Increases in abortion on-demand requests ranged from 36% to 108% in countries with person-to-person Zika virus transmission, even in countries where abortion is legally restricted, according to an article posted yesterday in NEJM.

In November, Pan American Health Organization (PAHO) issued an epidemiologic alert regarding Zika virus in Latin America. Several countries subsequently issued health advisories, including cautions about microcephaly, declarations of national emergency, and unprecedented warnings urging women to avoid pregnancy. Yet in most Latin American countries, abortion is illegal or highly restricted, leaving pregnant women with few options.

Abigail R.A. Aiken, MD, of University of Texas at Austin, and colleagues analyzed data from Women on Web (WoW), a nonprofit organization that provides access to abortion medications (mifepristone and misoprostol) outside the formal health care setting through online telemedicine in countries where safe abortion is not universally available. Researchers reviewed data with respect to requests for abortion through WoW between January 1, 2010, and March 2, 2016, in 19 Latin American countries.

Not surprisingly, Brazil had the greatest increase in abortion requests compared with expected requests (+108%), followed closely by Ecuador (+107.7%) and Venezuela (+93.3%, P<0.001 for all).

“In Latin American countries that issued warnings to pregnant women about complications associated with Zika virus infection, requests for abortion through WoW increased significantly,” wrote Dr. Aiken. “Our approach may underestimate the effect of the advisories on demand for abortion, since many women may have used an unsafe method, accessed misoprostol from local pharmacies or the black market, or visited local underground providers. But accurate data on these choices are difficult to obtain. Thus, our data provide a window on how concern about Zika virus infection may have affected the lives of pregnant women in Latin America.”


Source: Aiken ARA, et al “Requests for abortion in Latin America related to concern about Zika virus exposure” N Engl J Med 2016; DOI: 10.1056/NEJMc1605389.