The epidemic of Zika virus drove a spike in requests for abortion help in countries that ban or restrict abortions, researchers said Wednesday.
Zika virus can causes severe birth defects if a woman is infected during pregnancy, and officials have cautioned women to avoid getting pregnant if they live in Zika-affected zones or to avoid going to affected regions if they are or could become pregnant.
Several women whose fetuses have shown evidence of birth defects have opted for abortions in the U.S. and other western countries where abortion is legal. Examinations have confirmed the virus destroyed brain tissue.
There’s no treatment and no way to reverse the damage. There's no vaccine against Zika yet and global health officials say the best way to avoid Zika is to avoid mosquito bites.
But millions of women live in Latin American and Caribbean countries where the mosquitoes carry the virus almost unchecked. Many of the countries also restrict access to birth control.
Dr. Abigail Aiken of the University of Texas at Austin and colleagues decided to check and see what the epidemic’s done to requests for abortions.
They turned to a group that specializes in getting abortion pills to women in countries with restrictions via drone, speedboat and other methods: Women on Web (WoW).
They checked on abortion requests from 2010-2016 in 19 Latin American countries affected by Zika and compared them to three countries where Zika wasn’t expected to have an effect: Chile, Poland and Uruguay.
"Women were asked specifically if they were seeking abortion because of concern about Zika virus infection," Aiken’s team wrote in a letter to the New England Journal of Medicine.
They found a 36 percent to 108 percent increase in requests for abortions in countries where Zika was spreading, where there were national advisories to women and where abortion was legally restricted.
There were no significant increases in countries where Zika was spreading but where there were no advisories, or in countries where Zika was not spreading, they found.
"In Latin American countries that issued warnings to pregnant women about complications associated with Zika infection, requests for abortion through WoW increased significantly," they wrote.
"Official information and advice about potential exposure to the Zika virus should be accompanied by efforts to ensure that all reproductive choices are safe, legal and accessible."
The most obvious birth defects caused by Zika virus infection can be horrific, and include extensive brain damage that can lead to a small, deformed head, a condition called microcephaly. Other severe brain damage has also been documented in Zika-affected babies, although doctors say they do not yet know the range of birth defects that can be caused by the virus.
They also do not yet know what an individual woman’s risk is of having a baby with a birth defect if she becomes infected.
Reproductive rights groups say affected countries need to do more to help women avoid having an affected baby.
“Women must have urgent access to the full spectrum of reproductive health services to avoid the potentially tragic consequences of Zika exposure,” said Dr. Thomas Gellhaus, president of the American Congress of Obstetricians and Gynecologists.
“All women must have the legal right to abortion, unconstrained by harassment, unavailability of care, procedure bans, or other legislative or regulatory barriers. The Zika crisis makes it impossible to ignore that women around the world do not have access to this basic health care need,” Gellhaus added in a statement.
“Further, research and experience have shown that where abortion is illegal or highly restricted, women resort to desperate, dangerous means to end unwanted pregnancies, including self-inflicted trauma, consumption of chemicals, self-medication, and even unqualified, untrained and likely unsafe abortion providers.”
Zika’s carried by mosquitoes and can also be sexually transmitted. The World Health Organization says countries should give women access to contraception and supports legalized abortion, but has not specifically advised countries to change abortion laws because of Zika.
“Whether and when to become pregnant should be a personal decision, on the basis of full information and access to affordable, quality health services,” the WHO said.
“Women wanting to postpone pregnancy should have access to a comprehensive range of reversible, long- or short-acting contraceptive options. They should also be counselled on the dual protection against sexually transmitted infections provided by condoms.”