Zika Prompts Reproductive Considerations

By Beatrice Endler ’17

The birth of an infant with microcephaly is a major consequence of the recent Zika virus pandemic in Latin America. The reproductive issues surrounding the prevention of Zika-related microcephaly are complicated because abortions aren’t legal in many Latin American countries, and contraception isn’t widely available, but the Pope has condoned the use of the latter.

Microcephaly, as defined by the CDC, is “a birth defect where a baby’s head is smaller than expected when compared to babies of the same sex and age. Babies with microcephaly often have smaller brains that might not have developed properly.” Having a child with a neurological disorder can be problematic for impoverished families because specialized services, such as caregivers, can be expensive.

To avoid the birth of a newborn child with microcephaly due to Zika there seem to be three options: preventing the Zika virus infection, preventing pregnancy, or terminating the pregnancy prior to viability of the fetus. A call for the legalization of the third preventative measure, abortion, has been loudly opposed by religious figures within Latin America, as well as the Vatican.

The “Aedes aegypti and albopictus” mosquitoes are the host carriers of the Zika virus that can transmit the virus to humans. Ideally, these mosquito bites would be prevented through the use of physical barriers such as long sleeve pants and shirts, window screens, bed nets, and insecticide; however, people in countries like those of Latin America often don’t have access to or cannot afford insecticide. The CDC also suggests that people stay in air conditioned dwellings, as the mosquitoes that carry Zika tend to bite indoors, but this too is challenging for people in poorer countries.

In Rio de Janeiro, Brazil, citizens have remained largely uneducated about preventing infection, and go without bug repellent and bed nets. On Feb. 13, however, more than 200,000 soldiers were deployed to go house-to-house and dispense information regarding prevention, specifically the avoidance of stagnant water build-up, which is the prime breeding site for the mosquitoes that carry the Zika virus. Then again, this campaign to fight off Zika only lasted one day.

The connection between the Zika virus and microcephaly has yet to be completely confirmed, but the CDC has uncovered more strong evidence in support of this association.

In addition, other modes of transmission, besides transmission from Zika-infected mother to child, are also under investigation. Some recent cases of Zika were believed to be acquired due to sexual transmission. The discovery that Zika can persist in semen has prompted the CDC to issue new guidelines about contraception. It suggests that male partners of pregnant females wear latex condoms for the duration of the pregnancy.

It is interesting to note that the Zika virus has also been documented as being active in other bodily fluids such as saliva, blood, and urine, although it is not yet determined whether or not these are means of transmission.

An International Relief Organization, Operation Blessing, gives bed nets and insecticide to pregnant women in El Salvador (Photo: Operation Blessing/Flickr)

An International Relief Organization, Operation Blessing, gives bed nets and insecticide to pregnant women in El Salvador (Photo: Operation Blessing/Flickr)

In Latin America access to contraception is also problematic. This is because contraceptives aren’t available in many Latin American countries and some religious figures, especially those of the Catholic Church, oppose their use. Some governments in Latin America, such as that of El Salvador, have suggested that women postpone pregnancy until 2018.

Many of these countries have very strict laws about abortions. In countries such as El Salvador, Nicaragua, and Dominican Republic, abortions are illegal. In Costa Rica, Brazil, and Ecuador abortions are only legal if it is to save the woman’s life. When a Zika virus outbreak occurred in French Polynesia in 2013, legalized abortions were permitted and performed. In contrast, in most Latin American countries abortions are either illegal or are only permitted in cases to protect maternal health.  

Pope Francis was recently questioned as to his stance on the use of contraceptives as a means to slow the spread of Zika, as Zika is now suspected to be able to transmit through sexual contact. Despite his opposition to abortion, which he described as “a crime, an absolute evil,” the Pope stated, in an informal interview during a plane flight to Rome, that “avoiding pregnancy is not an absolute evil,” and it is a “lesser evil” than abortion.  

His acceptance of the use of contraceptives for the prevention of Zika transmission is significant, considering the extent of Pope Francis’ influence. The conservative clergy in Latin America have been in strict opposition to contraceptive practices, meaning that Pope Francis’ tolerance could lead to changes in contraceptive availability in Latin America.

Despite this new tolerance from the Catholic Church, attempts to prevent the rise of cases of microcephaly in Latin America are still hindered because of reproductive limitations, such as the illegality of abortions, and economic limitations, such as the price of preventative equipment, including bed nets and insecticide.