Orders from women in Brazil, Ecuador and Venezuela roughly doubled, while those from Colombia, Costa Rica, El Salvador and Honduras went up by from 36 percent to 76 percent, researchers said in a study published Wednesday by the New England Journal of Medicine. The authors of the study included a leader of the group based in Amsterdam that is supplying the pills, Women on Web, a nonprofit staffed by doctors helping women from countries where abortion is illegal or restricted to terminate unwanted pregnancies.
Even with the increase in demand for abortion pills, the number of orders received by Women on Web from Latin America and the Caribbean in that time period was small: slightly more than 2,300 in the region, with about 1,600 of those in countries where health authorities had warned about Zika’s potential to cause brain damage.
In the countries where Zika warnings were issued, there are typically about 3.5 million abortions per year, said Gilda Sedgh, the principal research scientist at the Guttmacher Institute, a reproductive health research organization which was not involved in the study. So, Dr. Sedgh said, “The increase in demand for abortion observed by the authors in countries affected by Zika could be spurious because Women on Web accounts for a small share of all abortions in that part of the world.”
The numbers could be “an early warning sign” of increased demand for abortion because of Zika, Dr. Sedgh said, adding that it is also possible that Women on Web “might have experienced an increase in demand as a result of increased visibility of their services when health advisories were issued.”
Access to abortion has been a contentious issue for years in many of the countries affected by Zika, but Zika has brought fresh attention to the debate. In Latin America and the Caribbean, according to a recent study, there are about 6.5 million abortions each year. Most of them are illegal, and an estimated 750,000 women a year are treated for complications from unsafe abortions in the region, Dr. Sedgh said. Women’s rights groups have long pressed for abortion restrictions to be eased.
The study looked at orders for pills between Nov. 17, 2015, when the Pan American Health Organization issued an alert saying Zika virus might be linked to a surge in infants born with tiny heads and damaged brains in Brazil, and March 2, 2016. It compared actual orders to the number that would have been expected based on orders during the previous five years.
Women on Web has a history of defying legal restrictions in such countries, which sometimes block access to its website or seize the packages it sends.
The nonprofit also asks women unable to pay for their prescription to write an email explaining why they needed the abortion pill and could not afford it.
“Some of the emails that came in were heartbreaking,” said Dr. Abigail R.A. Aiken, a reproductive health researcher at the Lyndon B. Johnson School of Public Affairs at the University of Texas, Austin, and the lead author of the study. “The fear and desperation was really hard to read.”
A woman from Venezuela wrote, “I contracted Zika 4 days ago,” adding, “I love children. But I don’t believe it is a wise decision to keep a baby who will suffer. I need an abortion. I don’t know who to turn to. Please help me ASAP!”
Even more than it has increased attention on restrictive abortion laws, the Zika crisis has highlighted the issues of access to contraception and ways that women are ill-informed about birth control or discouraged from using it in some of the countries. In the face of Zika, some countries have been working to increase the availability and use of contraception.
Women on Web is an offshoot of Women on Waves, which was founded in 1999 by Dr. Rebecca Gomperts. Women on Waves originally sailed a Dutch boat to countries that outlawed abortion, took women on board and performed abortions outside a nation’s territorial waters.
As internet access in poor countries increased, Dr. Gomperts began supplying mifepristone and misoprostol pills, a combination approved by the World Health Organization for abortion in the first 10 weeks of a pregnancy. The Women on Web site is posted in five languages and tops Google search results for “I need an abortion.”
Orders for pills may have been kept relatively low by other factors. In Brazil, where 1,210 women placed orders in the period studied, the website warns that the packages are “very likely” to be intercepted by customs authorities.
Each year, about 5 million babies are born in the tropical regions of Latin America, the Caribbean and the southern United States where Zika transmission has begun or is expected to soon.
By: Donald G. McNeil Jr. & Pam Belluck (New York Times).
Photo: Prime News Corner.
Review: Emerging Market Formulations &
Research Unit, FLAGSHIP RECORDS.
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