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The Zika crisis has exposed the consequences of religious opposition to affordable and accessible birth control methods in Latin America. Over 4000 babies with Zika-related birth defects have been born in Brazil alone. Unless the US wants a modern-day version of the thalidomide tragedy, we should learn from our Latin American neighbors.
Babies with Zika-related birth defects have already been born in New York, Florida, Texas, and California. Those are just the tip of the iceberg. As of October 12, 2016 there are close to 4,000 cases of Zika infection in the US including 878 pregnant women and over 25,000 cases in US territories that include almost 2000 pregnant women. The World Health Organization (WHO) has declared a global health emergency.
For the babies who contract the Zika infection during the first trimester of pregnancy, it is estimated that between one and thirteen of every hundred will have microcephaly and/or other defects associated with Zika infection including: mental retardation, impaired coordination, blindness, inability to eat or speak, dwarfism, seizures, hyperactivity, and other brain and nervous system abnormalities.
Many Zika-affected babies survive after birth and require lifelong intensive care and therapy.
In areas with active Zika transmission, public health experts are advising women of childbearing potential to consider avoiding or delaying pregnancy. WHO recommends that the full range of contraceptive methods, including emergency contraception, along with accurate counselling to enable informed decision-making, be readily available to sexually active women and men.
Unrestricted access to effective contraceptive methods is necessary to help women and families avoid unplanned pregnancies.
But even as the Zika outbreak was reaching our shores, between July 2015 and July 2016 twenty-four states made efforts to impede women’s access to contraceptive methods by limiting funding for family planning services. These restrictions disproportionately affect poor and adolescent women – the same women for whom raising a child with severe disabilities is most burdensome.
Ironically, many of the states that have proposed these restraints are in regions of the country where women are most at risk for unintended pregnancy and most at risk for contracting the Zika virus (the Southwest and Southeast).
In addition to restraints on family planning services, during the same period thirty-two states attempted to ban all or some abortions, and fourteen (most in southern states) implemented abortion restrictions. Again, these states are among those with the highest risk for unplanned pregnancy and for infection with the Zika virus. These states will also bear a burden of care for children with Zika-induced birth defects.
Ideological and religious opposition to contraception and abortion are responsible for regressive policies and programs that adversely affect women’s health. Whether women are of the same ideology or religion does not seem to matter.
Half of US pregnancies are unintended (not necessarily unwanted, but not planned). With the Zika crisis now in the US states and territories, mosquito eradication, personal protection from mosquito bites, ensuring the safety of the blood supply, and population surveillance are planned. Access to effective means of birth control and emergency contraception in the event of birth control method failure to prevent unintended pregnancies are also needed.
In addition, we need support for expectant mothers and fathers who, in consultation with their health care provider and spiritual advisor if they so wish, will need to make the difficult decision of whether or not to abort a fetus that has been diagnosed with birth defects. The people who will be responsible for the lifelong care of the affected child should be the ones to make that decision, not members of a political party or church, or a legislator who likely has not been, nor ever will be, in that intricate situation.
The Zika crisis is about to expose the consequences of political opposition to affordable and accessible women’s health care services and social policies that support families. It may also reveal the vulnerability of US families to the most personal and potentially tragic after-effects of political interference in reproductive freedom.
This commentary first appeared in an edited version on the Ms. Magazine blog, 31October2016. About 4 months later it received one comment. It is even more frightening than the blog. Please read it.
Johansson MA, Romero LM, Reefhuis J, Gilboa SM, Hills SL. Zika and the risk of microcephaly. 2016. N Engl J Med; 375:1-4.