is the opposite of the behavior of those who do not give great relevance to religion.  Table 2. Percentage of respondents who declared that abortion laws should be less restrictive, who helped them partners to abort or induced their own abortion, according to the importance they give to their religion *Invalid chi-square; ** Not significant; # p <0.001; ## p <0.05