Zika and Abortion

Tags

abortion, amniocentesis, contraception, El Salvador, gangs, religious fundamentalism, violence, Zika virus

The spread of the Zika virus is causing consternation and alarm in many countries. The symptoms of the mosquito-borne virus are generally quite mild, to the extent that many victims don’t even know that they are ill. Recently, however, it has become clear that, when contracted by women in the first trimester of pregnancy, Zika can cause birth defects such as microcephaly, brain damage, deafness, and paralysis. The World Health Organization has stated that as many as four million people in the Americas could be infected in 2016, and the U.S. Centers for Disease Control are cautioning pregnant women not to travel to certain countries in Latin America and the Caribbean where the virus outbreak is becoming severe.

The Central American country of El Salvador has been particularly hard hit, and the government has taken the unprecedented step of warning women not to become pregnant until 2018. This advice is bizarre. El Salvador is a poor country. Many women face barriers, both practical and cultural, to contraceptive use. Moreover, abortion — even when the fetus is known to be severely deformed — is illegal, and the punishments are severe.

The sign says “Stop Criminalizing Women.” The woman belongs to a protest movement in Chile, which, like El Salvador, has draconian laws that criminalize women who terminate their pregnancy. In both countries abortion is illegal under all circumstances, even if necessary to save the life of the woman. In El Salvador the exception that allowed abortion when the mother’s life is in danger was removed in 1998; in Chile it was removed under the military dictatorship in 1989.

An effective government strategy to combat the epidemic of birth defects would consist of three components: widespread sex education and cheap and easily available contraception; widely available prenatal screening for birth defects (amniocentesis); and safe, legal abortion. Since El Salvador has none of these, women in large numbers will inevitably get pregnant, and some will deliver babies with severe abnormalities.

Note that the government’s admonitions are not directed at men, as if they didn’t realize that men share responsibility for pregnancy. Rather, the clear implication is that women and women alone will be blamed for the expected public health catastrophe. A 25 January 2016 article in The New York Times about the Zika threat in El Salvador aptly describes the Salvadoran government’s pregnancy warning as “the equivalent of a Hail Mary pass that, to many here, only illustrates their government’s desperation.”

In this article the word “abortion” is conspicuous by its absence. This is a peculiar oversight by The New York Times, since the illegality of all abortion in El Salvador is one of the principal obstacles to an effective response to the public health crisis.

Also omitted from the coverage in The New York Times is any discussion of U.S. culpability for the deplorable situation in that country. During the years 1979-1992 the U.S. gave billions of dollars in financial and military aid to the right-wing government that committed large-scale atrocities during a civil war in which an estimated 80 thousand people died. After the war the huge quantity of weapons and the large number of demobilized and unemployed former soldiers set the stage for an epidemic of violent crime. In addition, in the mid-1990s the U.S. deported several thousand Salvadoran pandilleros (gang members, mainly from Southern California), who brought their criminal gangs back with them to El Salvador. Current estimates of the number of gang members in El Salvador (a country having 1/50 the population of the U.S.) range from 30 to 60 thousand. At present El Salvador has the highest homicide rate in the Americas.

The pandilleros are not the only U.S. export to cause havoc in El Salvador. Over the past two decades religious fundamentalist groups based in or funded from the U.S. have given rise to anti-abortion fanaticism on a level that was virtually unknown before. In 1994 the Kovalevskaia Fund (of which I am director) and the Salvadoran Women Doctors’ Association convened an international conference in San Salvador to discuss the medical consequences of illegally induced abortion. El Salvador’s Vice-Minister of Health attended, and topics included the use of herbal abortifacients and menstrual regulators by the indigenous peoples of El Salvador, the actions of RU-486, the efficiency of vacuum aspiration as an abortion technique, the work of South American abortion clinics and their education programs for midwives and obstetricians, and so on. There was a sprinkling of anti-abortion people among the 300 doctors and medical students in attendance, but discussions were wide-ranging and respectful. Yes, that is not a misprint. The abortion opponents in El Salvador listened to the discussions of these topics with interest and respect.

Now, however, such an event would be virtually impossible to organize because religious fundamentalists have become much more visible, violent, and well-funded than they were in the mid-1990s. Medical personnel are prevented from performing abortions even in cases of ectopic pregnancy or other life-threatening conditions. In such circumstances it is not surprising that the Salvadoran government fails to mention abortion in connection with the Zika crisis. That The New York Times fails to mention abortion in its own coverage is harder to explain.

Postscript (added 4 February 2016) Although the article on the response in El Salvador to the Zika virus did not mention abortion at all, a 3 February editorial in The New York Times did: “In Latin America, where many nations outlaw abortion, some governments have advised that pregnancies be delayed, which can create only greater anxiety for women who have sadly limited control over such decisions…. Immediate responses, like increasing access to birth control and abortion, face stiff legal and cultural resistance in the affected region.” The New York Times also carried an article “Surge of Zika Virus Has Brazilians Re-examining Strict Abortion Laws”.

Second postscript (added 8 February 2016) Today’s The New York Times has an excellent op-ed on the situation in Brazil by Debora Diniz, a professor of law at the University of Brasilia.