"They're not used to people asking what they need": work processes and care practices in feminist abortion accompaniment - a qualitative study.

This qualitative study examines the work process of feminist activists who provide accompaniment for self-managed abortions in a major urban centre in Brazil, where abortion remains criminalised in most circumstances. Based on in-depth interviews with eight accompaniers, and drawing on Brazilian collective health and feminist ethics of care, it analyses how they integrate technique, ethics, political commitment, and social awareness, thereby transforming accompaniment into a genuine practice of care. Findings show that accompaniment recognises those cared for as subjects with knowledge, desires, and evolving needs, rather than as passive recipients. Care is organised collectively but always tailored and responsive to the needs of each person, in an interactive, critical, and reflexive manner. In doing so, accompaniers combine technical-scientific knowledge with experiential knowledge built through prior care and exchanges within trusted networks. By engaging across all stages of the process, and guided by a project whose ultimate purpose is to make abortion a good experience for those accompanied, accompaniers prevent the fragmentation and alienation of care work. Accompaniment thus emerges as a model of care grounded in radical needs: needs that arise within existing social conditions but cannot be fully satisfied within them. Once recognised and collectively articulated, these needs expose the limits of the existing order and become a source of pressure for social transformation. The high personal cost of this activism, marked by overload, insecurity, and invisibility, challenges its sustainability and expansion. By describing its constitutive elements, this study broadens understanding of abortion accompaniment and underscores the need for public policies that integrate community-based knowledge, values and practices to foster more humanised, justice-oriented models of care.