Catherine Aiken, Addenbrooke’s Hospital in Cambridge
Fears about the dangers of Zika infection in pregnancy are fuelling a dramatic rise in illegal abortions in Latin American countries, a new study has shown. Because the practice is against the law in these places, women are feeling compelled to explore unsafe “back street” options that can place their health in serious jeopardy. And, ironically, this is happening in response to public health measures designed to educate people about the Zika threat… Catherine Aiken is one of the authors of the study and a women’s health doctor at Addenbrooke’s Hospital in Cambridge, and she explained the problem to Chris Smith…
Catherine - There’s been a huge surge in demand abortion across Latin America countries where government and health organisations have issued warnings about Zika virus, and what we see is it’s been panicking women. They’ve been feeling that they have to take matters into their own hands to procure abortion in settings where it isn’t legal to access it.
Chris - How big is that surge in demand?
Catherine - In the highest countries that we’ve seen is up to 150% increase.
Chris - And you know this how?
Catherine - We know this because we partnered with a non-profit, non-governmental organisation called Women on Web. They’re an organisation to provide telemedicine abortion all over the world but particularly in settings where legal abortion is restricted or not available. They do online consultations with women and they either provide abortion drugs directly or they give women advice on where they can be reliably obtained within their own settings. And were were very fortunate to obtain their data to model how demand for abortion in various regions across Latin America has been over the last five years, and then to study it since Zika virus has become an issue in these places to determine the effect, not only on Zika but also these public health warnings.
Chris - And, of course, if one worries people into putting themselves in the position of seeking an illegal abortion, they’re potentially putting themselves in the hands of unscrupulous operators and much worse health outcomes than anything Zika might throw at them?
Catherine - Quite right. So Women on Web's method of telemedicine abortion has been shown to be very safe, but it’s only available to women who have access to the internet and it’s only available to women who know about it. There are many, many other women who may well be driven to other much less safe methods of illegal abortion and we’re very worried about their health.
Chris - Rather than pursuing abortion, are we not also really in need of a decent test that will tell a woman whether or not she has Zika and, more importantly, if she has whether or not her baby’s at risk?
Catherine - Absolutely, that would be the very, very high priority. But we’re in a situation at the minute where we don’t have that, where we’re very unlikely to have that because the babies that we’re seeing now, their problems may not manifest for many years, and we may not be able to develop something like that within the timescale that these women need it. A very neglected part of this whole story and the whole epidemic is what’s actually happening to the women who are right now facing the day-to-day reality of pregnancies that they can’t prevent because contraception access is also limited, and that they can’t do anything about and that’s a very frightening place for them to be. And one of the main things we wanted to do from our work was to give them a voice in the world's media.
Chris - So, put their thoughts into a few words that you would have said to the politicians in these countries. What’s your message to them?
Catherine - My message would be that a public health warning on which people have no means to act and no means to help themselves, is a hollow and empty message that actually harms your population’s health rather than improves it.