“I don’t know if I have the courage”: reproductive choices in times of Zika
DOI:
https://doi.org/10.7322/jhgd.150807Keywords:
women, Zika, reproductive rights, abortion, reproductive choicesAbstract
In this transnational study, we aimed at providing insights into women’s views and attitudes towards their reproductive rights during the Zika epidemic. Women of distinct nationalities and ethnicities were recruited from various locations in Brazil, Puerto Rico, and the United States. We conducted semistructured interviews that suggest that participants reproductive decisions were intimately related to personal convictions and cultural beliefs, and their actions and thoughts were embedded in their sociocultural norms. The majority of women interviewed communicated that it takes courage to make the extreme, emotional, and overwhelming decision to have an abortion. The findings of this study suggest that women from different countries and regions, and with different levels of social capital, faced the same conflicts concerning reproductive decisions. Thus, we argue for the importance of considering cultural beliefs and behaviors when implementing health prevention or protection measures to control epidemics. This epidemic may be yet another opportunity for the improvement of women’s health by strengthening culturally sensitive family planning services, and a broad spectrum of public health interventions.
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References
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28. Valente PK. Zika and Reproductive Rights in Brazil: Challenge to the Right to Health. Am J Public Health. 2017;107(9):1376-80. DOI: https://doi.org/10.2105/AJPH.2017.303924
29. Camargo TMCR. The debate on abortion and Zika: lessons from the AIDS epidemic. Cad Saude Publica. 2016;32(5):e00071516. DOI: http://dx.doi.org/10.1590/0102-311X00071516
30. Carabali M, Austin N, King NB, Kaufman Jay JS. The Zika epidemic and abortion in Latin America: a scoping review. Global Health Res Policy. 2018;3:15. DOI: http://dx.doi.org/10.1186/s41256-018-0069-8
31. Collucci C. Brazilian attorneys demand abortion rights for women infected with Zika. BMJ. 2016;354:i4657. DOI: https://doi.org/10.1136/bmj.i4657
32. Diniz D. Zika virus, women and ethics. Dev World Bioeth. 2016;16(2):62-3. DOI: https://doi.org/10.1111/dewb.12119
33. Aiken ARA, Scott JG, Gomperts R, Trussell J, Worrell M, Aiken CE. Requests for abortion in Latin America related to concern about Zika virus exposure. N Engl J Med. 2016;375(4):396-8. DOI: https://doi.org/10.1056/NEJMc1605389
34. Diniz SG, Andrezzo HF. Zika virus – the glamour of a new illness, the practical abandonment of the mothers and new evidence on uncertain causality. Reprod Health Matters. 2017;25(49):21-5. DOI: https://doi.org/10.1080/09688080.2017.1397442
35. Guttmacher Institute. Unintended pregnancies in United States. Fact Sheet. [cited 2016 Feb 03] Available from: https://www.guttmacher.org/fact-sheet/unintended-pregnancy-united-states.
36. Schram PCF. Zika virus and public health. J Hum Growth Dev. 2016;26(1): 7-8. DOI: http://dx.doi.org/10.7322/jhgd.114415
37. Diniz D, Medeiros M, Madeiro A. Brazilian women avoiding pregnancy during Zika epidemic. J Fam Plann Reprod Health Care. 2016;43(1):80. DOI: http://dx.doi.org/10.1136/jfprhc-2016-101678
38. Muñoz AG, Thomson MC, Stewart-Ibarra AM, Vecchi GA, Chourio X, Nájera P, et al. Could the recente Zika epidemic have been predicted? Front Microbiol. 2017;8:1291. DOI: https://doi.org/10.3389/fmicb.2017.01291
39. Mordecai EA, Cohen JM, Evans MV, Gudapati P, Johnson LR, Lippi CA, et al. Detecting the impact of temperature on transmission of Zika, dengue, and chikungunya using mechanistic models. PLoS Negl Trop Dis. 2017;11(4):e0005568. DOI: http://dx.doi.org/10.1371/journal.pntd.0005568
2. McNeil Jr DG. Zika is no longer a global emergency: W.H.O. Says. The New York Times. [cited 2018 Jan 29] Available from: https://www.nytimes.com/2016/11/19/health/who-ends-zika-global-health-emergency.html.
3. Centers for Disease Control and Prevention. Zika Virus 2017 Case Counts in the US: US territories. [cited 2018 Jan 29] Available from: https://www.cdc.gov/zika/reporting/2017-case-counts.html.
