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

Background: Abortion is an importante cause of maternal morbidity and mortality in Brazil. Currently, all clinical abortion care in Brazil is performed exclusively by medical professionals. The objective of this study is to analyze the knowledge, attitudes and practices (KAP) of physicians regarding abortion care.Methods: Nationwide, hospital-based, cross-sectional study conducted between 2021 and 2025 with 1,276 physicians working in public and private maternity hospitals in Brazil. The KAP were assessed using a self-administered, anonymous questionnaire. Differences in proportions among the five Brazilian regions were detected using the chi-square test, with a significance level of 0·05.Findings: One third of physicians were unfamiliar with Brazilian guidelines, only 25% had adequate knowledge about the non-hospital use of misoprotol 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 likely undergoing induced abortion; and limits on the provision of legal abortion, such as the limited availability of a multidisciplinary team and a high reliance on conscientious objection to not providing care.Interpretation: 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 the care of women undergoing abortion, and the guarantee of supplies for MVA.