Health warnings about complications related to Zika virus significantly increased demand for abortions in Latin American countries, according to a new study published today in the New England Journal of Medicine.

It isn’t enough for health officials just to warn women about the risks associated Zika – they must also make efforts to ensure that women are offered safe, legal, and accessible reproductive choices

Catherine Aiken

However, in many of these countries, abortion is either illegal or highly restricted, leaving pregnant women with few options and potentially driving women to use unsafe methods, access abortion drugs without medical supervision or visit underground providers.

On 17 November 2015, the Pan American Health Organization (PAHO) issued an alert about the Zika virus in Latin America. Although the virus, spread by mosquitos, causes only mild symptoms, it can have serious complications for unborn children, ranging from eye and hearing defects through to microcephaly (abnormally small heads) and other severe fetal brain defects. Following the PAHO alert, several countries issued health advisory warnings, including urging women to avoid pregnancy.

For several years, one option for women seeking an abortion in Latin America has been Women on Web, a non-profit organisation that provides medical abortion outside the formal healthcare setting through online telemedicine, in countries where safe abortion is not universally available. A team of researchers from the US and UK analysed data on requests for abortion through the website between 1 January 2010 and 2 March 2016 in 19 Latin-American countries, assessing whether requests for abortion increased beyond expected trends following the PAHO alert.

The researchers found that in almost all of the countries that had issued health warnings about Zika and had legal restrictions on abortions, the number of requests for abortion through Women on Web rose significantly – effectively doubling in Brazil, Ecuador and Venezuela, and increasing by over a third in most of the other countries. In countries that had issued no health warnings, there was no statistically-significant increase.

Assistant Professor Abigail Aiken from the University of Texas at Austin, said: “Accurate data on the choices pregnant women make in Latin America is hard to obtain. If anything, our approach may underestimate the impact of health warning on requests for abortion, as many women may have used an unsafe method or visited local underground providers.”

Dr Catherine Aiken from the Department of Obstetrics & Gynaecology at the University of Cambridge added: “The World Health Organization predicts as many as four million Zika cases across the Americas over the next year, and the virus will inevitably spread to other countries. It isn’t enough for health officials just to warn women about the risks associated Zika – they must also make efforts to ensure that women are offered safe, legal, and accessible reproductive choices.”

The research was supported by the National Institutes of Health and the National Science Foundation.

Reference
Aiken, ARA et al. Requests for Abortion in Latin America in the Wake of Zika Virus. NEJM; 22 June 2016. DOI: 10.1056/NEJMc1605389


Declaration of interests
Rebecca Gomperts is Founder and Director of Women on Web. James Trussell serves on the Advisory Board of Women on Web. Marc Worrell is an IT Consultant for Women on Web.


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