4. Mlakar J, Korva M, Tul N, Popović M, Poljšak-Prijatelj M, Mraz J, et al. Zika virus associated with microcephaly. N Engl J Med. 2016;374:951-6. DOI: https://doi.org/10.1056/NEJMoa1600651
5. Brasil P, Pereira Jr JP, Moreira ME, Nogueira RMR, Damasceno L, Wakimoto M, et al. Zika virus infection in pregnant women in Rio de Janeiro. N Engl J Med. 2016; 375(24):2321-34. DOI: https://doi.org/10.1056/NEJMoa1602412
6. Kempner M. Why are some countries advising against pregnancy as the Zika Virus Spreads? [cited 2018 Jan 29] Available from: https://rewire.news/article/2016/02/01/countries-advising-pregnancy-zika-virusspreads/.
7. Boorstein M, Itkowitz C, Bailey S. Pope: Contraceptives could be morally permissible in avoiding spread of Zika. The Washington Post. [cited 2016 Feb 18] Available from: https://www.washingtonpost.com/local/social-issues/pope-contraceptives-could-be-morally-permissable-in-avoiding-spread-ofzika/2016/02/18/64d029de-d673-11e5-be55-2cc3c1e4b76b.
8. Conaway J. Abortion Rights Still Face Challenges in Several Latin American Countries. NotiSur - South Am Polit Econ Affairs. 2017;26(43).
9. Nash E, Gold RB, Ansari-Thomas Z, Cappello O, Mohammed L. Laws Affecting Reproductive Health and Rights: State Policy Trends at Midyear 2017. [cited 2018 Jan 29] Available from: https://www.guttmacher.org/ article/ 2017/07/laws-affecting-reproductive-health-and-rights-state-policy-trends-midyear-2017
10. Center for Reproductive Rights. The Legal Right to Abortion in Puerto Rico. Fact Sheet. [cited 2018 Jan 29] Available from: https://www.reproductiverights.org/document/the-legal-right-to-abortion-in-puerto-rico.
11. Lathrop E, Romero L, Hurst S, Bracero N, Zapata LB, Frey MT. The Zika Contraception Access Network: A feasibility programme to increase access to contraception in Puerto Rico during the 2016–17 Zika vírus outbreak. Lancet Public Health. 2018;3(2):e91-9. DOI: https://doi.org/10.1016/S2468-2667(18)30001-X
12. Programs Aim to Make LARC a Choice for Women. [cited 2018 Jan 29] Available from: https://www.reliasmedia.com/articles/142467-programs-aim-to-make-larc-a-choice-for-women.
13. Torjesen I, Zika Virus Outbreaks Prompt Warnings to Pregnant Women. BMJ 2016;352: i500.
14. Galli B. The Zika virus is a matter of reproductive injustice. [cited 2016 Feb 03] Available from: http://rhrealitycheck.org/article/2016/02/03/zika-virus-matter-reproductive-injustice-2/.
15. Ryan KJ. Humane abortion laws and the health needs of society. Res L Rev. 1965;17(2):424-34.
16. Swan C, Tostevin AL. Congenital abnormalities in infants following infectious diseases during pregnancy, with special reference to Rubella: third series of cases. Med J Austr. 1946;1(19):645-59.
17. Karrer R. The Formation of Michigan’s Anti-Abortion Movement 1967-1974. Michigan Historical Rev.1996;22(1):67-107. DOI: https://doi.org/10.2307/20173555
18. Mohr JC. abortion in America: the origins and evolution of national policy. Oxford: Oxford University Press, 1979.
19. Thompson M. Who’s guarding what? A post structural feminist analysis of Gardasil discourses. Health Commun. 2010;25(2):119-30. DOI: https://doi.org/10.1080/10410230903544910
20. McNeil Jr DG. Health Officials Split Over Advice on Pregnancy in Zika Areas. The New York Times. [cited 2016 Feb 03] Available from: https://www.nytimes.com/2016/04/15/health/zika-virus-pregnancy-delaybirth-defects-cdc.html.
