By Halah Flynn
It has been roughly a year since Brazil reported a link between the Zika virus and microcephaly as a birth defect. Reports of infections have spread to every hemisphere of the globe, as headlines detailing stories continue to dominate top-tier news media.
By now, Zika has become a household term, resulting in a spike in bug repellent sales and investment in vaccination development. For many parents in developed countries, Zika means an increase in prevention methods. For women in underserved communities of the Global South, the implications of the virus are much different.
The spread of Zika is endangering women’s bodies, but not in the way we are medically inclined to think. Yes, it implies monitoring symptoms closely and taking blood samples to test for the virus. But it also implies something much more dangerous: loss of reproductive rights.
The World Health Organization responded to the outbreak by recommending that women “be informed and oriented to consider delaying pregnancy” until 2018. In the meantime, women infected with Zika have given birth to thousands of babies with microcephaly, a once-rare birth defect that now poses an extreme threat to women and children across the globe. Public officials in the Latin American region echoed the response to delay pregnancy, without actually providing these women and families with resources to do so.
Health advocates say that the problem with this is twofold.
First, it makes the assumption that all pregnancies are planned. In reality, at least half of pregnancies in Latin America are categorized as unexpected. Pregnancies regularly occur outside of family planning, due to a lack of contraceptive resources, inadequate sexual health education, or rape. By not acknowledging this, public health officials only have addressed a small percentage of pregnancies and births that will occur — those that are a result of family planning.
This pitfall in health policy highlights the unaddressed threat of sexual violence against women across Latin America. According to the Women and City Summit in Santiago, Chile, half of women living in Latin American cities experience sexual assault in their lifetime, yet only 14 per cent actually report to a medical professional or social worker. Without the adequate supports to report sexual violence and a lack of prevention initiatives, women cannot effectively approach safe family planning in the face of threats like Zika.
Second, this recommendation places the entire burden of family planning on women, without giving them resources or opportunities to follow guidelines. “The government is not issuing any recommendation for the men to use condoms, which is very unfair,” said Paula Avila-Guillen, a Colombia-based programs specialist for the Center for Reproductive Rights in an interview with Time magazine. “That makes the women responsible for everything.”
In many Zika-affected areas, reproductive rights are already severely limited by federal regulations. In Chile, Haiti, Suriname, Nicaragua, Honduras, El Salvador and the Dominican Republic, abortion is completely illegal, even in the case of pregnancy that is the result of rape or which poses a threat to the mother’s life. In rest of South and Central America some of the most restrictive abortion regulations in the world exist. Without the option to terminate a pregnancy, women are forced to give birth, and still deprived of access to clinics with Zika testing, disease prevention or treatment for infections and high-risk births.
So what resources do these women have? Not a whole lot.
For women who are not already pregnant, contraception is in extremely low use. In Latin American and Caribbean countries, access to basic contraception like birth control and IUDs is highly restricted, and the supply of these items is also very low. Therefore, women who qualify for access might not even find available contraception at all.
For women who fear they may have been infected, Zika testing and treatment is the recommended route. It’s not as easy as it sounds, as underserved communities are understaffed with primary care providers likes family nurse practitioners in clinics that lack funding for testing resources. In many cases blood samples are taken from clinic patients to a central lab — a process that can add weeks to diagnosis and treatment time.
Considering all the barriers to accessing safe, supportive family planning resources, it is evident that a large portion of women living in high-risk areas ultimately lack control over whether they will get pregnant in the next two years, not to mention how they will navigate the threat of Zika infection.
Encouraging celibacy for the next two years is unrealistic, and providing recommendations without resources to follow them is irresponsible. Women’s bodies are not controllable tools for disease prevention, nor are they an expendable source for advancing unsafe family planning practices.