BACKGROUND: Two qualitative studies have been conducted between 2002 and 2009 in Poland and Brazil, two different geopolitical settings in which the Catholic Church has had a significant political influence and where abortion is highly restricted. In both countries, struggles for abortion rights have played an important role in challenging the current restrictive policies and bringing attention to the plight of women unable to obtain abortions. This article examines the political role that physicians play in these contestations, drawing on some findings of two larger qualitative studies. METHODS: In Poland semi-structured interviews were conducted with 26 physicians in Warsaw and Krakow and with 55 women aged 18 to 45 in Gda?sk. In Brazil questionnaires were administered and semi-structured interviews conducted with 22 obstetrician-gynecologists and 23 health professionals in two public maternity hospitals in Salvador da Bahia. FINDINGS: This article argues that gynecologists' perspectives and practices not only reflect or heed religious precepts on reproductive rights, but are also deeply influenced by inadequate medical training and by the fear of being prosecuted or stigmatized, especially in Brazil. The political non-engagement of physicians in Poland is driven by the lack of abortion rights discourse in the public arena, poor links with women's rights groups, and the lack of political unity within the medical community. CONCLUSIONS: Comparisons between Brazil and Poland ultimately suggest that strong liaisons between physicians and the feminist movement influence physicians' attitudes and political engagement and are most promising in abortion rights advocacy efforts.