Pregnant, Sick With Zika—and Prohibited From Getting an Abortion

January 31, 2016 8:18 AM

"The way these governments are handling the virus is foolish, highly unrealistic, and insensitive to women." But Zika Virus Isn't The First Disease To Spark A Debate About Abortion

"The virus might help shift the discussion from a matter to one of social values mired in religious beliefs into a matter of public health — and the risks Zika poses to the future of Latin America."

posted by roomthreeseventeen (21 comments total)

So if we take abortion off the table for a minute, are the public health officials in these countries taking steps to increase access to contraception and to decrease stigma associated with using birth control? It seems to me that, if you're going to tell women not to get pregnant for two years, that should be utterly uncontroversial.
posted by ArbitraryAndCapricious at 10:08 AM on January 31, 2016 [39 favorites]

Perhaps the message should be targeted to men, not to get women pregnant. I mean, last I checked, we don't just spontaneously divide.
posted by Hal Mumkin at 10:38 AM on January 31, 2016 [35 favorites]

Similar argument, slightly different focus in a Guardian blog From Rubella to Zika: pregnancy, disability, abortion - query here is about the focus on 'high-tech' (or just 'tech' re. DDT etc) approaches to the disease, vs. the fact there's an underlying issue with basic, primary healthcare - especially reproductive care. The tension between Rubella as a 'western' disease and Zika as a 'tropical' one is palpable.
posted by AFII at 11:07 AM on January 31, 2016

To be super clear, I'm pro-choice. But as far as Zika virus is concerned, promoting contraception should be a higher priority than legalizing abortion. There is a strong correlative link between microcephaly and Zika but it hasn't yet been proven and from what I understand, microcephaly is difficult to diagnose in utero (I don't think they really know until the third trimester, if then). We don't know yet what percentage of pregnant women who contract Zika give birth to children with neurological symptoms. Abortion should be legal but improved access to contraception would give women the ability to plan their pregnancies which will help improve their lives, regardless of Zika virus.
posted by kat518 at 11:08 AM on January 31, 2016 [12 favorites]

Obviously something's going on, and out of an abundance of caution it's worth avoiding pregnancy until it's sorted, but: Is there actually a definite causal link between Zika and microcephaly?
posted by Sys Rq at 11:11 AM on January 31, 2016 [1 favorite]

"Perhaps the message should be targeted to men, not to get women pregnant. I mean, last I checked, we don't just spontaneously divide."

I don't understand what this comment means. Is it saying that abortions won't be necessary if men don't get women pregnant? Or that people shouldn't have sex? What's being said here?
posted by I-baLL at 11:15 AM on January 31, 2016 [3 favorites]

I-baLL, it's the sexism of contraception being a women's issue: Men should also have a responsibility to care about contraception, but it's women who bear the biggest reproductive burden and who are expected to be responsible for not getting pregnant. But it takes two to tango, and all that.

I don't believe we should target men exclusively, but, for example, it would be great to have effective campaigns that targeted men who either don't think about contraception, or actually refuse to use contraceptive methods like condoms.
posted by Kutsuwamushi at 11:23 AM on January 31, 2016 [34 favorites]

Obviously something's going on, and out of an abundance of caution it's worth avoiding pregnancy until it's sorted, but: Is there actually a definite causal link between Zika and microcephaly?

No, to date, a causal link between Zika virus and microcephaly has not been established. There has been a dramatic increase in cases of both Zika and microcephaly in Brazil. However, microcephaly has many causes and not all of the new cases have been attributed to Zika. That said, it's difficult to test for Zika, most of those who contract Zika won't develop symptoms, and Zika may cause other neurological symptoms in children besides microcephaly. It's unclear whether all pregnant women who have Zika will have children who experience neurological symptoms.

Basically, there are still many more questions than answers but microcephaly is so awful that people don't want to mess around.
posted by kat518 at 11:49 AM on January 31, 2016 [2 favorites]

Is it saying that abortions won't be necessary if men don't get women pregnant? Or that people shouldn't have sex? What's being said here?

Men should get vasectomies.
posted by mikelieman at 12:12 PM on January 31, 2016 [3 favorites]

Promoting contraception may prevent many cases, but leaving it at that will only put a pregnant woman with the disease in a worse social position.
posted by Brian B. at 12:14 PM on January 31, 2016 [4 favorites]

Re Zika and microcephaly:

In the four-month period since last October, there have been more than 3,500 reported cases of microcephaly in infants born in Brazil alone, compared with the average of 163 cases reported nationwide each year, according to the World Health Organization.

