Zika: Soaring demand for ‘abortion pills’ adds to pressure for reproductive rights reforms

A Colombian woman waits for test results after being diagnosed with the Zika virus at the Erasmo Meoz Hospital in Cucuta, Colombia. (AP Photo/Ricardo Mazalan)

Demand for abortions in countries affected by Zika has increased dramatically as women seek out ‘abortion pills’ online, according to a new study, adding to the pressure on governments to liberalize their laws on reproductive rights across Latin America.

The research, published on Wednesday in the New England Journal of Medicine, is the first to measure the response of pregnant women to Zika advisories in countries where contraception is rare and abortion is highly limited or banned.

According to the findings, an unprecedented number of women across Latin America are accessing the website Women on Web, which has a long history of helping women obtain pills to terminate early pregnancies in countries where abortion is illegal. In Brazil, Venezuela and Ecuador, the requests for help from the site have doubled, while in other Latin American countries they have risen by a third.

The increases are drastic, but the findings reflect only a small portion of overall demand for abortion in the wake of Zika, since only a very small fraction of women wanting, or obtaining abortions do so through Women on Web, said study co-author James Trussell, senior research demographer at the office of population research at Princeton University.

“What is appalling is for governments to advise women not to get pregnant without providing them with a means to do so and offering no help at all to those who are pregnant,” Trussell said in an interview with Humanosphere.

Since it was first detected in Brazil last year, the Zika virus has been linked to more than 1,500 cases of microcephaly, a rare birth defect that can lead to severe developmental problems. In light of the significant public health threat posed by the outbreak, reproductive rights advocates have been putting increasing pressure on Latin American governments to ease up their laws on abortion and birth control, warning that injuries and deaths from unsafe abortions continue to rise.

To date, Cuba and Uruguay are the only two countries in Latin America that have legalized abortion and made it widely available. The main reasons are that the region is predominantly Catholic, legislatures have been exceedingly slow to enact change, and many Latin American countries have dramatically different social circumstances from those in the U.S.

Thus, although reproductive health advocates have fought against these obstacles in Latin America for decades, policy changes have been slow.

Under certain circumstances, however, physicians and health professionals have been able to provide women with reproductive health resources they need without intervening with the law. Before Uruguay legalized abortion in 2012, according to the New York Times, women used an inexpensive, over-the-counter ulcer medication, misoprostol, to privately terminate their pregnancies and make it look like miscarriages.

Knowing that unsafe abortion was a leading cause of maternal mortality in Uruguay (accounting for nearly 30 percent of maternal deaths), physicians would explain how to correctly use misoprostol, but provide no information on how or where to obtain the drug. In this way, physicians were not breaking Uruguayan law – which, at the time, considered abortion to be a crime.

Some advocates are citing the “Uruguay model” to be used in other Latin American contexts. Others urge policymakers to create a legal exception for abortion or to frame abortion and contraception in terms of human rights and reproductive health equity. It remains to be seen whether Zika will bring lasting change in the region.

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Lisa Nikolau

Lisa Nikolau is a Madrid-based reporter for Humanosphere, covering gender equality, indigenous rights and poverty in Latin America and worldwide. Find her on Twitter at @lisanikolau, email lisa.nikolau@humanosphere.org or see her latest work at www.lisanikolau.com