Pregnancy Prevention and Birth Outcomes in Latin America

"Some of the emails that come in [to website Women on Web] were heartbreaking. [A woman from Venezuela wrote:] I contracted Zika four days ago. I don't know who to turn to."
"Please help me ASAP!"
"When you issue these kinds of advisories [notifications to the public by national health authorities to avoid pregnancy due to Zika], but you uncouple them from pathways to safe and legal care, you create a really difficult situation for women. Many of these women felt underinformed and very scared."
Dr. Abigail R.A. Aiken, reproductive health expert, University of Texas, Austin

"The increase in demand for abortion observed by the [study] authors in countries affected by Zika could be spurious because Women on Web accounts for a small share of all abortions in that part of the world."
Dr. Gilda Sedgh, principal research scientist, Guttmacher Institute

Material to prevent Zika infection by mosquitoes are displayed at the 69th World Health Assembly at the United Nations European headquarters in Geneva, Switzerland, May 23, 2016. Reuters/Denis Balibouse

Women in seven Latin American countries that have suffered Zika outbreaks have frantically been ordering abortion pills on line, since fear and discretion go hand in hand for these women living in countries where abortions are illegal. That would include countries that have officially given warning to their citizens that the Zika virus may cause severe birth defects. Websites like Women on Web have noted a considerable increase in contacts requesting help to interrupt pregnancy.

According to a study published by The New England Journal of Medicine last month whose authors includes a leader of the Amsterdam-based group supplying the pulls, increased numbers of requests have come in from Brazilians, Ecuadorians and Venezuelans. While requests have doubled from those sources, women making contact from Colombia, Costa Rica, El Salvador and Honduras rose from 35 to 75 percent.

Yet orders received by Women on Web emanating from Latin America and the Caribbean in the period between November 2015 and March 2016 represent a minuscule proportion of the number of abortions that actually take place. Women find ways to abort unwanted pregnancies, and they may not always be successful outcomes. There is an estimated 3.5 million abortions annually in countries where authorities issued Zika warnings.

The pathology of Zika's threats to health give impetus to a new look at strictured access to abortion in the many countries now affected by Zika. In Latin America and the Caribbean about 6.5 million abortions take place each year, and most of them are illegal; in those places where abortion can take place legally if a foetus is felt to be compromised, only in the first trimester is abortion permitted.

The study authored by Women on Web studied orders for abortion pills from the time the Pan American Health Organization issued their alert stating that Zika could be linked to a disastrous surge in infant deformities. The study authors found statistically significant increases in requests for abortion in seven of the eight countries where Zika is circulating, where abortion is limited and women had been warned by authorities of the risk of Zika in pregnancy.

And the stark reality is that the current Zika outbreak has been linked to over one thousand, four hundred cases of microcephaly, a rare birth defect that can lead to severe developmental problems.