Knowledge, attitudes, and practices of Brazilian physicians regarding abortion care: a nationwide cross-sectional study

The objective of this study is to analyze the knowledge, attitudes and practices (KAP) of physicians regarding abortion care in Brazil. We conducted a nationwide, hospital-based, cross-sectional study between 2021 and 2025 with 1,276 physicians working in public and private maternity hospitals. The KAP were assessed using a self-administered, anonymous questionnaire. Differences in proportions among the Brazilian regions were detected using the chi-square test, with a significance level of 0·05. One third of physicians were unfamiliar with Brazilian guidelines, only 25% had adequate knowledge about the non-hospital use of misoprostol and almost 40% reported that Manual Vacuum Aspiration (MVA) was never available in the service. Professionals in all regions reported very low agreement with permissions that would extend the legal termination of pregnancy in the country; the existence of prejudice and a lack of empathy toward women who likely terminated their pregnancies; and a high reliance on conscientious objection to not providing care to legal abortion. The results reinforce the need for training of medical professionals addressing women's sexual and reproductive rights beyond biological and clinical management aspects of abortion care, the involvement of other health professionals in clinical abortion care, and the guarantee of supplies for MVA.