That is a massive jump in the numbers. Something is obviously causing that increase. And I'm stunned that El Salvador would request that women not get pregnant until 2018. That is a huge public policy shift to couch in terms of a "suggestion," and what would the hidden implications and effects of such a move be? Particularly when:

El Salvador's anti-abortion laws have become particularly notorious after a 2013 case in which the country's highest court rejected the request of a woman and her doctors that her pregnancy be ended in order to save her life. The woman survived but the baby died following a C-section. Women in El Salvador are regularly prosecuted and imprisoned for abortion and even for miscarriages and stillbirths.

There are no words.
posted by Existential Dread at 1:39 PM on January 31, 2016 [17 favorites]

Per mod instructions, I am dropping my links in here, though I don't think they fit at all:

Impoverished coastal city in Brazil becomes epicenter for Zika outbreak
The road to hell
Brazil’s Distributed Generation Connections Triple In 2015
posted by Michele in California at 2:32 PM on January 31, 2016 [1 favorite]

I mean, if you want infant abandonment and infanticide to go up, then prohibiting women from getting abortions of a fetus likely to suffer a profound disability is one way to do it. One thing antichoice types seldom discuss is how much of that sort of thing happened before contraception and abortion came along.
posted by emjaybee at 2:50 PM on January 31, 2016 [14 favorites]

This Nature article discusses some of the issues around quantifying the extent and the risks of the Zika outbreak in Brazil:

The experts agree that the reported size of the microcephaly increase so far is probably inflated — and this chimes with the latest figures from the Brazilian government. On 27 January, it said that of 4,180 suspected cases of microcephaly recorded since October, it has so far confirmed 270 and rejected 462 as false diagnoses.

posted by sneebler at 5:12 PM on January 31, 2016 [1 favorite]

Does anyone think that incidence of rape will increase with this kind of "policy." You can't just have women "crossing their legs." This is such a horrorshow.
posted by amanda at 5:27 PM on January 31, 2016 [1 favorite]

What's a "false diagnosis" of microcephaly look like? Somebody thought their baby had an abnormally small head and brain, but it didn't? Or it did, but not small enough to rate a diagnosis? Absent a good explanation, those numbers sound inappropriately dismissive.
posted by toodleydoodley at 5:57 PM on January 31, 2016 [5 favorites]

The tension between Rubella as a 'western' disease and Zika as a 'tropical' one is palpable.
Uhhh. Rubella is still out there doing its thing in poor countries without vaccination infrastructure, causing 100,000 cases of congenital rubella syndrome a year. It isn't an accident that the Region of the Americas is the first WHO region to eliminate rubella, but rubella wasn't a "Western" disease before the vaccine, and it isn't now. Likewise, Zika isn't going to stay a tropical disease - mosquito-borne disease is a problem everywhere but Antarctica, and Aedes aegypti has made inroads plenty of places that aren't especially temperate.
Infectious disease disparities between poor and wealthy countries are real and rooted in racism and colonialism, but distinguishing infectious agents and vectors as specific to the poor or the rich is counterproductive.
posted by gingerest at 11:48 PM on January 31, 2016 [4 favorites]

poor countries without vaccination infrastructure,

If poor countries were the only ones with unvaccinated children, the US would be a better place.

As it stands, it's only a matter of time before rubella also makes a comeback. (The Guardian blog, I think, underplays the threat of both rubella and Zika -- if deaf-blindness were the only concern, congenial rubella syndrome would be far less terrifying.)
posted by steady-state strawberry at 4:35 AM on February 1, 2016

those numbers sound inappropriately dismissive.

What's the alternative? People are panicking, possibly in an appropriate way, but the diagnostic criteria they're working with are vague. This might be a situation where we have to wait for more information before we know what's going on. Which means either lengthy epidemiological studies, or some miraculous discovery that clarifies the relationship between Zika and microcephaly.

Brazilian health authorities are treating all fetuses with head circumferences that are more than two standard deviations below the average, and newborns with a head circumference of less than 32 centimetres, as suspected cases. But these criteria will inevitably capture many healthy children within the normal growth range who do not have microcephaly.

But head circumference is only a proxy measure, note Lopez-Camelo and Orioli: confirming microcephaly requires a diagnosis of small brain size, and a decreased rate of brain growth.

posted by sneebler at 7:33 AM on February 1, 2016

I wonder if it is something else? Is it the new Thalidomide? Did they market a new anti nausea medicine? Thalidomide is still on the market. Accutaine for acne, treatment for mycobacteria that cause leprosy. With close, but not the same, drugs, you never know. Say a compounding pharmacy gets it just off, or illicit drug making outfit has made a knock off of a commonly abused drug. What if a lot of people have zika and it is not zika at all?
posted by Oyéah at 1:28 PM on February 1, 2016 [1 favorite]

primalux I have just seen that link and am wondering if there is any scientific citation for these stories.
posted by adamvasco at 3:43 PM on February 2, 2016