21. Campos TC. Zika, public health, and the distraction of abortion. Med Health Care Philos. 2017;20(3):443-6. DOI: https://doi.org/10.1007/s11019-016-9739-9
22. Blanchard K, Starrs AM. Contraception, safe abortion, and the Zika response. Lancet. 2017;389(10079):1603. DOI: https://doi.org/10.1016/S0140-6736(17)31010-3
23. Abraído-Lanza AF, Viladrich A, Flórez KR, Céspedes A, Aguirre AN, De La Cruz AA. Commentary: Fatalismo Reconsidered: A Cautionary Note for Health-Related Research and Practice with Latino Populations. Ethn Dis. 2007;17(1):153-8.
24. Daryani P. Zika’s Never Ending Emergency. Hopkins Bloomberg Public Health. [cited 2018 Jul 03] Available from: https://magazine.jhsph.edu/2018/zikas-ongoing-impact-babies-and-families-brazil.
25. Campesino M, Schwartz GE. Spirituality among Latinas/os implications of culture in conceptualization and measurement. ANS Adv Nurs Sci. 2006;29(1):69-81.
26. Prata ARS, Pedroso D, Menezes G, Drezett J, Torres JHR, Bonfim JRA, et al. Juridical perspectives of interruption of pregnancy with zika virus infection regarding medical, emotional and social consequences. J Hum Growth Dev. 2018;28(1):77-81. DOI: http://dx.doi.org/10.7322/jhgd.14387
27. Lopes MHBM, Vilela MFG, Marques D, Silva EM. Zika virus infection in Brazil and its repercussions on reproductive health. J Communication Healthcare. 2018;11(1):62-8. DOI: https://doi.org/10.1080/175380 68.2017.1374917
28. Valente PK. Zika and Reproductive Rights in Brazil: Challenge to the Right to Health. Am J Public Health. 2017;107(9):1376-80. DOI: https://doi.org/10.2105/AJPH.2017.303924
29. Camargo TMCR. The debate on abortion and Zika: lessons from the AIDS epidemic. Cad Saude Publica. 2016;32(5):e00071516. DOI: http://dx.doi.org/10.1590/0102-311X00071516
30. Carabali M, Austin N, King NB, Kaufman Jay JS. The Zika epidemic and abortion in Latin America: a scoping review. Global Health Res Policy. 2018;3:15. DOI: http://dx.doi.org/10.1186/s41256-018-0069-8
31. Collucci C. Brazilian attorneys demand abortion rights for women infected with Zika. BMJ. 2016;354:i4657. DOI: https://doi.org/10.1136/bmj.i4657
32. Diniz D. Zika virus, women and ethics. Dev World Bioeth. 2016;16(2):62-3. DOI: https://doi.org/10.1111/dewb.12119
33. Aiken ARA, Scott JG, Gomperts R, Trussell J, Worrell M, Aiken CE. Requests for abortion in Latin America related to concern about Zika virus exposure. N Engl J Med. 2016;375(4):396-8. DOI: https://doi.org/10.1056/NEJMc1605389
34. Diniz SG, Andrezzo HF. Zika virus – the glamour of a new illness, the practical abandonment of the mothers and new evidence on uncertain causality. Reprod Health Matters. 2017;25(49):21-5. DOI: https://doi.org/10.1080/09688080.2017.1397442
35. Guttmacher Institute. Unintended pregnancies in United States. Fact Sheet. [cited 2016 Feb 03] Available from: https://www.guttmacher.org/fact-sheet/unintended-pregnancy-united-states.
36. Schram PCF. Zika virus and public health. J Hum Growth Dev. 2016;26(1): 7-8. DOI: http://dx.doi.org/10.7322/jhgd.114415
37. Diniz D, Medeiros M, Madeiro A. Brazilian women avoiding pregnancy during Zika epidemic. J Fam Plann Reprod Health Care. 2016;43(1):80. DOI: http://dx.doi.org/10.1136/jfprhc-2016-101678
38. Muñoz AG, Thomson MC, Stewart-Ibarra AM, Vecchi GA, Chourio X, Nájera P, et al. Could the recente Zika epidemic have been predicted? Front Microbiol. 2017;8:1291. DOI: https://doi.org/10.3389/fmicb.2017.01291
39. Mordecai EA, Cohen JM, Evans MV, Gudapati P, Johnson LR, Lippi CA, et al. Detecting the impact of temperature on transmission of Zika, dengue, and chikungunya using mechanistic models. PLoS Negl Trop Dis. 2017;11(4):e0005568. DOI: http://dx.doi.org/10.1371/journal.pntd.0005568
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