Requests for abortion pills have increased significantly in seven Latin American countries after Zika-related health warnings were issued there, according to a study published today in the New England Journal of Medicine.
After the Pan American Health Organization (PAHO) issued a health alert in November 2015 about the potential risk of Zika-related birth defects, several Latin American countries issued national emergency declarations urging women to avoid pregnancy. In countries with these advisories, including Brazil, Ecuador and Venezuela, the number of women requesting abortions has almost doubled compared to before the alert, according to the study.
There was no increase in requests in countries without such health advisories.
The researchers -- from the University of Texas, Austin and other universities around the world -- collected data on abortion requests from the website Women on Web (WoW). Women can submit abortion requests via WoW, and the site puts them in touch with physicians to meet their needs. WoW is one of the options for women in many Latin American countries where abortions are illegal, restricted, or unsafe, according to the study authors.
Dr. William Schaffner, an infectious disease specialist at Vanderbilt, noted that the increased abortion requests highlight a “disconnect” between Zika-related pregnancy warnings and available resources for women to avoid pregnancies.
“Although advisories, recommendations, advice have been given in many of these countries that women delay their pregnancies, the tragic disconnect was that services enabling couples to prevent pregnancies were not often provided,” Schaffner told ABC news.
Because WoW requests do not capture information on women pursuing abortions through other means -- like black market pills or underground providers -- the authors noted that their results may underestimate the number of abortion requests in these countries.
While the study draws a link between the timing of the Zika-related advisories and these increased abortion requests, no causal connection can be conclusively determined.
“Just because abortion levels rise in areas with Zika, it does not mean it is directly because of Zika,” Dr. Frank Esper, a pediatric infectious disease physician at University Hospital at Case Medical Center in Cleveland, told ABC News.
However, the authors did ask some women if Zika played a role in their decision to request abortions, and many said that it did.
“It does not surprise me that in a situation where the risks may be high, and fear and anxiety even higher, women are making very difficult reproductive health decisions,” said Dr. Jennifer Ashton, an obstetrician/gynecologist who is the ABC News Chief Women’s Health Correspondent.
The World Health Organization predicts about 4 million people in the Americas will contract Zika virus infection through 2017--and that number will include pregnant women in the United States. Even though abortion laws are different in the U.S. than in many Latin American countries, Dr. Christine L. Curry, assistant professor of obstetrics and gynecology at the University of Miami, foresees similar challenges.
“Legality, access, and affordability are three different things,” she said. “Many women have problem with access to care even if abortion is legal.”
Curry mentioned that two of the states where Zika virus may hit hardest -- Florida and Texas -- have some of the strictest abortion laws in the U.S.
Schaffner stressed that one key message for Americans is that prevention is essential.
“The issue is pregnancy prevention,” he said. “If there’s any hazard of acquiring Zika sexually or via mosquito pregnancy prevention is first and foremost way to prevent it from occurring.”
Dr. Monique Dieuvil is a family medicine resident at the University of Florida Health in Gainesville, Florida. She is currently a resident in the ABC Medical Unit.
Dr. Kester Wong is a family medicine resident at the University of California at Davis and a resident in the ABC News Medical Unit.