Is It Realistic To Recommend Delaying Pregnancy During Zika Outbreak?

Jan 27, 2016
Originally published on January 27, 2016 3:07 pm

For women who are pregnant, or hope to be, the news about the Zika virus can be terrifying. The mosquito-borne pathogen is being linked to a significant increase in Brazil of a rare birth defect called microcephaly.

The virus has already spread to 22 countries in the Americas. That's led four countries, Ecuador, El Salvador, Jamaica and Colombia, to recommend that women delay their pregnancies. It's a strategy that is being criticized by some.

Monica Roa, programs director of Women's Link Worldwide, an organization devoted to the human rights of women and girls, spoke to NPR's Renee Montagne about the issue.

Roa, who is based in Madrid, discussed how realistic these recommendations are, especially because they don't account for victims of rape or sexual violence. She also talks about the option of abortion for pregnant women infected with Zika, which is illegal in some countries in Latin America.

Here are excerpts from Roa's interview, edited for length and clarity.

Some countries are recommending that women delay getting pregnant. Is that a realistic recommendation in Latin America and the Caribbean?

More than 50 percent of pregnancies in Latin America aren't planned. That's why these recommendations [to delay pregnancy] are both naive and ineffective. They fail to take into account the prevalence of rape and sexual violence in the region, which accounts for many of these unplanned pregnancies.

In countries where abortion and emergency contraception is illegal, what options do women have if they have been exposed to Zika?

That's why the debate should be on the table. In countries like Colombia, women have the option of using emergency contraception or interrupting the pregnancy legally if they are infected with the Zika virus. However, most women — especially those in the most affected areas — do not have clarity over these laws. There is a lack of information and access to these services. And that is for the countries where these kinds of reproductive health services are legal.

In some other countries, like El Salvador, these kinds of reproductive rights are illegal. This might lead to women getting more unsafe abortions, and putting their health and life at risk.

What support could governments in the region give to help women reduce their risk of becoming pregnant in the first place?

These recommendations must be accompanied by massive campaigns, informing both men and women about the access to and use of contraceptives. [That access] is lacking throughout the region.

Women who are pregnant should have information about the possibility of interrupting the pregnancy if the law allows it in that country. In the countries where the law doesn't allow for [abortion], I think the debate [about reproductive rights] should be on the table and discussed in the context [of Zika virus infections].

The health system should [also] be prepared to give all the attention that these babies [born with microcephaly] and their families are going to need in the best possible way.

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Transcript

RENEE MONTAGNE, HOST:

For women who are pregnant or hope to be, the news about the Zika virus can be terrifying. It's a mosquito-borne pathogen that's being blamed for a huge increase in Brazil of a rare birth defect called microcephaly. The World Health Organization said this week that it expects Zika to spread to every country in the Americas except Canada, and that's led four countries - Ecuador, El Salvador, Jamaica and Colombia - to recommend that women delay their pregnancies. It's a strategy that is being criticized by some. Monica Roa is with Women's Link Worldwide, an organization devoted to the human rights of women and girls, and she joined us from Madrid.

Welcome to the program.

MONICA ROA: Thank you. Good morning.

MONTAGNE: How many women in Latin America and the Caribbean actually plan their pregnancies in a way that they could delay them?

ROA: More than 50 percent of pregnancies in Latin America are unplanned.

MONTAGNE: Are not planned.

ROA: Not planned, unplanned.

MONTAGNE: So that's a high enough number to wonder what the challenges are in telling women to delay their pregnancies.

ROA: Well, that's why we're saying that these recommendations are both naive and ineffective, not only because of these unplanned pregnancies but because also they fail to take into account the prevalence of rape and sexual violence in the region which also accounts for many of these not planned pregnancies.

MONTAGNE: Well, in countries where abortion and emergency contraception is illegal, what options do women have if they have been exposed to Zika and are worried? I mean, what - maybe you could give us an example of what somebody can do?

ROA: Well, that's why the debate should be on the table. In countries like Colombia, women have the option of using this emergency contraception or interrupting the pregnancy legally in the face of the Zika virus. However, most women, especially those in the most affected areas and also many of the public officials that are in charge of the health policies, do not have clarity over these laws. There is a lack of information and there is a lack of access to these kind of services. And that is for the countries where these reproductive health services are legal. In some other countries, like El Salvador, these kind of reproductive rights are illegal and the situation is worse for women.

MONTAGNE: In fact in El Salvador, women have been jailed, given rather long prison sentences, for miscarriages where they're accused of actually aborting their baby.

ROA: Well, this might lead to actually women getting more unsafe abortions and putting their health and life at risk.

MONTAGNE: Well, then what support - and all the governments are different obviously, but - could the governments in the region give to help women reduce their risk of becoming pregnant in the first place?

ROA: Well, first of all, these recommendations that the governments are giving must be accompanied by massive campaigns informing both men and women about the axis to end the use of contraceptives, which is something that is lacking throughout the region. And then women who are already pregnant should have the information of how to carry the pregnancy to term in the safest possible way - if that's their option - and also get all the information about the possibility of interrupting the pregnancy if that's something that the law allows in that country. In the countries where the law doesn't allow for it, I think the debate should be on the table and be disclosed in this context.

MONTAGNE: I guess from what you've just said though, it would be fair to say that we're going to be seeing more of these babies being born in the near future with the birth defects caused by the Zika virus.

ROA: I think so, and I think that the health system should be prepared to give all the attention that these babies and their families are going to need to treat the situation in the best possible way.

MONTAGNE: Well, thank you very much for joining us.

ROA: My pleasure, thank you very much.

MONTAGNE: Monica Roa is with Women's Link Worldwide. She spoke to us from Madrid. Transcript provided by NPR, Copyright NPR.