[Medical harm reduction practices related to unsafe abortion in primary health care in the city of São Paulo, Brazil: contexts and barriers to implementation].

Unsafe induced abortion is a public health problem responsible for high morbidity and mortality during the pregnancy and postpartum period. In view of the State's negligence in addressing this problem, various preventive strategies have been proposed. One of them involves healthcare professionals working to reduce the risks of unsafe abortion. The aim of this study was to identify primary healthcare physicians in the city of São Paulo, Brazil, who embrace this perspective, and to understand the challenges they face in providing such care. It is a qualitative research with a hermeneutic-dialectical approach, conducting semi-structured interviews with eight professionals. The results show that this work faces many obstacles, including fear of stigma and moral judgement, the growth of conservatism in the country, and the limitations of public health policies, whose maternal and infant orientation guides care practices in the pregnancy-postpartum cycle. As a targeted public policy, harm reduction strategies require political commitment, continuous education, targets and metrics to comprehensively address individual needs and reduce mortality due to unsafe abortion.