Zika Virus — a Disregarded Reality

Health authorities are telling women in Latin American and the Caribbean countries to practice abstinence, or have safe sex and delay pregnancy because of Zika virus. But this message on Zika misses and disregards the reality.

The women here simply lack reproductive rights, face an unfair social and justice system, and are not given an ability to make a choice. This region has a significant unmet need for contraception and sex education, and it has one of the most restrictive abortion policies worldwide.

The recommendations for abstinence and safe sex come from the fact that if mothers become infected with Zika virus during pregnancy, their newborns may be born with microcephaly or with other brain abnormalities. Zika virus primarily spreads from mosquitos — the Aedes aegypti species that are also known for spreading Dengue, Chikungunya, and yellow fever. But Zika can be sexually transmitted too.

Microcephaly is a condition where a baby is born with an unusually small head. Being born with a small head is not always problematic, but the outcome can vary greatly. In a severe case, microcephaly leads to serious damage brains; it can cause seizures and hearing loss; problems with vision, speech, and movement/balance may arise. As the child may also have gastrointestinal problems, difficulty eating, and swallowing, the child is at higher risk for malnourishment, poor physical growth, and development.

There is no treatment for microcephaly. There is no prophylactic vaccine to prevent Zika infection. The first human trial of a vaccine has been approved, but it will likely be years before a vaccine is ready.

Undoubtedly, prevention is critical for the current Zika epidemic. And sure, not having sex and not getting pregnant would reduce the number of Zika-induced microcephaly.

But doing nothing might be better than telling people to stop having sex.

Abstinence should be a choice, but sadly it isn’t something every woman possesses.

Rape is an invisible crime. No doubt, women have the right to maintain their anonymity. But they also deserve the right to disclose without facing victim shame and other stigmas, so the offenders will face their consequences.

By sending the message for abstinence, I believe we have implicitly assigned the blame and guilt to the mother. “Oh, she shouldn’t haven’t been sleeping around. Oh — poor baby.” No woman should have to disclose being raped in order to “defend” and “justify” her pregnancy.

Safe sex?

Roughly one of every 10 women in their reproductive age has an unmet need for contraception in the region of Latin America and the Caribbean islands.

In the most recent study (I could find), it was estimated that the Latin America and Caribbean region accounted for 8% of global pregnancies in 2012. This region had the highest global rate of unintended pregnancies (unplanned births, miscarriages, and abortions) at 56%.

The overall number of pregnancies including those unintended is much higher in regions like Asia and Africa. But this annual number of unintended pregnancies here is still significant at 10 million. Not to mention, unintended pregnancies are very much likely to be underreported too.

Unintended pregnancies: unplanned births, miscarriages, and abortions.

Unplanned births: Increasing use of condoms and other contraceptive measures is critical. Condoms should be free and be available everywhere, but in Latin America and the Caribbean, they are hard to find and nearly impossible to afford. In Venezuela, condoms are legal, but last year a 36-pack cost $755.

Yikes.

Yet, we haven’t heard much news on increasing condom accessibility, except in the Olympic Village of Rio. We also haven’t heard many efforts to educate the locals on how to properly use, or change the social norms regarding condoms.

Miscarriages: There have been cases where miscarriages have occurred in women with Zika infection. The link between Zika virus and miscarriage is unclear, so it’s far too premature to suggest a link.

But the common misconceptions about miscarriages are highly relevant here.

Miscarriages are common — they occur 15 to 20% of pregnancy cases. Genetics and medical problems play a large role, but they can naturally occur too. Feeling of guilt and shame are common reactions for women with past miscarriages. Before more evidence becomes available, we should be highly cautionary and avoid suggesting any link between Zika virus and miscarriages.

Abortions: Latin America and the Caribbean has one of the most restrictive abortion policies. Getting a safe abortion from a medically qualified professional under sanitary conditions is not an option for Latin American and the Caribbean women. In fact, there are women currently in local jails for “a suspected abortion”, when in fact, they likely had a miscarriage.